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Tuesday, April 27, 2010

"Obesity"

 "Obesity"



Brian Lynch

It is certainly not as simple as having to do with food. It has almost nothing to do with food.


The reason most of us are overweight is, in fact, well-known but oddly avoided. We come upon the concept that it might have something to do with our feelings, but for the most part, quickly set this possibility aside.


True enough, our culture offers many reasons to help us avoid: Plenty of food, and even if poor plenty of empty and innutritious calories, “not enough time for activity” and “the fat gene.” In short, we throw up our hands in despair.


It is confusing and the reasons we do not act fold in on each other causing more despair and worsening the emotional turmoil.


The bottom line is much of our eating is to self-medicate. Much of our weight has to do with shame, the shame in the sense that I have wanted something other than food and not gotten it. My desire has been thwarted. It hurts and I do something about it, I eat.


As has often been pointed out we do not need to smoke or drink or use drugs but we have to eat.


And we now know so much more about how to articulate what happens to us.


One easily elicited reason for our state of girth is the shame that comes with the pounds. As I said we eat due to shame but then are thrown into a shame spiral or “bind.” We feel shame for our very weight. This alone can increase the eating but we also now isolate ourselves so as not to be seen. It is a vicious circle. Shame begets shame and eating begets eating. 


This is often exacerbated by our self-image which we now know is so much determined by our social status and family. We often, that is, will not surpass our family; to do better than my parents would shame them and myself. My mother is big I cannot lose more than her or I will shame her.


True enough, there are all kinds of exceptions and genes do play a role. Adopted thin kids in large families tend not to be large! It takes discipline to read and learn from various sources. But if the shoe fits, wear it. I am not discounting genes. I am saying a hundred years ago we probably had much the same genes what we didn’t have was the same activity and eating habits. 


What then in this society where well over half of adults are overweight? Being overweight becomes “normal.” It becomes a family emblem, “the way to be.” Again, if I lose weight and take care of myself it will be shaming to all those that are not doing it! Thus, this ignites another vicious cycle. Those that shame will oh so subtly or viscously sabotage my every effort to be different: To lose weight, to be healthy.


Then there is the painful logic of the 30-40-year-olds who have “just gone to the doctor” and been told that they are in perfect health. Yet they are 100 lbs overweight. This is what I call “disavow.” Disavowal of any thought of the disaster that might and probably will come in ten years of heart disease, diabetes, and stroke or out-and-out death. It simply reminds me of the patient I saw the other day that I had long worried about who had been doing well on one long-term contract that I knew had to end someday, and so it did, and now he is in shock in this poor economy. So we hope as doctors that our overweight patients will have a “minor” stroke or heart attack before a major one to see if they might take the hint.


A confession dear reader; so was I about ten years ago in terms of my weight. I was much over the mark.


Yes, being overweight has little to do with food.





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