“Obesity is One of the Last Bastions of Prejudice in our Society.”

Last week, an obese news anchorwoman, Jennifer Livingston, confronted a cyber bully. That confrontation went viral on the internet and the young woman received a lot of public support. A writer friend of mine, Ginger Calem, who is a well-known blogger on health and fitness issues, then wrote a great blog post about this incident, Being Mean Sucks.

These two events got me thinking that the time might be ripe to dispel some myths about weight gain and loss.

I started my psychotherapy practice thirty years ago specializing in weight management and compulsive eating issues (later I became a trauma recovery specialist). I thought this specialty would be an ‘easy’ way to jump-start my practice. It did get my practice rolling quickly, but dealing with these issues turned out to be far from easy.

Weight management (Notice I don’t call it ‘weight control.’ We cannot control our weight; we can only attempt to manage it.) is one of the most lucrative industries in this country. Want to make a fortune? Write a book, develop a program, or better still come up with a pill that will supposedly help people lose weight quickly and effortlessly.

There’s just one problem. Weight loss is neither easy nor quick. And all these get-slim-quick schemes do is perpetuate the myth that it is.

The title of this post is a statement made by one of my clients years ago. She went on to say, "And sadly, this group of oppressed people believe they deserve to be oppressed." Why do they believe that? Because they too have bought into this myth. If they are fat, it is simply because they are lazy, out of control, lacking in willpower and/or just plain inferior human beings. Doesn’t matter what other remarkable things they have achieved in their lives, they are not completely okay in their own and others’ eyes.

Nothing is simple or easy about losing weight. The mechanisms that control human weight, both physical and psychological, are the most complicated I have ever encountered as a psychologist. I’d rather try to explain how someone ends up a serial killer than try to explain why we have so much trouble losing weight.

But I will attempt to do so here because I think the time has come for our society to stop making people feel bad about something they have little control over.

During the next couple posts, I will share with you the reasons why it is not easy, and some helpful hints on how to combat the problem. These reasons can be broken down into four categories. I will address the first two in this post.

• Physical factors that affect everyone’s metabolism and eating behavior.
• Physical factors that make it hard to lose weight.
• Social connections/issues with weight and food.
• Psychological connections/issues with weight and food.

Our metabolism slows down in winter and/or when we are inactive:
Our bodies were designed to handle much more primitive conditions than we experience in modern society. In order for the species to survive, human beings needed to be able to make it through cold winters and other times when food was in short supply.

So imagine this. It is early summer and the elk have grown fat eating that rich spring grass. The hunters chase the elk herd down and manage to kill a good number of them. The elk are butchered, a portion of the meat is set aside to be dried for winter consumption, and let the feast begin!

The guy who eats until he can’t possibly stuff anymore in ends up nice and fat. The prissy little miss who says, "Oh, no, I can’t possibly eat all that" stays nice and slim.

Then winter comes along.




Snow covering ruins of cave dwellers in Cappadocia, Turkey (photo by Nevit Dilmen)


Fat guy emerges from his cave the following spring, lean and hungry. But he emerges. Skinny miss died of starvation in mid February. Fat guy woos himself a bride and starts a family, passing on his genes for overeating when highly palatable food is available. Skinny miss didn’t live long enough to reproduce.

Fast forward a couple of eons and you have an entire human race that overeats when delicious food is available in large quantities. Except that we now don’t just overeat a few times a year, after a big hunt, with lots of lean times in between. Now we are invited by every clerk in every fast food restaurant to supersize that high fat, highly palatable meal we just ordered. So we have a huge cup of sugary drink and a large container of fries to go with that quarter pound of beef and cheese and special sauce. The sandwich, by itself, would have provided enough calories to get us through the day, but more importantly it would have filled us up. But we eat it all because it tastes so good!

Fat people don’t lack willpower any more than skinny people do. Human beings in general are not programmed, as a species, to have the willpower to resist highly palatable food laid out in front of them!

Back to that winter-time cave. There’s pretty much nothing to do. So everyone huddles around the campfire and tells stories. This is a good thing, because activity burns more calories and they need to conserve their food supply and their bodies’ fat reserves to make it to spring. Some of those cave dwellers have a natural tendency to have their metabolism slow down when they are inactive. They survive better than the people who can’t relax and pace up and down the cave until spring, or until they die of starvation, whichever comes first.

Eons later, we have an entire species whose metabolic rate slows down when we are inactive. And we have television and computers and video games enticing us to be less and less active.

Okay, time for some Helpful Hints before this gets too depressing.

HH#1: Do NOT make losing weight your goal. Make becoming more fit and healthy your goal. You can’t control the first, you can the second. And chances are pretty good that if you get more fit and healthy, you will lose weight, or at least inches. More on this in a bit.

HH#2: Participate in some kind of rigorous physical activity two to three times a week for at least an hour. Go to the gym, aerobics or Zumba class, take up running, power walking, whatever. (If you have been completely sedentary, work up to this gradually.) Aerobic activity not only burns calories but it also raises our metabolic rate for some time after we stop. But try to find something you really enjoy, otherwise you may not stick with it.

HH#3: Do some kind of activity every day. Walk the dog, mow the lawn (ride-on mowers don’t count!), do something. Park your car at the far end of the parking lot, take the stairs instead of the elevator, etc. Look for ways to put more activity into your daily life painlessly.

NOTE: It is impossible to lose weight and keep it off while remaining sedentary! It is also impossible to be fit and healthy while remaining sedentary.

HH#4: Limit eating in restaurants, especially fast-food ones, to a rare treat. At fast food restaurants, don’t order the meal. Order a sandwich and water, coffee or tea, and if you must have fries, order a small one separately. Trust me, you will be just as satisfied when you are finished eating, and you’ll feel less guilty. At regular restaurants, ask for a box up front and put one third to one half of the meal in the box before you start eating. You will be less tempted to overeat if it is out of sight, and you can anticipate how yummy it will be tomorrow when you heat it up for lunch.

Sleep deprivation increases hunger:
There are several chemicals in our bodies that regulate the delicate balance between calorie intake and energy expenditure. Two of them are ghrelin, a hormone secreted by the stomach lining that stimulates hunger, and leptin that is secreted by your body fat and inhibits hunger. These two hormones, ideally, counterbalance one another. But when we are sleep deprived, our bodies compensate for the lack of rest by decreasing leptin levels and increasing ghrelin levels, i.e. our appetite goes up.

HH#5: Get enough sleep. This will also give you more energy to be active. If you are sleep-deprived on any given day, be extra careful to avoid high-calorie, low nutrition foods.
　
Genetics does play a role for many people:
Ever heard either of these statements. "Being overweight is not inherited." Or, "if someone’s had a weight problem all their lives, it’s probably not caused by biological factors." These are both myths.

And sadly, the second one is a direct quote from an endocrinologist regarding a client of mine. She was resisting taking a referral from me for an evaluation because he had "always had a weight problem." (To me that indicated it was more likely to be biologically based.) I insisted; she gave in. Good thing, because it turned out he had a rare disease that would have killed him if it had gone undetected for even a few more months.

Research has found that there are a multitude of genes that affect body mass and metabolic rate so yes, genetics do predispose us to be skinny or heavy or somewhere in between. But our behavior and the environment also impact on how those predispositions pan out.

In addition, genetics may or may not play a part in a couple other factors. Obese people tend to have leptin resistance. Their brain just doesn’t absorb all of the leptin their fat cells are releasing so their appetite is not inhibited like it should be.

Obese people also tend to have a lower number of dopamine receptors in the part of the brain that registers pleasure. So how do dopamine receptors affect weight? Dopamine is a neurotransmitter that has many roles. One of them is to stimulate reward centers in the brain that give us that "ah, that felt good" feeling. Without these reward centers, we would not be all that motivated to do the things we need to do in order to survive as individuals or as a species, i.e., to eat, drink and have sex. With fewer dopamine receptors in these reward centers, it takes a lot more pleasurable activity to achieve a sense of satisfaction. So these people are motivated to eat more (this is also related to other addictions).


Metabolism slows down when we cut back on our eating:
To make sure we survive periods of short food supply, our bodies are designed to maintain our current weight (this is called ‘set point’ or sometimes, ‘settling point’). If our calorie intake goes down, our metabolism slows down to compensate. So after a few weeks of dieting, we plateau, get frustrated and stop the diet. And then gain all the weight back, and then some, when we go back to our regular eating patterns. So dieting doesn't work. We have to change our eating behaviors for the long haul (more on this next time).

'Set point' is no longer a theory. Scientists now understand how this works biochemically. But I think we’ve had enough chemistry lessons for one day.
　
HH#6: Cut back on calories slowly (while increasing your activity to keep your metabolism stimulated). Start by reducing and then eliminating empty calories (high calorie, low nutrition foods). Don’t buy the junk food; don’t bring it into the house. Nobody in the family needs it. Not you, not your spouse, not the kids, not the dog. Again, human beings are not programmed to resist highly palatable food that is readily available!

HH#7: Next step is to reduce portion sizes. Again, do this gradually. Notice how many spoonfuls of something you tend to put on your plate at a meal (especially starches). Cut back half a spoonful for the next few days, then another half a spoonful for a few days.

And if you are like me and are used to taking seconds (a hard habit to break), slowly cut back the first serving, while not allowing yourself to increase the second one, until you are taking two servings that equal what used to be one.

HH#8: Replace desserts with something equally satisfying but more nutritious. When you feel a yen for something sweet after a meal or as an afternoon snack, have some fresh or canned fruit, perhaps with yogurt.

Men can indeed lose weight much easier than women (in general):
A woman will naturally have more fat and less muscle than a man of the same weight. Women are hormonally programmed to carry more fat reserves so that if we are pregnant or nursing a baby when famine strikes, mother and child are more likely to survive. Muscles burn calories, fat just sits around and, well, gets fatter. So men have a higher metabolic rate, in general, than women do.

HH#9: If you are a guy whose woman is trying to lose some weight, tell her you love her and you are rooting for her. And then shut up, because you have no idea how much harder it is for her to lose than it is for you. If you are woman trying to lose weight, show this post to your man.

HH#10: Put the scale in the attic! As you start to lose fat by increasing exercise and slowly reducing caloric intake, you may not lose much weight right away. Muscle is more dense than fat (think a small, lean steak versus four sticks of butter). So as you increase the muscle and decrease the fat, you will slim down and tone up without necessarily losing all that much weight. Indeed, you may even gain a little, but if the inches are coming off, if your clothes are looser, if you are feeling better, that is what counts.

How you look and how you feel is what it is all about, not numbers on the scale! Those numbers may just discourage you and make you give up even though what you are doing is actually working. The numbers on the scale have also become tied to our sense of self-worth in our society. But more on that next time.

And also more next time on ways to improve eating behaviors, after we talk about the psychological and social implications of weight and eating in our society.


(Posted by Kassandra Lamb. Kassandra is a retired psychotherapist turned mystery writer. She writes the Kate Huntington mystery series.)
　

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