OBESITY: THE PERFECT STORM

WRITER: RICHARD T. BOSSHARDT, M.D., FACS

In “The Sixth Sense,” the protagonist, a young boy, sees dead people who do not know they are ... dead. I can relate. I see fat people.

Recently, I was at a public meeting and on the stage four women were talking. I was struck by what I saw. Three were overweight or, more accurately, obese — each would have easily exceeded the body mass index of 30, the medical cutoff for obesity. The fourth woman was slim. I know three out of four adults in the U.S. are overweight or obese (and most of the very obese are women) but to see it so graphically demonstrated drove the statistic home. I looked around the room, at the large number of people gathered there, and the ratio held. When I was in France — a country notorious for its diet heavy in cheese, butter, eggs, cream, pastries and wine — a couple of years ago, I was impressed by how few obese people I came across, unless it was in an area with a heavy preponderance of Americans.

What has happened to us? It’s a question

I ask myself almost every day.

I believe two features of modern life have combined to produce the current epidemic of obesity in the U.S.: One is today’s sedentary nature of life; the other is what has happened to our diet. Our bodies were designed to move. Even those who do not subscribe to the intelligent design hypothesis of our origin have to admit that the human body is uniquely made. We are not the strongest, fastest or most agile animal. We cannot fly or swim like some other creatures. The sum total of our physical attributes, however, gives us capabilities beyond that of any other living thing.

For much of human history, we have had to move through our own power. From dawn to dusk we moved to find or grow food; provide for shelter and clothing; and travel from one place to another. If there was one characteristic that defined life, it was physical labor. With the industrial revolution there began an inexorable march of technological progress that has seemed as inevitable as it has been irresistible. It’s made our lives easier and more comfortable.

From a purely physical standpoint our success as a species in harnessing the power of steam, fossil fuels, the sun and even the atom to do our work for us has succeeded beyond our wildest dreams. Never in the history of mankind have people been so free of the burden of physical work.

That same technology has presented us with a dizzying array and unlimited quantity of food that does not require any effort on our part to obtain or prepare. Studies say most meals are either eaten out or prepared by someone other than the consumer. Surveys have consistently shown fewer families than ever are routinely preparing meals at home. In our frenetic culture, it is no surprise that one-third of our food consumption comes from what we call “fast” food, that which we can eat “on the go.” Portion size has steadily increased and a single meal can exceed all reasonable allowances of calories, sugar, fat, salt, etc. Modern technology is wonderful. It is liberating. It is a dream come true. It is killing us.

Medical journals, indeed whole libraries, are replete with information on obesity. We know more about obesity now than at any time in human history and yet the problem grows worse. The present generation of children has been marked as the first whose life expectancy will be less than that of their parents, studies suggest.

I don’t have all the answers, but there are some things that, as a physician, I know:

• You are what you eat. There is a computer abbreviation “GIGO.” It stands for “garbage in, garbage out.” If you eat unhealthily, you will become unhealthy. You cannot fuel your body on crap.

• You cannot gain weight unless you consume more calories than you use on any given day. There is a balance here. It may be different for every individual, but no study has ever shown that a starving person has gained weight. I am not implying you have to starve to lose weight but most obese people eat more than they need. To those who protest they hardly eat and cannot lose weight, I challenge them to journal everything that goes in their mouth for several weeks. I think they will be shocked.

• We learn our eating habits from our parents. Our children learn from us. Obese parents tend to foster obesity in their children. People eat poorly for all the wrong reasons. Ignorance is one, which is why educating yourself on the elements of a healthy diet is so critical. Another is treating food as anything other than what it is — sustenance for our bodies.

• Nearly all diets work … temporarily. The problem is, unless the three points above are addressed as well, almost no diet will work forever.

• Diets alone rarely work. You need to move, too. A form of active, consistent exercise that will boost your metabolism must be present for weight loss.

• The biggest obstacle to losing weight is between your ears. Once your mind has committed to the goal, it is only a matter of time.

Every long journey begins with that first step. It doesn’t have to be a big step, just a small one in the right direction, followed by another. God help us and our country if we don’t soon experience a national awakening to the problem of obesity, the single biggest medical issue of our time.