Dr. Nemetz is the Medical Director of Affiliated Physicians and he is here to answer your questions and share valuable health information. Ask any health related question and your answer could appear in next month's wellness newsletter.

 

Obesity  

 

Part 1

I don't want to offend people. I'm sitting here wrestling with the idea of how to approach, from a medical standpoint, the subject of obesity. Americans as a group are definitely too fat. We know who we are.

 

How did this happen?

The Surgeon General's current report on obesity is a clarion call to think of our problem as seriously as a previous generation began to heed the original 1964 Surgeon General's report on the health hazards of smoking cigarettes. Our collective too-fatness must be thought of in the same category. Smoking peaked in the United States in the mid-1960s, when 42% of adults were smokers. That rate has dropped to about 20% today, and it's falling. We need to find a way to achieve a similar improvement in our obesity rates.

 

This is all from the current Surgeon General's report on obesity:

• An estimated 300,000 deaths per year may be attributable to obesity. (Cigarettes account for 400,000 deaths, out of an annual total of 2.4 million)
• Individuals who are obese (BMI > 30) have a 50 to 100% increased risk of premature death from all causes, compared to individuals with a healthy weight.
• High blood pressure is twice as common in adults who are obese than in those who are at a healthy weight.
• A weight gain of 11 to 18 pounds increases a person's risk of developing type 2 diabetes to twice that of individuals who have not gained weight.
• Women gaining more than 20 pounds from age 18 to midlife double their risk of postmenopausal breast cancer, compared to women whose weight remains stable.
• For every 2-pound increase in weight, the risk of developing arthritis is increased by 9 to 13%.

I have a few favorite theories that illustrate something of how we have reached this point. First of all, it is simply not normal, in the context of human history, to spend your entire lifetime living in a world where the food supply is completely unlimited, all the time. We are the last in the line of a thousand generations of people who survived to get to us. How did they do it? They survived by packing on fat when the food supply was plentiful, and then when there was a famine, they would shut their metabolism down, burn calories slowly, survive the period of famine, and then theoretically reproduce later on. None of us would be here if our ancestors didn't possess an efficient mechanism for banking calories, and we have it too.

 

But then what do we do if there isn't any famine anymore? In our modern world the food is essentially limitless, it's cheap, it's delicious, it's highly advertised, it's part of socializing, it's a great pleasure, it's deliberately packed with extra fat, sugar, and salt to make it "hyperpalatable" (from former FDA chief Dr. David Kessler's excellent 2009 book, "The End of Overeating"). In order to be at a medically favorable weight now, we have to somehow train ourselves to eat less than what our bodies are consistently demanding that we consume.

 

How?

 

Well, in Part 2, nobody asked for it, but I will share, yes, my dieting secrets. It could be titled "How I lost 35 lbs., without drugs, gimmicks, or liposuction (and you can too!)" I'm sure it would be published if only there could be a merger arranged between the New England Journal of Medicine and the National Enquirer. Until then, only Affiliated Physicians' readers are privy to such specialized content.

 

If you can't wait for next month, click here for Part 2.

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