The Santa Barbara News Press published a Sunday Op-Ed piece by Dr. John La Puma, MD on help for those people who are successful in many other areas in life, but not in managing their own weight. What those parents often need are ways to be role models, personal attention and an executive approach. Text below.
by Dr. John La Puma, MD
Ann Sampson is wildly successful. She writes, produces and directs movies seen all over the country. She owns homes in Vancouver and Chicago. She is funny, witty, youngish and attractive. She is nationally recognized for her creativity, her spirituality and her care of others.
But Ann has a problem. Her blood pressure is up, even though she now drinks green tea instead of espresso, and has gotten off the Metabolife. Her blood sugar is up, and her brother died of diabetes just last year. Her arthritis is worse now. She can’t play tennis for more than a few minutes without becoming short of breath. And sometimes she stops breathing when she sleeps, waking every few minutes at night, with dark circles under her puffy eyes to show for it in the morning.
Ann is obese. Like 31 percent of American 5-foot-6-inch adults, she weighs 186 pounds, or more. Like 64.5 percent of American adults, she is overweight. Her normal weight is 155 pounds, or less.
Ann’s disease likely will kill her.
Obesity, combined with a sedentary lifestyle, is the second leading cause of death in the United States, second only to smoking. Between 1991 and 2000, obesity in this country rose 60 percent — a change that cannot be chalked up to genetics.
Ann is a patient of mine, and she has had her struggles. But she has persevered and is finally, 2 years out, feeling truly successful. As Oprah has said, “I’ve been through lots of diet programs, and there’s nothing like getting up and getting going and going for a walk in the morning.”
And that’s what Ann learned to do — put one foot in front of the other, literally and figuratively.
That’s exactly what’s needed to be successful in keeping weight off — one-on-one accountability, daily exercise and your own individual plan. At least, that’s what has worked for those in the National Weight Control Registry — 3,000 people who have kept off 30 pounds or more for five years.
Obesity cost us $118 billion in direct and indirect health- care costs in 2001, a number that’s hard to imagine.
Here’s a different way to understand it — an obese person spends $395 more annually on hospital and outpatient care, while a smoker spends $230 more and a problem drinker spends $150 more. And right behind this obesity epidemic is a diabetes epidemic, and that’s very expensive.
Men’s Fitness Magazine again published its Fattest Cities and Fittest Cities lists, for the third consecutive year. (Santa Barbara is on neither list, though San Francisco, San Diego and Sacramento all are among the top 10 Fittest Cities). For the third consecutive year, Houston is the fattest city.
My friend Doctor John Foreyt at Baylor College of Medicine again was quoted by USA Today as saying, enough already. Last year, he said, “This is stupid. All cities are fat.”
He’s right. But why? Is it a toxic food environment, with high-fat, high-sugar foods in school vending machines and on every corner? Is it too few PE programs and too few parks? Is it 99-cent value meals, where supersized is better, no matter what the quality?
Is it fast food’s brilliant marketing to children, hooking them and their beleaguered parents early and often? Is it the loss of family meal time and decent cooking skills, and their replacement by squeezable tubes of yogurt in the carpool home?
Is it billboards for women saying you’re not good/sexy/useful unless you’re thin? Is it a culture that signs up for backside liposuction one year and yearns for buttock implants (can you say J-Lo?) the next?
Is it the carbohydrate, the insulin, the leptin, the ghrelin?
It’s some of each. But most of all, it’s us. We have met the enemy and he is us. I know — I was once 30 pounds overweight, and it is still a struggle for me. Every day. And I know how good food can taste, how hard it is to exercise, how easy it is to overeat, and how much obesity is not what everyone thinks it is.
Obesity is not a disease of willpower. It is not a cosmetic problem. It is not a moral problem, in which there are good or bad people, good or bad foods. It is a disease that is visible, and about which you can hear jokes on Letterman and Leno. And that’s wrong — no one with a disease should be ridiculed. Ever.
People with the disease of obesity deserve to be treated like people who have heart disease, stroke, diabetes, arthritis and cancer — seriously and with respect. Not only because they need treatment, but because if they go untreated, many will develop exactly these diseases.
If we want to make a difference in health care, we need to treat this epidemic before the next one hits.
Dr. La Puma is the author of the New York Times Bestseller “The RealAge Diet: Make Yourself Younger with What You Eat!” (4/2001) and “Cooking the RealAge Way: 80 Recipes That Turn Back Your Biological Clock!” (6/2003). Both are published by Cliff Street/Harper Collins, and co-authored with Dr. Michael Roizen