The Land of the Fat

The link to a recent (and excellent) article “The Fat Trap” by Tara Parker-Pope in the New York Times was posted on Facebook with a snarky comment implying that the author, who admitted that she herself is some 60 pounds overweight, lacks credibility. Ironically, the gist of the essay is that most obese people have a different genetic configuration than those who are naturally thin. My own biased opinion is that a fat author is way more trustworthy than a thin person who would probably maintain that despite all the current scientific research that concludes otherwise, fatness is due primarily to a lack of self control and will power. The article points out that any sort of food deprivation, causes a brain chemistry change that, to put it very simply, makes the brain send out a message to eat as much as possible henceforward. There are stories about orphans who've endured famine who are adopted into homes where food is plentiful that hoard and hide food. This apparently is the natural response to deprivation and unfortunately, a single episode of food restriction triggers a chemical change which is permanent. Diets make people fatter because of how we're wired and not because, as I grew up believing and still often have to fight myself not to believe, we're weak willed or lacking in character.

There is a big campaign against childhood obesity in the state of Georgia. At the website http://www.Strong4life.com/ there are stark black and white videos of fat kids. One fat boy sits on a stool facing his fat mother. He asks her, “why am I fat?” and her only response is to drop her head in shame. Other kids stare at the camera and say they hate going to school because they are teased. WTF? Fat kids already know that other kids treat them like shit. Overweight people have plenty of shame without a huge media campaign to ratchet it up. What kind of positive change could this possible affect? I presume that there were medical consultants involved with the Georgia project yet the tone seems to completely fly in the face of current medical wisdom. Obesity, like diabetes or epilepsy, is an incurable disease. It would be outrageous try to induce guilt in an epileptic for being weak willed or lazy or to ascribe parental blame. The state of Georgia's war on obesity may be laudable for intent but the end product is pathetically counterproductive.

It is also agreed that it is more healthful to maintain a high weight and eat a balanced diet and exercise regularly than to do the lose/gain yo-yo thing. Tara Parker-Pope's piece notes the extreme unlikelihood of an obese person maintaining a substantial weight loss. The article chronicles a retired couple, both of whom have kept off over a one hundred pounds for more than six years. Both exercise for over two hours a day 6 to 7 days a week and stick to a highly restricted eating regime. They weigh themselves daily and scrupulously keep a diary of every bite they eat. This is what is required for them to treat a disease for which there is no cure and both indicate how nearly impossible it would be to devote the time required to maintaining their weight loss if they weren't retired.

I have struggled with this disease for as long as I can remember and will always bear the emotional scars of being fat in a world that ostracizes fat people and the map on my torso of jagged scars, from bariatric surgery and a number of subsequent operations required to treat resultant complications and remove loose flesh. Ultimately I lost over 150 lbs but found myself unable to discontinue strong pain medications in the ginormous doses necessitated by the malsorption that is consequence of my Roux-en-Y procedure. For about a year after my last surgery I purchased Norco-an opiate that is preferred by addicts because it doesn't contain Tylenol, which causes kidney damage-from scurrilous online purveyors. I weaned myself from opiates about five years ago but I still get calls from drug peddlers a couple times a month, another reminder of the pain and degradation I've endured in my quest to be thin.

And, I am still not cured. People are amazed that I still struggle with my weight after “taking the easy way out” and “having my stomach stapled.” But ten years after bariatric surgery, the salubrious effects have substantially diminished and at the beginning of the summer my clothes were getting snug. I realized I'd gained 20 pounds in addition to the other 30 I'd never managed to shed post-surgically. I knew I needed more than good intentions and I corralled two girlfriends to join Weight Watchers with me. I like the meetings and the plan is realistic. Foods are ascribed a point value and it's a good way to get a handle on portion control. I do better when I write down everything I eat. I started walking for an hour in the hills five days a week and now I walk 3 ½ miles every week day and five on Saturday and Sunday. I feel good physically and sleep well but lose weight excruciatingly slowly. The realization of the extent to which I will need to restrict my eating and the level of exercise I will have to maintain for the rest of my life is a bitter pill. But it is proven that formerly fat people have to consume less and exercise more, than do people who have never been fat, to maintain a normal weight.

My two Weight Watchers friends are both self-assured professional women with successful lives yet we all agonize over getting the scale to drop a pound or two. Even if it's freezing we wear the lightest clothing we own to the meetings where we're weighed. We e-mail each other lists and photos of everything we eat and give each other pep talks all through the week. It is extraordinary how much planning and emotional energy this weight loss thing requires when we are so competent and self confident in just about every other facet of our lives.

So, having been a fat kid and a fat adult I think I am qualified to judge that much of the public health approach to combat the scourge of childhood obesity as mean-spirited and dangerous. This is not to say that the government should bow out on health and nutrition issues. Based on irrefutable scientific findings Congress went after the tobacco industry and via a public awareness campaign and a heavy tax on cigarettes the smoking rate in the U.S. has declined from about 43% in the 1940s to about 19% now. Even thin people have negative health outcomes exacerbated by the consumption of crappy food but whenever there is mention of a public information campaign or taxing sugary or high fat foods there is squawking about government interference and personal choice, fomented I'm sure by food and beverage industry lobbyists. Naturally slender people also suffer health consequences from a sedentary lifestyle so instead of singling out the fat, a more apt message would be to encourage people of shapes and sizes to strive for lifestyle that incorporates a sensible diet and exercise.

The Georgia campaign implies that fat kids and their parents are themselves to blame for the ridicule and cruelty they endure. Too bad we can't just encourage people of all ages to enhance body and spirit by getting off their butts, eating less crap and treating others with respect and compassion. Fat chance.