I read a lengthy article about the causes of obesity today. It was supposedly a review of a documentary called "Fat" but it read like as article from New Scientist magazine, summing up some of the latest scientific discoveries as to why more and more people are packing on the pounds. Clearly, the "eat less, exercise more, use a little self-control" rhetoric is simplistic. Science has amply demonstrated that there is not one single cause of obesity and that there many factors at work that undermine will power.
It was of interest to me because I'm borderline clinically obese, have a number of the stereotypical obesity-related health problems, and in the last few months have gained 10 pounds after losing about 25 and keeping the weight off for two years. And wouldn't you know, I have been overeating today.
It has to do with the article. The mere thought of dieting is enough to set me on a binge, and just because the binge no longer includes pints of Ben & Jerry's, 3 or 4 candy bars, or a bag of Chips Ahoy, Double Stuff Oreos, or Pepperidge Farm Orange Milanos, doesn't mean I am not binging. You can overeat so-called healthy foods, too.
The only true diet that has ever worked for me is a combination of exercise (beyond walking) and enough pleasant mental preoccupation that eating doesn't become a prime activity in and of itself. And here is where I see the short-comings of obesity studies. Much in the article I read today, as well as other articles, focused on discovering which chemicals signal hunger and which signal fullness, and what might interfere with the chemical that tells the brain that the stomach is full. The underlying assumption of those experiments is that people will stop eating when they are full.
WRONG-O!! Some people eat when they are not physically hungry. I know; I'm one of them. All the studies in the world about hunger and satiety triggers will not do a thing for me. Where are the studies about the psychological need to eat? We seem to have studies on the psychological need to not eat, or to purge what you've eaten. But overeating seems to be a matter of ruthless genetics or lack of self-control to the doctors and scientists dealing with fat people.
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Why is it that every time I start a diet or even think about it, or read an article about weight loss, I stuff myself? Scientists think there is an evolutionary root to overweight. Until very recently, i.e. less than 100 years ago, most people suffered from food insecurity. Therefore, the human body evolved to store fat against the lean times. Most people in developed countries–not all, there is hunger in the US and other generally well-fed places–no longer need this evolutionary safeguard against starvation. But evolution is slow. And bodies are still programmed by evolution to survive in hunter-gatherer societies, not in cities where food is plentiful year-round. So losing weight, even for an overweight person seeking to lose it deliberately, is a signal to the body of impending starvation, even when the person losing the weight has plenty of food in the house, knows that the weight loss program will not induce starvation, and is even happy about losing weight. (You've never seen people happy about starving, have you?) The metabolism is slowed to burn fewer calories, and excess calories are stored as fat.
Yet excess fat, especially around the stomach, where I have a lot of mine, creates all sorts of health problems that science has only recently begun to discern. So the body storing fat, especially around the middle, is creating one harmful situation in order to prevent another. Go figure.
Will somebody show me, because maybe I haven't seen it, the studies exploring this disconnect between body and mind? Why won't my body listen to me when I tell it that it will not starve to death if I weigh 130 instead of my current 162? Why doesn't it get the message when I go almost every day to a big supermarket, and almost every weekend to a local farmers' market, that there is plenty of food to be had? I have had issues with money where I have not been able to afford the types or amounts of food I wanted, but they have always been short-term episodes, days, or a week at most, and it wasn't as if I didn't have anything! Thanks the gods, I have never been that bad off. And as a child, there was always food on the table. So why is my body stuck with an operating system built on racial memories of hunter-gatherers of old, or even of my own past life memories of times when maybe I did starve to death. That was then. This is now.
Same with what my mother may or may not have eaten while she was pregnant with me, and the fact that I, like most children born in the U.S. in the 1950's, was formula-fed rather than breast fed. Why, over half a century later, could these "epigenetic" factors still effect me, programming me to store unneeded and unwanted fat?
And while I am on the subject of poverty, there is indeed a link between poverty and obesity. Poor people don't have the same access to fruits and vegetables that better off people do. That's obvious in a poor neighborhood with liquor stores on every block, but no supermarket for miles. But I must say I don't think scientists spend enough time studying the importance of eating as a subconscious political statement, especially for the poor. When you are poor, you already face various forms of deprivation. To then be told "don't eat this, don't eat that, eat smaller portions," etc. feels like one more deprivation. And eating what you want, as much as you want, feels like freedom.
Eating is also a form of entertainment for poor people, over and above the general use of food as the center of social occasions. This is something I know of from a personal perspective also. Comfort foods, sweets in my case–I don't have a sweet tooth; I have 32 of them–are cheaper than just about anything else you can do for fun these days, even with the price of food skyrocketing. And if you are working two or three jobs to make ends meet, there is little time or energy for physical activity as an entertainment, but there may be an hour or two to rest in front of the TV with a bag of chips. Even for the kids, who may be playing video games instead of being outdoors. When we cut the school budgets, the first things to go are the fun activities like music and art. Sports become "pay to play" affairs if they are offered at all. And cities are so built up there is hardly any play space. Sandlot baseball? What's a sandlot?
What exactly do we know about the psychology of comfort food? Why, in our moments of grief, stress, exhaustion or elation, will we always turn to things like chocolate or pizza, not chopped veggies or apples?
How deeply has science studied the function of food as trustworthy friend: if you have it stored or have at least a little money, food can be more reliable than people. Food was always there when I wanted to celebrate something. A rare victory in a competitive tennis match or an excellent performance by some choral group I was in, that none of my friends came to watch. A banana split or an open face turkey sandwich with dressing, smothered in gravy was always there. But why did the food turn to fat? Tennis and singing, neither of which I do any more, expended a lot of calories.
Then there is fat as the B.S. detector. Having been told repeatedly by my mother that employers would not want me and men would not be interested in me because I was fat, I came to see fat as a shield against those only interested in my body. (This was a very big issue for an intellectually-oriented girl coming of age in the feminist 70's). And I saw proof that fat worked to weed out the insincere in the late 80's when I was both working full-time and going to school part-time. I went on the Jenny Craig program for a while and lost 34 pounds in 3 months. As the weight was coming off, more people, male and female, were stopping by my office and stopping me in the halls at school to talk. Many of those same people disappeared when the weight reappeared. Are there psychologists who teach people like me how to use tools other than fat to weed out the phonies?
Science has a long way to go to unravel the mysteries of obesity. There is much good science being done on its physiology, but I think science is way short on the psychological side. Especially for those of us who will ignore the biological signals of fullness and eat anyway. Another concern with the physiological approach is that medicalization of obesity leads to Big Pharma getting people hooked on expensive patent nostrums with side effects. The extremely obese need medical help. But I simply don't trust our for-profit medical industry to do the right thing for most of us. It wants us taking all sorts of prescription medications for life, even as the law requires them to list possible side effects in their ads. Pay attention to the side effects of all the medicines advertised on television some evening. It's downright scary that they will put stuff on the market that might even kill you. Sure, it's rare. But that's of little comfort if it happens to you or a loved one. And generally all these medicines do is suppress symptoms. They don't get at root causes.
But, on the other hand, I also have to ask all the New Age philosophers who say our bodies are constructs of our beliefs, why is it that our bodies still react to the conditions of 10,000 years ago, rather than those of today? What of that lack of communication between the mind that is supposedly constructing this life experience and the body that seems to have a mind of its own. Can we talk? In what language? How do we, as creators of our lives and circumstances, tell our bodies who's boss. And can we avoid being a mean boss who will only spark rebellion over time?
Both the philosophers and the scientists still have a lot of work to do.
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