Thursday, August 26, 2010

Lauren's Straight Talk about Health, part two

The second high risk behavior I want to share with you is being overweight. Being overweight sucks. I'm not sure which sucks more. Being overweight or smoking. They might suck equally. If you are overweight AND you smoke, well, you've got issues. I'll be seeing you one day. The thing is, weight is a continuum. Smoking is an all or nothing thing. If you quit, you have to quit completely and never do it again. Eating, now that's another story. You can't give up food. Its the worst addiction to have if you think about it, because its the only thing that you can't go cold turkey on. You have to eat. You have to learn how to do it in moderation. No addiction expert would ever advise you to try just smoking in moderation. You have to go cold turkey or you won't succeed.
And if you're one of those people who thinks that their weight is not related to a food addiction...please. Tell someone else about your bad genes, thyroid issues and glandular things. Every reputable source I have ever found is pretty clear cut on this. Being overweight is about one thing and one thing only. Calories consumed exceed calories expended. Plain and simple. There is one and only one weight loss approach that is effective. I'll even tell you it for free. This is not a difficult concept. Close mouth, move ass. There is no colon cleanse, detox regiman, secret herb from the jungles of the African Sahara (hehe) special combination of foods or mantra that will alter this cold hard fact.
I am not trying to say that overweight people are just fatasses with no self control. There ARE a plethora of different situations that CAUSE people to consume more calories than they expend. Psychological issues, mobility issues that limit ones ability to expend calories and yes, even glandular issues. Those issues are only exacerbated by excess weight though, so if you don't deal with the underlying problem and get on your way to a healthier weight than you will only make those problems worse. Using it as an excuse to justify excess weight is a really bad idea.
I have seen people die for no other reason than an inability to control their weight. Diabetes, high blood pressure, high cholesterol, poor circulation, chronic pain, degenerative joint disease, anxiety, all manner of psychological disorders (if you can't get a handle on your issues with eating, then why would you think you could manage any of the other stressors in your life very well?) nonhealing wounds and skin breakdown, oh my! Granted, I know that not everyone who struggles with their weight is morbidly obese, but if you aren't headed the correct way, towards a more healthy weight, then you're most likely headed in the other direction which is morbid obesity; few people just get somewhat overweight and then stay there.
Here's the thing. I love fat people! I am not a fat phobe. I have had excellent relationships with some of my fattest patients. Also, I have some food issues myself. I have found myself elbows deep in a carton of Chubby Hubby ice cream at 2 oclock in the morning and wondered whether it would be totally insane of me to go to the store for some more because one pint was surely not going to be enough. I comfort myself with food. If I had anything to be depressed about (which I don't) I would probably weigh a metric ton. I'm writing this blog as much for myself as anyone out there. I would never ridicule overweight people gratuitously. I would never ridicule them at all.
The problem is that a lot of people who ARE overweight have not been counseled by anyone to lose weight BECAUSE it is such a sensitive issue. Your average doctor will sit there all say talking about your high blood pressure reading and the cold hard facts of what that means medically, but shys completely away from dealing with the numbers on the scale because its uncomfortable and embarassing to talk about weight. Plus, you can't look your doctor up and down and throw his own blood pressure numbers back at him, but he's secretly afraid that you WILL say something about his weight if he starts talking to you about yours.
As a society, we feel completely comfortable with criticizing and chiding those who choose to smoke. However, if we mention someone's weight, as in, "You really should think about losing some weight Deloris. Its gonna kill you someday you know," that's totally unacceptable social behavior. Why? Why is one ok and not the other? I'm not advocating that we start or continue giving anyone a hard time, whether smokers or overweight people. I'm just pointing out an interesting disparity. I happen to have one of the good doctors. One who isn't afraid to throw it out there. At 30 my cholesterol is a smidge above normal, my resting blood sugar is a trifle troubling and my abdominal circumerference is one eensy weensy inch beyond the cutoff for being high risk for heart disease. She flat out told me; "Lauren, you either lose 5 pounds and stay at that weight or don't and you'll be a diabetic in 10 or 15 years." I wouldn't appreciate hearing that information from, say, my hairdresser, but I kind of appreciated her candor since she is the person I pay to give me unpleasant facts such as that. I lost the 5 pounds and I'm doing everything I can to keep it off. I do NOT want to be a diabetic. If you can't count on your doctor to drop little bombs on you like that, then fire your doctor and find one who will.
So. in closing, don't get fat. If You ARE fat already, lose weight. If you are impossibly skinny and you can eat whatever you want to and not gain weight, you suck. Go back to your home planet.

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