What can stop obesity?

via themonthly.com.au

via themonthly.com.au

Kevin Hague pointed out this interesting read about getting, being and staying fat.  It is written by Karen Hitchcock, a doctor at the coal face of obesity.  And instead of a harsh lot of facts ending in telling you to just eat less, it is truly insightful look at what the problem is really about.

In the late 1980s I spent a year in the US as an exchange student. The exchange organisation allocated me a local support person named Emily. Emily was white and loud and the fattest person I had ever seen outside a caravan park. She looked different from the rare very fat people I’d seen in Australia. She smelt good and her climate-controlled house meant she did not sweat. She was very well dressed. Her husband was some kind of professional; I didn’t know they even made suits that big.

Emily’s family ate like the bejesus. I went to her house once a month for pizza: heavy, oily discs of cheese half a metre across. One each. Before pizza one night I watched the daughter eat a huge bowl of guacamole with a dessertspoon. I couldn’t take my eyes off her. I had no concept of calories; I’d simply never seen anyone eat so much avocado in one sitting. I wondered if it would make her vomit. I kept watching as she put down the empty bowl and turned the page of her novel.

I loved Emily. She cared for me the same way she ate: enthusiastically, generously, without restraint. Her bulk did not disgust me. But I never once ate any pizza. The thought of her pizzas made me sick. All those pools of fat. Twenty-five years later I am a physician and Australia is filling up with Emilys.

Louise was an educated 35-year-old who had recently lost her high-ranking job and was making ends meet by freelance consulting. Admitted to my ward with pneumonia, she had a high fever and a fast pulse, needed oxygen and was coughing up large amounts of purulent sputum. She was also fat, weighing about 120 kg. I knew that – barring underlying lung disease – obesity was one of the greatest risk factors for life-threatening pneumonia in young people. I felt a responsibility to tell her that her excess fat had harmed her in a way she may not have realised. Every day before my ward round I would say to myself that I was going to broach the subject with her. It seemed a good opportunity to intervene. And yet each time I stood by her bed and looked at her bedside table piled high with literary novels, open blocks of chocolate and teddy-bear biscuits, each time I lifted her pyjama top and pushed my stethoscope into her soft white flesh, I couldn’t do it. I was embarrassed to mention her weight; it felt like I was a puritan taking the high moral ground. It felt mean.

As a doctor, I no longer know what to do about the obese. Australians are getting fatter, and our society is geared towards making them that way – consumption doesn’t just drive economic growth. So is fatness a doctor’s problem? Studies show that verbal interventions during an episode of serious acute illness can result in a change in behaviour – people quit smoking, cut down on their drinking and sometimes lose weight. But usually counselling people to lose weight is hopeless. Then there are the questions of morality, personal responsibility, associated diseases, resource allocation, quality of life and aesthetics. I have moments of clarity – I think of the way Emily ate – and obesity seems simple: more in than out. Then I am engulfed once again by the high science of genetics, by the concept that obesity is a disease.

It’s a bit of a read, but hey, it is a Saturday.  Read the rest of the article here. (Start at I love reading articles…)

 

H/T Kevin Hague

 


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  • Whafe

    A very good article. It is more than scary as to the cost of tending to the obese is going to cost the world…

    Wonder if most obese people are pinkos? I mean it is directly realated to entitlement and it is someone else’s responsibility to fix me.

    • James

      Nope…its mainly due to a lack of knowledge about nutrition and what REALLY makes body fat….And the medical community is front and center to blame as they are mostly clueless and espousing wrong information which people think must be correct…cos a “doctor said so. Doctors in fact receive very little nutritional training and just spout the dusty old and wrong part line they have taken on as neo-religious mantra….”fat makes you fat”…cholesterol is bad for your heart…exercising makes you slim…A calorie is a calorie…All wrong.

      • Lion_ess

        “The medical community is front and centre to blame…” Yes, it’s always someone else’s fault, aye James. Perhaps they could put health warning labels on all foods for the stupid, stating that too much of this product could make you fat.

        • James

          When people are being told one thing by professionals when in fact its wrong then what do you expect…? The low fat mantra has been promoted for decades…and people took it as gospel.

          • Lion_ess

            People are stupid and take anything as gospel – even the gospel.

    • IWantToBeLikeMallardOneDay

      I would guess that they are libertarians. If they want to eat shit and take the consequences for it then they’re welcome to cark it badly in their mid-thirties. Have away!

  • Middleagedwhiteguy

    I get pissed off every time I hear obesity referred to as an epidemic. It’s as if obesity is something inflicted on you as opposed to something inflicted on yourself, by yourself. By portraying it as an affliction, the obese have given themselves an excuse. It’s as if they are saying it’s not my fault and you all need to so something to fix me because I didn’t break myself.

    Harden up, eat less, get off the damn couch.

    • James

      Obesity is mainly due to a hormone imbalance that causes insulin to store sugar and carb’s as body fat not allowing it to be released as fuel to the rest of the body…causing hunger which cause the person to eat,usually more carb’s and sugar and so repeating the cycle…Switching to a high saturated fat diet with some protein fix’s this and neuters the insulin which now has nothing to make body fat with….and so the already stored fat can be released for use.

      People don’t tend to become fatter because they over eat and are slovenly….they overeat and become slovenly BECAUSE they are becoming fatter in the first place…thanks to insulin.

      Forget exercise as a way to slim down…for many people it doesn’t work at all…and can in fact make you fatter as it drives your appitite up…and then you eat more of the very foods that put fat on you.

      • Bunswalla

        I guess it’s possible that somebody, somewhere has espoused a bigger pile of misinformation, half-truths and faux-scientific hokum, but I doubt it.

        By far the greatest cause of type-2 diabetes, which is the epidemic of the developed world, is insulin-resistance caused by too much sugar in the diet.

        Exercise and diet are by far the greatest preventers of this horrible disease. Cut down the sugar (it’s nearly impossible to cut out completely as it’s present in so many natural foods in one form or another), get plenty of regular exercise, and eliminate highly refined and processed carbohydrates as much as possible.

        Losing weight isn’t the be-all and end-all, and neither is fat the enemy so many believe (hence the half-truth comment), but weight-loss will be a pleasant and healthy byproduct of the above lifestyle changes. Nothing wrong with getting your heart rate up and increasing your metabolism.

        • James

          Oh exercise has many benefits sure.,..but fat burning ones way to slimness isn’t one. The benefits of exercise have a massive genetic variable also….some people get great benefit….others will get very little no matter how much they do.

          The trick is not to put the fat on in the first place…and thats down to diet. I know people who are solid carnivores and eat no carb’s at all….they are not required in the human diet. I don’t go that far…but I know they are the factor I need to take account of for my weight and health.

        • dyannt

          I cringe when I see toddlers being given full strength fruit juice instead of plain water – or milk. (NOT flavoured milk) I can’t think of a quicker way to get kids onto the obesity track that they’ll probably battle for the rest of their lives.

      • dyannt

        Exercise is a way to firm up. Many people would prefer to stay fatter and firm, than slim and wrinkly. I know that from long experience.

      • Mediaan

        James, this is rubbish. A good brisk walk or other excercise gets your body into balance better, and you make better choices. Similarly, your comment about your cream and cheese and butter brekkie, to me it just sounded quite revolting…

    • IWantToBeLikeMallardOneDay

      Where’s the pathogen?

  • James

    The No.1 cause of our raising obesity and type 2 diabetes rates is…bad and outdated medical advice. The Calories in-out mantra that doesn’t stand up to scrutiny…the “food pyramid” that is completely back to front…the demonizing of Saturated fats as being bad for the heart and fat forming…when in fact nothing could be further from the truth. The “exercise more to slim down” nonsense that has failed due to it being bullshit…the list goes on…

    Back to my brekie of left over whipped creme, a cube of creme cheese and a butter based coffee….mmmmm! ;-)

  • Orange

    “As a doctor, I no longer know what to do about the obese” – that sounds completely daft. Every doctor I know (and I know rather a lot) is incredibly direct and matter of fact regarding such things and would set up action plans with diet, exercise, and anything else required. They would not be shy at all.

  • Lion_ess

    Strokes are a good way to deal with obesity. I watched a severely obese fellow, who was only ever seen drinking black coffee in company (the inside of his car told another story – full of McD wrappers and pastry flakes), lose 50kg within about 6 months of having a stroke – after telling people his problem was a metabolic imbalance. People don’t get fat on lean meat, fish and greens – it’s the dead processed foods that cause obesity and the fact these are addictive via their high sugar or salt content. By the way, the food pyramid that was taught in schools was the masterpiece of Kellogs. Eliminate wheat, flour, sugar, corn, pasta, rice, potatoes from the diet and there would be very little obesity.

    • Mediaan

      Your last sentence is an excellent idea. I have to say, my car is also full of used black coffee cups, McD wrappers and pastry flakes…

  • Harroputza

    I don’t want to pretend like I have the cure-all for being overweight, but I went to Spain for a year and ate almost nothing but chocolate, cheese, fish, chorizo and jamon, did no exercise and lost 8kg. The thing was that their eating style is more eating in courses.

    So instead of my dinner here, where I load up an entire plate while I’m still hungry, I had my (small) plate made for me by the matriarch of the house. You eat, and there is a pause until the second course. You start feeling full, so you don’t have to eat as much. She gives you your second (small) plate, and you eat a bit more and feel really full. So you’ve eaten two courses, but in total, you’ve eaten half of what you would have eaten had you loaded up your own plate with hungry eyes.

    You can probably get away with very little exercise and eating whatever you want if you have the self-control to eat more slowly.

  • johnbronkhorst

    “What can stop obesity?”
    POVERTY…….genuine poverty…….but according to labour and the greens we have that now…….but how can we have both these opposite problems at the same time???

    • James

      Poverty is not a guarantee of slimness…..many poor populations have many obese individuals within them. During the early years on the depression in the US a German doctor was astonished at the numbers of obese children in the poorest areas of the big cites….It was the carb’s they took in that caused their insulin to store fat….despite their situation. It gave the lie to the calories in-out dogma.

  • Ururoa

    I think eating style and variety of the ingredients, not necessarily total volume, has a big impact. Living in Japan I was amazed at the total volume people would eat in a sitting, yet they didn’t get fat. They eat lots of smaller dishes spread over a longer period of time, instead of our style of one plate loaded up.

    I also think that the range of ingredients make a huge difference. In a typical Japanese home-cooked meal there will be ingredients sourced from the deepest oceans right through to the highest mountains, and everywhere in between. This range of foods from different biomes has to help ensure you get a good mix of nutrients in your diet.

    And soup, soup with every meal. Don’t ask me why that would make a difference, but it does.

    • Mediaan

      Sounds yummy. I adore Japanese food.

  • Mediaan

    The writer of that, and I laboured right through the bloody thing, is a woman who looks as though she is making a ton of money out of curing fatness. I wasn’t impressed. Load of words, not much help.

    I am a vegan, thin, way under “average” weight, BMI was 17 when last measured, but I eat constantly. My jaws are seldom not chewing.

    If I can, I eat a mountain of fried potato chips every day, dipped in classic NZ tomato sauce. Not many days go past when I am not hopelessly over-indulging in something between meals. Today it’s an olive tapenade dip and slabs of crusty bread.

    It’s What You Eat.

    That is the key.

    So. Cut out something and see how you go. What have you got to lose?

    THREE POSSIBLE WAYS OF CHOOSING FOOD THAT DO MAKE PEOPLE THIN:

    1. Being strict vegan.

    2. Being vegetarian.

    3. Cut out all white or cream-coloured things – like the white fat part of meat, fish, chicken, all flours, sugar, milk products. No potatoes, corn, or baked goods made with flour. No butter because it’s milk. No brown sugar because that is white sugar basically, but for the fine brown sugar it’s coated with something after refining.

    — What do you eat? You only eat bright coloured things (often, if vegetable, high in tannins). So eat coloured vegetables, lean red meat, and anything not including a white thing. So you can eat dark chocolate (I ignore the sugar in that one), but not chocolate biscuits.

    This food selection is healthy, includes heaps of vegetables and enough protein, and weight will drop off fast in weeks.

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