Weight gain is not inevitable or uncontrollable

An op-ed column in today's News & Observer complains that the state health insurance plan's higher premiums for obese clients is unfair. It is, says the writer, "tantamount to charging employees for having a heart attack or needing chemotherapy." The writer assumes that people are powerless to control their weight, in the same way they might be powerless against a genetic anomaly that causes heart disease or a cancerous tumor.

It just ain't so. Although some people may be congenitally susceptible to putting on weight, they are not helpless against this predisposition. People who are naturally shy can overcome that tendency, and people who tend to gain weight can curtail their eating. Even if your body tends to convert calories into fat, it cannot do that unless those calories are consumed. People with weight-gaining tendencies can also counter this predisposition by burning calories through physical labor or exercise. As one ages, metabolism slows down. If you're eating as much at 40 as you did at 20, and haven't increased your exercise, you're going to gain lots of weight.

Among the hazards of unemployment, I was told recently, was weight gain. Jobless people tend to ease their frustrations and depression by snacking a lot. After a year of joblessness, I have had the opposite experience. I've actually lost about 10 pounds while unemployed — and not because I've quit eating.

What I have done is reduce consumption of prepared foods. When we both worked, my wife and I tended to eat instant meals more often — microwave dinners, fast food, hot dogs, etc. Since I have the time to cook, we've prepared more meals from scratch (or nearly scratch), and we've eaten healthier. We've also paid attention to portion size. I've also exercised more, by doing yard work, walking the dog and actually going to the gym (gym membership is one luxury I did not give up as we reduced our living expenses). As a result, I'm leaner and healthier and feel better (in part because job stress is gone).

Controlling weight is not easy. Fad diets won't do it. Intermittent starvation won't do it. A commitment to eat healthily, exercise regularly and avoid snacking as part of an overall lifestyle change will prevent the common pound or two or four a year weight gain over 30 years that most people experience as they age.

My challenge, when I get a job, will be to maintain my eating habits while working in sufficient exercise in a desk-job environment. It's not easy, but it's not impossible.

Catering to shoppers' obese tendencies

All the latest health reports agree that obesity is a growing concern in America. The Land of Plenty has become a land of lack of restraint and nonstop consumption. Earlier this week, RTI researchers reported that obesity adds significantly to the nation's health-care costs, which is a major concern as Congress attempts to create a universal health-care system. Obesity adds nearly $150 billion annually to health care costs, and obesity treatment's share of health care costs is growing.

Obesity is a two-fold problem: Over-consumption of calories and lack of exercise to burn those calories. Eating too much (especially of the wrong foods) and failing to exercise lead almost inevitably to unhealthy weight gains.

Lately, I've been wondering if society isn't "enabling" the plunge into obesity. Advertising touts the enjoyment of food. Restaurants serve large meals with double an adult's daily caloric needs (and all-you-can-eat buffets are even worse). City planning discourages walking and practically forces people to use cars to get to places. Children spend their days planted in front of a television or video game, often consuming snacks nonstop, resulting in a frightening spike in diabetes among children. Elevators discourage use of stairs, which are often hard to find. Too many people see abdominal fat as a normal and inevitable eventuality.

And then there are the electric-powered shopping carts. All the supermarkets, home-improvement stores and discount stores have them. Presumably, they are meant for disabled shoppers who cannot walk or who can't push a cart and wield a walker or cane at the same time. But I've noticed that most of the people who use these powered carts do not appear to be disabled except by their own weight. Packing on an extra 100 pounds certainly makes it more difficult to walk. Those pounds also put extra stress on hips, knees and ankles, leading to pain and, often, expensive joint replacements.

But here's the catch: the more you sit and the less you walk, the more weight you're going to put on. Providing electric-powered carts for people who need the simple exercise of walking only "enables" more obesity. Stores are not going to eliminate the powered carts, nor are they going to say, "Sorry, ma'am, but you need to walk; it'll be good for you," even if doing so would be in the customer's best interests. Losing excess weight is difficult, and the more you weigh (and the older you are), the harder it gets. It will take a lot of walking, plus some hard-to-muster self-restraint to work off 50 pounds. Nevertheless, walking when given the opportunity (in an air-conditioned facility with a level floor) would be a good, though not painless, first step.

Tobacco's nemesis sets sights on sugar, fat, salt

Several years ago, when Congress and the courts were cracking down on cigarette smoking, some defenders of tobacco warned that food would be the next battleground over behavior. They were dismissed with a chuckle.

They might have been right. Dr. David Kessler, who as FDA commissioner led the Clinton administration's fight against tobacco, has a new book and a new whipping boy: fatty, sweet food. Kessler was on NPR's "Diane Rehm Show" Wednesday and also was featured on NPR's "All Thing Considered" last week. Kessler claims America's epidemic of obesity and Type 2 diabetes is the result of deliberate, coercive and clandestine collusion by the food and advertising industries. In his radio interview Wednesday, Kessler portrayed American consumers as helpless and hopeless victims of this conspiracy to addict them to sugar, fat and salt. He compared the brain's reaction to sugar, salt and fat to its reaction to heroin or nicotine. Consumers are conditioned to eat unhealthy foods so that the big food companies, fast-food joints and expensive restaurants can make more money off of them as they addictively return for their sugary soft drinks, their fat-dripping bacon double cheeseburger and their fat-marbled steaks.

Stimulated by the release of the brain's pleasure chemicals and manipulated by devious advertising showing healthy, happy people having fun over their sweet, fatty food and drinks, consumers are unable to resist, Kessler claims. Consumers are not responsible for their own actions. They can't resist that chocolate-covered pretzel or that 24-ounce sugary drink. They are putty in the hands of Madison Avenue and the sugar lobby. The conspiratorial industries, not consumers, are responsible for America's health problems.

If this sounds familiar, it is the argument made in lawsuits against the tobacco industry: Its sly advertising and addictive nicotine left consumers no choice but to become two-pack-a-day smokers. Personal responsibility and self-discipline, whether talking about tobacco or obesity, are not part of the equation, in Kessler's view.

Kessler is getting a lot of attention with his book despite his difficult-to-swallow leap that sugar is heroin and fat is nicotine. His theory feeds on another addiction common in modern American society: the idea that individual responsibility is not a factor in life. If you can't stop smoking, it's not your fault; blame the tobacco industry. If you can't stop eating and gaining weight, food processors, restaurants and supermarkets must be conspiring against you. If you make bad grades in school, it's not because you failed to study or work hard; it must be because the teachers don't like you or the textbooks are culturally biased. If you're not rich but other people are, it couldn't be because they worked harder, had more talent or hit the market at an opportune time; the cards must have been stacked against you.

Personal responsibility: American society is against it, and Kessler's new book feeds the culture of denial.