by Barbara Berkeley, MD
Who are we to disagree with the greatest of mind of the 20th century?
This week we were treated to the latest data on the prevalence of overweight and obesity in the United States. We sure talk a lot about obesity and we sure claim that we "know what to do" (a favorite line that new patients like to tell me), but here are the facts. Our too-fat state is not getting any better. To the contrary, we are getting fatter, sicker, more diabetic and more limited in our enjoyment of a long, full life.
Our mantra for the last few years has been that about 2/3 of Americans are either overweight or obese With about 1/3 of those falling in the obesity category. New prevalence data published in JAMA this week shows that we're getting worse. This data was collected between 2007 and 2012, so it may not represent an even more dire state of affairs in the past several years.
We now are able to say that the ratio of overweight to obesity has flipped in women. About 30% of adult women are overweight, but almost 37% are obese. In men, 40% are overweight and 35% are obese. While that means more overweight than obese men, it also totals to a whopping 75% of men who are too heavy. And the figure for women is climbing with 67% either overweight or obese.
The JAMA article begins with this statement (I have added the bolding):
More than two-thirds of Americans are either overweight or obese, according to new estimates. Overweight and obesity are associated with a variety of chronic health conditions, which could potentially be avoided by preventing weight gain and obesity.
Like every discussion of weight in America, the idea that we can prevent or reverse weight gain with our current notions of dieting is laid out as a simple fact. As you and I both know, dear readers, this is a ridiculous assumption.
But what is especially ridiculous is our insistence in believing that overweight and obesity will be defeated by eating less and exercising more. For the past 30 years, we've been running, sweating, dieting, and counting our steps till our pedometers die of fatigue and we're getting bigger and bigger.
This is the definition of insanity.
What we are told is that these measures work, but that you people don't employ them correctly. That's convenient, because it lays the blame at your door. You're just a weakling with absolutely no willpower. You're just a parent who doesn't take the right control over your kids' food. You're just a couch potato who refuses to use the treadmill that's right there in your basement.
This makes no sense. What is abundantly clear is that our beliefs about weight are wrong. Our beliefs about what can control weight permanently are equally deluded. It takes people a really long time to come to believe this, but when they do, they start to look for more creative ways to figure out their weight.
Take a look at what Einstein is writing on his blackboard above. To successfully battle the obesity epidemic, you need to become a seeker, someone who tries to acquire answers and experiments with different solutions. That is the source of wisdom, both dietary and otherwise.
This blog is a way for me to share the solutions that I have come up with. There is no question that they work if they are followed. You may find other solutions that are unique to you. They are all right. There may be many more ways than one to skin this cat.
In my personal and professional world, here are the insanities and here are the beliefs:
Insanity: Overweight comes from eating too much. Belief: Overweight comes from a problem in the way your particular body handles modern food. Other people may not have this problem. They may eat just as much as you do and never get fat. Does that mean that YOU eat too much?
Insanity: Overweight comes from exercising too little. Belief: Exercise helps to stabilize weight but is not very good at all at creating weight loss. LeBron James had to lose 30 pounds last summer. He exercises at a world class level every day of his life and plays 40 minutes of basketball in over 100 games per year, sometimes depleting himself so much that he needs IV hydration. If he could gain weight while doing this, how is it possible that exercise causes weight loss?? Do you really think you are going to get skinny by walking 10,000 steps or jogging around the block?
Insanity: A good diet is one in which we eat everything in moderation Belief: There is no such thing as being moderate in a world full of addictive foods. Can a cocaine addict be moderate in a crack den? We have all been addicted by breads, cookies, sugar, pasta and other carbs. Forget moderation. You're living in a tsunami.
Insanity: All calories are the same and it's all about calories. Belief: This is utter nonsense as far as I'm concerned. 100 calories of starch stimulates insulin and therefore fat storage. 100 calories of protein or fat does not. In addition, most of my patients have insulin resistance which means that they store excessive fat when insulin is produced. Calorie counting is notoriously unreliable as many studies have shown. And silliest of all is the fact that calorie counting does not take into account the fact that the body can slow or speed it's burning of calories depending on the situation. It's your body that's in control, not you.
Insanity: That this whole problem is so incredibly complicated and takes so much effort to figure out. Belief: Stop eating ALL carbs except for non tropical fruits and vegetables. (Much more info in my book, Refuse to Regain). Do some exercise 5 days a week to stabilize your weight. Eat very little from a package and just eat what's real. That will return you to the diet that your body has been comfortable with for most of human existence. Try it. Then let me know how it went.