Is Obesity a Disease?

In my last post I shared what I know about the anti-obesity drugs that are coming on the market and my thoughts on safer alternatives.  I received quite a bit of feedback from readers, one saying “this is brilliant. I’m so glad you wrote this. I will admit I explored these myself. I decided a while ago it wasn’t worth the risk and this just confirms that.”  Another, a medical doctor said  “I just completed a 38 hour review course on General Internal Medicine for Specialists . We had sessions on obesity, diabetes, heart disease, etc.. They advocated lifestyle changes as step one to reducing “unhealthy weight"; then adding professional counseling if this does not result in a 5% reduction in 3-6 months. Then just 3-6 months in Step 2 with a rapid transition to Step 3 - drugs! Then 3-6 months with drugs before going to Step 4 - operation! I thought this very aggressive since it can lead to an irreversible operation within a year! If I were treating patients, I would allow 1-2 years in Step 2 , looking for at least a 10% weight reduction. I would include aggressive Cognitive-Behavioral Training as well as Nutritionist counseling in Step 2.”

Using just this sampling of responses to my newsletter, it made me step back and ask the question - Is obesity a disease?

Modern medicine now defines it as such.  I understand that obesity is linked to a number of diseases: high blood pressure, heart disease, sleep apnea, Type II diabetes and some forms of cancer.  But is obesity itself a disease, or is it a condition that is the result of  chronically poor nutrition?

Let me define what chronically poor nutrition and resulting weight issues looks like to me:

   1.   a regular diet of low nutrient high calorie foods, leading to chronic hunger

   2.  constant dieting, trying restrictive diets that tip essential nutrients out of balance with a goal of rapid weight loss, resulting in loss of muscle mass and altering metabolism

   3.  snacking, especially when it takes the place of meals

   4.  overindulgence in refined sugar and white flour

   5.  absence of vegetables, fruits, whole grains, nuts, beans/legumes and/or lean meat

   6.  night time eating

   7.  insufficient intake of water

   8.  loneliness

   9   boredom

  10. anxiety

  11. unmanaged stress

So you see, nutrition and weight are not just about food. No question, nutrition and weight issues are complex.  That’s why in my work I begin with the food part, looking to stabilize eating practices to three nourishing meals each day.  But the deeper work needs to be done too.  How do you take care of yourself?  Is it just outward appearances, or do you give yourself enough rest, social connection with people you care about, and time for the things you enjoy?  Do you get outside in the daytime to listen to the birds, look at the sky and just be?

I worry that people who only focus on the idea that weight loss is the answer will succumb to the intense marketing of obesity drugs you will see this year. It looks so simple, until you look at the fine print of side effects and the need to remain on the drug indefinitely or the lost weight will return.  Time magazine has again brought some of the serious issues related to these drugs to light.

Don’t blame yourself - when was the last time you saw an ad for broccoli?  Or carrots?

Obesity is not the result of laziness or gluttony,  It’s the failure of our government to make nutrition education a priority, all the while subsidizing the food industries that produce inferior foods and charge a lot of money for them.  By calling obesity a disease, it suggests that people are helpless where what we really need is better affordable food choices at the market and comprehensive education on food and the basics of meal preparation.  We need public service announcements and community organizations that teach shopping and cooking skills.

In the meantime, don’t put your health and happiness at risk by obsessing over your weight.  You are unique,  the result of your anatomy, your food and how you care for yourself. That’s where your power is.

Meryl Streep - Wise Woman

I had the honor of speaking at the MA Conference for Women in 2017.  Meryl Streep was a keynote.  Here’s what she said about weight: “Don’t worry about your weight.”   “It’s a big waste of time. When I think about how many years I’ve wasted thinking about that subject, it’s just idiotic.  And we lose so many genius people and their genius ideas because they are looking in the mirror and saying ‘Oh my God, my ass is too big’”

The audience of 11,000 women erupted.  I hope you just did too.

A Sobering Message on American Health and What To Do about It

If you've been following me you know I am passionate in my belief that we each have an innate ability to heal and be well.  In the US we have the most expensive health care system of all developed nations but by no means the healthiest. Bloomberg news reported the proportion of Americans dying from coronavirus infections is the highest in the developed world. It’s time to develop a better concept of health care - one with a focus on wellness, not sickness. You’ll see from the list that follows how poorly the US ranks despite spending more money on health care per capita than any other nation.

Here are the numbers as of February 19, 2021 

US              493,138

Brazil           243,457

Mexico       178,108

India           151,111

UK               119,614

Italy               94,887

France         83,542

Russia         81,048

Germany    67,249

Spain           66,704

What about Life Expectancy?

An equally important list to look at is the overall lifespan of Americans in comparison to other nations. We rank an abysmal 37th on the list of industrialized countries. Even more sobering is the latest news that suggests we’ve lost a year in our lifespan due to covid 19 deaths. 

As a health and wellness coach, it has been extremely frustrating to me over the past year that those with the most public voices with regard to Covid 19 speak only about the virus and the vaccine. There’s been not a whisper about self-care in the midst of all the fear based reports. 

What is Wrong with The American Health Care System?

You might say it starts with the misleading name. The real focus of the American health care system is treating illness.  As it stands today it should be called The Sick Care System.  The US spends more per capita on pharmaceuticals and medical care than any other developed nation. You only need to look at the approach to Covid 19 to recognize we as a nation focus on sickness, not wellness.  We need to make a major shift by making wellness our first priority. And we need to do it not only for ourselves but for the beleaguered front line providers who are constrained by the rules of the health care system. 

Defining Wellness

In my opinion, wellness should not be limited to health care screenings. They may have value in creating a baseline, indicating where some improvements are needed.  For instance, a screening of your blood levels, lipid levels, your heart rhythms, muscle tone, etc. and your nutrient levels could help you know what aspects of your lifestyle need improvement. From there you could develop some health goals that are designed to build on health.  Unfortunately in the US health care system, doctors are given little time to advise people on making lifestyle changes except in very general terms. More often because of the limited time with a person, doctors may prescribe a medication as a quick fix to suppress symptoms, This approach does not lead to lifestyle changes that need to be made.

A Better Message for Covid and Wellness

We can’t keep looking at a virus or heart disease or Type II diabetes or even Alzheimer’s as the threat.  The true threat is lack of information and guidance on how to be healthy.  The US health care system does not do that. It focuses on which medication or procedure will “fight” that virus or disease. Its focus is on correcting or treating instead of preventing.  We must shift to a wellness based health care system if we want to be well. 

The Basics

Have you had fewer colds or flu this year?  The worthwhile message we’ve received from CDC, FDA and news outlets is threefold:  wear a mask, wash your hands, and practice social distancing. Overall, people have been healthier by following these practices.  What these information sources have failed to discuss is prevention through lifestyle practices that should be a part of every day, pandemic or not.  I describe them in 5 sections:

1. Eat healthy foods. Start with simple whole foods, fruits and vegetables, whole grains, nuts and seeds, legumes, with high quality seafood and meat. To benefit you these foods must be free of additives and chemical preservatives, synthetic hormones and antibiotics. Ideally that means organic whenever possible. Add clean water and herbal teas.

2. Get enough sleep. Research shows seven to eight hours is a good marker for adults.

3. Move. The tendons that let you stretch and the muscles that lift you up weaken if they aren’t used. Try the 20 minute rule and get up every 20 minutes, if even for a short stretch. Get continuous movement in some way every day, ideally outdoors where you are breathing in fresh air.

4. Manage your stress. Unwanted stress is known to suppress your immune system. If you need help, try a simple meditation. I created a short one for anyone who doesn’t feel like they can meditate but would like to give it a try.

5. Using your baseline bloodwork, consider taking a very limited number of supplements to give your body a boost. Right now, several studies show the importance of adequate D levels in preventing serious covid illness. D cannot be absorbed from the sun in the northeast US between November and March, so most of us here need a little extra help. Metagenics is my preferred manufacturer and you can learn more about them here.

I’m Overweight. Should I Diet to Be Well?

In the US, 70% of adults are overweight and 40% are obese.  We know that for most people being overweight is a health risk, but we also know that 85% of diets fail.  They fail because they do not establish long term lifestyle practices.  Many incorporate restrictive calorie counting  that slows metabolism and creates stress and hunger.  When you learn to eat properly you will not be hungry. Your body will be getting the nutrients you need and your brain will work to adjust your appetite mechanism because it knows you are getting enough nutrients. Healthy eaters come in all sizes; not all are slender, but it is rare for a healthy eater to be obese.  

Our fear-based, sick focused system is not working.  It’s time to envision a better way for you and for the future of our country. How do you approach your health care and what will keep you healthy? 

Resources:

Food Becomes You - Simple Steps for Lifelong Wellness  my playbook  for making healthy food prep easy 

Food Rules by Michael Pollan - a simply written rule book that tells it all 

Health Assurance for All - Inside American Health Care Michael Metzler   - how it fails its citizens

Rev Up Your Metabolism!

Ever wonder what metabolism has to do with weight gain or loss?  Metabolism is basically the sum of all of the activities your body has to do to stay alive and breathing and keep you rockin'.  It's calculated as a  basal metabolic rate; the energy, or calories you need simply to be alive in a resting state.  Calculate yours here and then come on back to see what you need to do to lose unwanted weight.  

It makes sense  that your goal is usually a HIGH metabolic rate and definitely NOT a low one, yes?  Here are some ways to wake up that metabolism engine of yours:

1.  Make sure you're eating ENOUGH.  Yes, I said it; you may not be eating enough for your body to know it's okay to burn off some energy.  Your body is sometimes smarter than your rational mind; it knows if you don't have enough food so it takes action and slows the burn. Not good when you're wanting to lose weight. 

2.  Eat regular meals.  Breakfast is most important, so make it a good one filled not with muffins and bagels but with high protein foods - fish, eggs, plain Greek yogurt, and some veggies like kale, onions, mushrooms. 

3.  Build muscle. This is a BIG deal!  Fat only burns 9 calories per pound and muscle burns a whopping 38 calories per pound.  Lift those weights, practice yoga, do your squats, ladies and gentlemen. 

4. Eat sea veggies, nuts and wild seafood.  These give you a blend of iodine and minerals like selenium to nourish your thyroid. You need a heathy thyroid to have a healthy metabolism. 

So how does my healthy eating plan fit in when we're talking metabolism?

It's all about balance.  In my book Food Becomes You you can find simple recipes that give you a blend of all the foods you need to get your metabolism into just the right level. It might take some time, you won't see rapid weight loss, but rapid weight loss in the past is exactly why you might have been having trouble losing weight now.  

Seasonally, it also makes sense to do a concentrated Cleanse. At Wellness and you, we schedule a Cleanse in the Spring and Autumn and another just after the Holidays. It consists of approximately one week of focus eating of foods compatible with the season and is combined with specific self-care practices for mind, body and spirit. You can learn more by visiting the programs page.