Is Obesity Really a Disease of Affluence?
Not in America
Filmmaker Jack Collins has graciously consented to allow me to embed this excellent short film that he has created. I encourage everyone to watch it as it dispels a number of powerful myths about obesity in America.
CONSIDERING PRESCRIPTION WEIGHT LOSS MEDICATION?
You have tried to change the way you eat, sometimes
intelligently sometimes desperately. You have exercised religiously,
occasionally and sometimes not much at all. You've lost weight fast and seen it
come off slowly. You have seen it come back too, sometimes fast.
You have read books that tell you it’s all in your head,
books that claim you are the victim of a global food conspiracy; books that
make weight loss seem so easy or so complicated.
And all the while you have been told, in words, in gestures and in stolen glances that your weight is your fault. Sometimes you have
believed this yourself. Sometimes friends, spouses, children, parents and even
doctors have told you this.
You may not have tried everything to lose weight, but you
have tried a whole lot. But until now, there is one thing you have not tried:
prescription weight loss medications.
Perhaps you never knew such medications existed, perhaps you
thought they were just another gimmick or maybe you were justifiably leery
because of dangerous weight loss drugs from the past. Maybe this is the first
time your weight has ever become a real problem. Whatever the reasons, the leap
to taking prescription weight loss medications is one you are about to take for
the first time.
What ARE Prescription Weight Loss Medications?
The simplest definition is this: prescription weight loss
medications are prescription drugs that have been shown in numerous
peer-reviewed, placebo controlled clinical trials to be safe and effective for
Despite the horrors of weight loss medicines from the past,
FDA-approved medicines like phentermine have passed the test of time and
numbers. Phentermine was approved in the United States by the FDA in 1959, over
50 years ago. Since then the drug has been taken around the world by tens of
millions of human beings with a very good record of safety.
Like all medications, weight loss drugs are not for everyone
and they can, when used inappropriately in people with certain serious medical
conditions, be dangerous. But prescribed intelligently and carefully, these
medications are both safe and effective.
Prescription weight loss medications really do work but they
are NOT miracles. Studies show they can improve both the rate and amount of
weight lost in people following a reasonable program of diet and exercise by
increasing metabolic rate and reducing food intake. The effect tends to
diminish but not vanish over time and so weight loss drugs generally only help
“so far”. The rest remains up to each person individually and depends upon
adherence to livable changes in eating and activity.
Holland Clinic uses medication as a part of a much larger
program of education, motivation, behavior modification, dietary change and
exercise to help our patients achieve the greatest amount of LIVABLE and
SUSTAINABLE weight loss. Medications are the not the central focus of our
program but they are an important aspect of it. As with any serious medical
treatment our most important goals are your health and quality of life.
Is Your Weight Your Fault?
No. It is NOT. Fault implies that your weight is the result of an error. But what might such an error be? Did you
somehow choose your genetics or your parents? Regardless of your genes, are you
a glutton? Do you deliberately overeat simply because it “feels good”? Or are
you lazy, failing to exercise because somehow you have no ambition? In 22 years
of practicing medical weight loss, I have yet to meet anyone who satisfies even
one of these criteria.
Might it be that you lack “willpower”? Well, most of my
overweight patients are very successful people in life. They seem to have lots
of willpower regarding other life goals like education, employment and parenting.
So why would they somehow fail to use this willpower to alter their weight?
Obviously they wouldn't.
No, again, your weight is not your fault any more than my
male pattern baldness is my fault. Body weight is not a reflection of a person’s
character. Not at all.
Do “Emotional Problems” Cause Obesity?
No. Obesity causes emotional problems. Any person who grew
up being told by parents, teachers, doctors and society at large that he or she
eats too much is certainly going to develop an unhealthy emotional relationship
to food. The weight comes first, the
emotional issues second. It would happen to anyone.
Will Figuring Out “WHY” You Eat Solve the Problem?
Will learning why we breathe help us breathe less? No. We
eat because we are hungry and hunger is a survival urge. Hunger hurts.
The hungrier we are, the more we hurt. We might be able to rise above
that for a short while but in the end, if we are hungry, we go on hurting until
The Many Flavors of Hunger
Have you ever been in a plane crash in the Andes mountains
and starved for weeks? No, neither have I, but it’s reasonable to believe that
any person under those circumstances would be hungry almost to the point of
madness. But what about the urge to eat
chocolate 2 hours after lunch? Is that
hunger? Yes, it is, but obviously it is
hunger of a different character and intensity than starvation. Have you ever awakened in the
night and “had to have” a pickle or a soda? Hunger comes in many different
flavors but in the end, it’s all hunger. Hunger is that which makes us want to
Hunger and Metabolism are the Issues, Not Your Moral Fiber
Modern science is showing that obesity is a complex illness
with many causes but in the end, it boils down to one or two basic problems:
derangement of appetite and or derangement of metabolism.
Understanding the “Fat Thermostat”
Body weight is a REGULATED parameter. Normally we have
hormones and neurotransmitters that carefully monitor and control body weight. In obesity, the balance of these factors becomes altered as if, by analogy, the thermostat in a room became damaged or broken. You can read a lot more about this in my online book.