Reflections on Obesity and the Weight of the Nation

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

A REGISTERED DIETITIAN’S VIEW OF OBESITY CONTRASTS WITH HBO’S WEIGHT OF THE NATION

While awaiting the heavily promoted premier of the HBO documentary, Weight of the Nation, I took the time to reflect on what I have learned about obesity in my 35 years of experience treating people who are overweight or obese. It just so happens my career spans the same trajectory as the epidemic, but I’m pretty sure I am not to blame!

Much has changed in this country since the mid-1970’s when obesity rates began to soar, and it all matters. But it is also true that no one thing is more important than any other in bringing about this unprecedented weight gain among Americans of every race, class and region.

I cannot offer all the mind-numbing statistics, frightening graphics, and challenging expert opinions of a high-tech television production, but I can tell you some things that need to be said.

What Obesity Is Not

All obesity is not same. Every person who reaches the benchmark to be classified as obese got there in his or her own way. It’s the result of a complex interplay of personal biology, environment, and lifestyle, where no two situations are exactly the same because no two people are exactly the same. This becomes even more apparent as the epidemic spreads around the world.

Obesity is not curable. There are many different factors that play a causal role in developing obesity and there no cure for it. Once you become obese, you must spend the rest of your life treating it or risk becoming even fatter or dying of the chronic diseases that accompany it.

 

Obesity is not easy to diagnose. Weighing a person and measuring their height is easy. Using those figures to calculate body mass index (BMI) is also easy. But deciding if someone is obese based on their BMI is not. More sophisticated measurements are needed to determine what the percentage of fat is in the body and where it is located to fully understand whether someone is at risk due to their body size and composition.

 

Obesity is not easy to prevent or treat. The best advice medical science has to offer as a means to prevent obesity is to maintain a state of “energy balance.” That advice is difficult to follow. It requires knowing precisely how many calories you consume every day (over a lifetime) and how much energy you expend every day to offset them. These are intangible values. Once you become obese, you are expected to create an energy imbalance by expending more calories than you take in. Only at this point, your body has a whole new way of dealing with energy that defies the mathematics of using calorie control to achieve weight control.

Obesity is not a plague. Obesity spread very quickly in the last three decades, but it is not a scourge that must be routed out by any means possible. Drastic measures have been proposed to “fix” the way we grow, distribute, and sell food in this country, while the obese have been scrutinized, marginalized, and penalized for their weight. In the panic to find a solution we have lost sight of the fact individuals become obese and it is individuals who need help dealing with it.

I hope I can look back 35 years from now and reflect on all that we learned about obesity to lift this weight from our nation.

 

Remove the distractions that lead to mindless eating to stop overeating and lose weight

Research on Mindless Eating Offers New Insight into Obesity

Eating while distracted can lead to overeating and weight gain

Research presented by Dr. Marion Hetherington at the 2011 Food & Nutrition Conference & Expo about multitasking and mindless eating provided proof that weight gain isn’t just about what you eat, but how you eat.

Dr. Hetherington explained that “satiation” is the sensation that lets us know when to end a meal or stop eating. “Satiety” describes what we feel after eating that tells us we’re satisfied, but not stuffed. Hunger is the signal that it’s time to eat again. Being able to detect each of these physical conditions has strong cognitive component.

Or simply put, we must pay attention when eating so our mind can process all of the signals that our body receives through sight, smell, taste and touch, in addition to the barrage of gastrointestinal signals transmitted with each bite.

According to Dr. Hetherington, several studies show that if you eat while doing other things, such as watching TV, reading or even talking, you can end up overeating. Appetite regulation is also affected by the amount of food available, such as large servings or buffets, even if the food doesn’t taste that good.

Based on this emerging research, a new direction for treating weight gain and obesity has evolved that focuses on the act of eating. Evelyn Tribole, MS, RD explained how Intuitive Eating, an approach she helped pioneer, allows people develop a healthy relationship with food and their own body.

Intuitive Eating is based on 10 principles which begin with rejecting the diet mentality and all the externalized rules for “dieting” that go with it. In this way the physical cues of hunger and satiety can begin to guide eating.

Ms. Tribole described “eating amnesia” as what occurs when you eat while distracted. She went on to explain that eating intuitively requires being aware of the food in front of you, as well as your emotions and body sensations.

The benefits of overcoming mindless eating and eating more intuitively go far beyond weight control according to both speakers. Practitioners gain a whole new appreciation for how to live in their own bodies and more accurately interpret their other needs, feelings and thoughts unrelated to food.

Given the abysmal results of most weight loss diets and the constantly changing food landscape, it makes sense to redirect your attention to how you eat, instead of what, if you want to lose weight. Why not shut down all the electronics and other distractions at your next meal and see how it feels?