An Obese Woman Responds

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My recent comments about obesity as both a health issue and an overall economic issue generated quite a number of responses.  Some people wrote, detailing medical histories that made it impossible for them to get down to a normal weight.  While there are always exceptions, I wanted to share with you a seemingly “impossible” situation faced by a woman who weighed over 400 pounds.  She knew that losing weight was going to be very difficult, but she made the changes in her life that kept her on the path to good health, and she’s a real inspiration to us all (I’ve not included her name, for reasons of privacy):

Dear Dr. Laura:

I am an obese person.  Two years ago, my sister asked me to have surgery.  I did not want to have it, because I was afraid of the risk.  I did not know how heavy I was, because my doctor’s scale limit is 400 pounds.  I promised my sister I would change my behavior, but not go on a diet.

I went to the doctor and got some information and a health exam.  Then I began to make plans on changing my behavior.  [In the past], I was not eating breakfast or lunch.  I was so hungry when I got home, I would eat easy fast food instead of taking the time to prepare food.  I would also binge late at night.  The doctor suggested I no longer skip meals.

First change:  I eat breakfast and lunch.

Second change:  Drink before eating.  I drink water, and, for flavor, sometimes Crystal Light.  I learned that when the body needs something, it is not specific.  It just says “I need,” and “stomach feels empty.”

Third change:  Choose better foods.  If heart tells brain “I need nutrients,” and stomach tells brain “I am full of garbage,” the brain sends the message “empty stomach.”

Fourth change: Thinking of food in a different way.  It’s neither my entertainment nor my entitlement.  Better food will get me up the stairs at work.  At 200+ pounds overweight, life becomes stationary.  Nutrition can replace that.

Fifth change:  Reduce the amount of food.  The doctor suggested that I keep a log of my food and drink.  I wrote down everything for two weeks.  I was eating more than I thought.  Over time, I reduced my starch in half and then in half again.  Today…I do not plan food or write it down.  For me, I would be thinking of food too much.  I eat set breakfast and lunch meals.  Dinner is now something that can be made in 30 minutes.

Sixth change:  Move more.  Your nagging worked.  The doctor suggested low impact exercise over a long period of time.  No jack rabbit starts and stops.  I can’t sustain walking out of water, so I walk 1 hour in water and backstroke 1 hour, six times a week.  I get stares.  I stare back.  I am not ashamed.  I have changed.

There is no diet for me to break from.  The only thing left is to feel the frustration.  It renews my dedication to my life change.  The first two years, I lost 70 pounds.  It’s the first time in 15 years I have not gained weight.  I have been exercising for a month.

Thank you, Dr. Laura, for all your nagging.  I wish I would have started earlier.  The last two years made it possible.  It gave me a foundation of nutrition that sustains me while I move.  I now move more and eat less.  I can hardly wait until next year.

Thanks again for the kick in the butt.

The High Cost of Obesity

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It seems that it’s very much in the nature of human nature to expect more without having more expected of us.  Because so much energy is being focused on the cost of health care and the proposed programs for universal health insurance, the flip side of the equation is starting to get attention.

The Centers for Disease Control and Prevention unveiled a free website application last week called LEANWorks, designed to motivate employers to start “healthy living” and weight loss programs for their employees, because being overweight is a major cause of certain illnesses, and also contributes to missed work days and higher insurance costs.  Of course, representatives of organizations like the National Association to Advance Fat Acceptance are up in arms over this.

A keystone to the LEANWorks program is the “obesity cost calculator” for companies to estimate how much their obese and overweight employees are costing them in higher insurance rates and missed work days each year.  The ultimate point is to get preventive programs in place.

Of course, the “fat advocates” don’t want responsibility - just perks.  They are claiming everything from prejudice to discrimination.  In their view, facts are irrelevant.  It’s just their “feelings” that count. 

It’s no secret that obesity is a big risk factor for chronic diseases.  Obesity has accounted for over 25% of the rise in medical costs between 1987 and 2001, according to Dr. Bill Dietz, Director of the Division of Nutrition, Physical Activity and Obesity at the CDC.  While it is also true that people of normal weight have medical issues which result in work day losses and higher insurance costs, most of their conditions are not as controllable as excess body fat.

It is the moral responsibility of those who are overweight and obese, of those who smoke, of those who abuse alcohol and various drugs to correct their activities for the greater good of the community which has to take on responsibility for the negative consequences of their behavior, and their lack of self-discipline and commitment to health.

If the greater “we” is responsible for taking financial hits in order to cater to the predictable consequences of your actions, then you become accountable to the greater “we,” and we cut out the nonsense about discrimination and prejudice against fat.  It isn’t healthy, plain and simple.  And now that you think about it, it isn’t fair, either.

Calorie Police or Helpful Nutrition Information?

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Beware “The Calorie Police!”  At least, that’s how some look at the newly proposed Federal legislation which would require chain restaurants with 20 or more establishments to post the calories of everything they serve, right on the menu.  The National Restaurant Association, which originally fought calorie posting, now says it supports it.

Dr. Lynn Silver, Assistant Commissioner, Bureau of Chronic Disease Prevention & Control at New York City’s Department of Health and Mental Hygiene says “We hope this law will have a significant impact on both the frequency of obesity and diabetes in our city [which already has the law, by the way].  We estimate that in our city there will be 150,000 fewer people obese because of this.”

Well, I don’t know if that’s true, since every time I go out to eat, I see relatively fit people eating fish and vegetables and fat people eating lasagna with extra cheese.

I’ve only encountered the calorie menu one time so far, and it was in New York.  There were dishes I thought were healthy, but I was totally wrong about them.  I definitely ordered my meals completely based on calorie content, leaving out foods I knew were yummy but which were calorie-laden.  Nonetheless, I was shocked to see how many relatively innocent-looking dishes had enough calories for the entire day and the next morning too.

I know people who have worked in a number of restaurants, and they tell me that to make food “delicious,” extra sugar, fat and salt are added by the bucketful.  Butter, butter, and more butter; sugar to make the food sweeter, and salt to give more flavor.  This is especially true when the meat, poultry or fish is not of the highest quality or if it’s a bit old.

I’ve gotten to the point that no matter what I order (even fish), I ask for whatever sauce they are serving to be put on the side.  I never have salad with dressing - again, I order any dressing on the side.  If I use any sauce or dressing at all, it’s a micro drizzle for a little taste. 

Do I think this will diminish obesity?  No.  I do think, however, that it will help people with self discipline as well as the motivation to be healthy to make the right choices and not be undermined right under their noses.  I think that, generally, folks with limited motivation and self-discipline will ignore or rationalize the calorie facts and add unwanted pressure to our health system, where the health-conscious have to financially support the health-unconscious behavior of others. 

I do believe that the calorie count posting laws might serve to have restaurants cut fewer corners when it comes to the quality of their cooking and their menu planning.  And that I am looking forward to!

Knowing is Better Than Not Knowing, or Why I “Push” Some Callers to Discomfort

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Researchers at the University of British Columbia studied people who had undergone genetic testing to determine their risk for developing the neurodegenerative terminal disorder known as Huntington’s disease.  Did you know (and can you believe) that those subjects who learned that they had a very high likelihood of developing this horrendous and ultimately fatal disease were “happier a year after testing than those who did not learn what their risk was.”

Many of you probably think that not knowing would result in more happiness, but you’d be wrong.  According to Dr. Daniel Gilbert of Harvard University, “…when we get bad news, we weep for a while, and then get busy making the best of it.  We change our behavior; we change our attitudes.  We raise our consciousness and lower our standards.  We find our bootstraps and tug.  But we can’t come to terms with circumstances whose terms we don’t yet know.”

Even those of you who listen to my program regularly may be shocked when I tell somebody their mother or father or spouse or even their child is a bum.  You may wince when I have them scream out how righteously angry they are at parents who didn’t protect them.   You may also sometimes recoil from your radio when you hear me push and push and push a caller until they reveal their innermost horrible truth.  Perhaps you’ve seen me as cruel…or hawking for ratings stemming from the drama.

The fact is, that as a professional psychotherapist I have long realized the value of dealing with the truth - as ugly as it might be.  I’ve seen and heard people fighting to keep ugly truths submerged as though it protected them.  In fact, the energy that goes into burying reality is huge, and not available for healthy living.

Not everyone who calls is willing or ready for this evolutionary leap in their lives.  Sometimes, they have to think about it more and come back later.  That’s fine.  The seed is planted.  I don’t see my job as making every caller feel happy at the end of our brief conversation.  I see my job as one of freeing them from their own personal jail of denial and avoidance, all of which lead to depression, anxiety, and poor (very poor) choices in life.

Knowing is always better than not knowing.  Several recent callers have demanded that I give them some magic to get their loved one to stop smoking or stop being obese.  I tell them to give up that ongoing, unpleasant battle, and simply enjoy the time they do have with that person.  Accepting what is out of your control opens you up to more happiness, because you are left with dealing with “what is,” instead of fighting to have it be something else. 

You can wrap your arms and joys around what is.  You can’t do the same thing with what you wish was the truth.

Getting “Physical”

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Last week was my annual “girl parts” checkup - pelvic exam and mammogram.  I am grateful to be able to say that all’s well with me.

I’m blogging about this because I want all you men and women to have your yearly physicals, including full blood work, cancer screening, colonoscopies (I do that every 5 years now), and maybe even a full body scan.

Ultimately, it really doesn’t matter what does or doesn’t “run in your family.”  Your body physiology and behaviors (such as nutrition, substance abuse, physicality, and environment) are all unique to you, so don’t think you’re “safe” because no one in your family has “such and such.”

I also realize that many of you may be scared that if you get a checkup, something will be found.  Well, that logic would be okay with me IF not going to a doctor for a physical insured that you wouldn’t get anything serious.  That’s just not how life works.

I’m always nervous before my yearly exams.  At 62, I figure I will eventually have to deal with something, although I just might go out mid-breath in my sleep at age104.  I take very good care of myself, but….you never know.  After I finish the battery of tests, and get a happy answer, I can breathe easier, and I go out and play.

I will admit that I hate going for dental checkups, however, because they usually DO find something I have to deal with (ugh).  But I have a really cool ceramic molar implant with a tiny American flag painted on it - occasionally, doing something crazy  like that is how I cope.  

Morning-After Pill for 17 Year Old Girls?

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Out-of-wedlock sex is just no big deal anymore.  It’s even the basic plot of many television sitcoms, making it seem like a royal good time.  After all, isn’t sex just a natural instinct and desirable physical release?  If you have an itch, it should be scratched, right?  At least that’s what I see my dog Bebe do when she clearly has an itchy paw.

Religious teaching be damned.  There should be no guilt about a good romp in the hay that is meaningless, whether extra-marital or non-marital.  Why the big fuss?

Well, let’s see.  We can throw in the “fuss” basket some of the following:

1. Sexually-transmitted diseases, some of which can kill.
2. Unwanted pregnancies, some of which we can kill or raise without a complete and loving home with two parents, who have a sacred covenant called marriage.

Of course, there’s also the unexpected consequence of realizing that very little out-of-wedlock sex has any meaning whatsoever after so many such experiences.  Women feel used and desperate; men feel crass and disappointed.  And never mind the hurt feelings that come from ultimate rejection when one gets bored and the other underestimates what being sexually intimate results in with regard to feeling about themselves and their life.

This all leads up to the fact that the Food and Drug Administration (FDA) has been ordered by a federal judge to allow 17 year old girls (not women) to have Plan B, the morning-after pill, without a prescription, as it is available to those over 18.  This has been an ideological issue, as some folks wish for girls (married or not) to have no impediment to “expressing their sexuality” with the back-up of the morning-after pill, as well as abortion. 

This is astonishing to me, considering all the medical and emotional issues that surround sexuality.

The morning-after pill is a contraceptive that reduces the chance of pregnancy if taken within three days after sexual intercourse.   It contains a high dose of birth control drugs. The pill works by preventing ovulation or by interfering with implantation of a fertilized egg.

I’m just sad that girls, often having sex with adult males, figure it’ll all be okay without a condom, because the adult male reminds them that “there is always Plan B or an abortion.”  Not to worry…no big deal.

Well, over 32 years of a radio call-in program has provided me proof that there is no easy fix for the feelings of guilt, loss, being used, and multiple meaningless sexual experiences.  I, for one, am sad that we keep opening the door wider and wider for women and men to feel less and less responsibility and awe about each other.  No wonder anti-depressants are among the best-selling drugs in America.

Obese Woman Told to Get An MRI At The Zoo

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I recently read a news report from Kansas City about a 5 foot tall, 275 pound woman who needed an MRI exam.  The problem is that MRI tables often can’t support heavier patients and the tubes into which the patient must be moved generally can’t fit someone of her girth.

You don’t usually see body scanners that will accommodate bigger patients, because they don’t provide the clearest images, and those that have large openings increase the possibility of the magnetic field dissipating into the room.

The obese woman in question reported that someone at the hospital suggested that she could go to the zoo for an MRI as they accommodate larger critters.  The suggestion was made to “help” and not to “insult.”  According to news sources, the woman said: “I thought, I know I’m big, but I’m not as big as an elephant.  And my husband got mad.”

Sadly, she has a tumor on her spine, has had multiple surgeries, and now has partial paralysis. This event is purported to have happened two years ago.

I’ve heard that there are some court cases to force airlines not to charge obese people for the two seats it takes to carry them.  This is yet another situation where no responsibility is taken for being obese.  What is it with our thinking that no matter what irresponsibility we demonstrate, the world is supposed to accommodate us?

There is a difference between making access for folks who are in wheelchairs and making access for people who simply abuse their bodies and then demand that the consequences of their actions be borne by others.

This woman eventually did find a place with an “open” MRI machine.  I hope her treatment is successful and she takes from this experience some sense of purpose in getting her body more healthy, rather than anger that not everything will adapt to her.  She has some responsibility too.

I Got the “Look of Death” from My Wife

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How many times have you inadvertently said something that caused your spouse to give you that unmistakable “look” - the one that an emailer refers to as “the look of death?”  Today,  I’m offering some tips to men and women about how not get yourself into those situations, and positive steps you can take so you never get that “look” again!

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