Health Care News & Discussion
The Obesity Epidemic
09/04/2000 1:32 PM
When I had my annual physical examination earlier this year, my doctor told me that I should lose 25 to 30 pounds. Having recently listened to an audiotape on the subject, I remembered that it takes 10-12 calories per pound to maintain one’s weight.
I calculate that my current diet was about 2500 calories per day. With one pound of body fat equal to 3500 calories, I knew if I removed a fifth of the food from my plate, I should then lose one pound a week.
I must have decreased my intake by more than 500 calories; in eight weeks I had lost 12 pounds and in 16 weeks I had lost 20 pounds. We then had guests and the process had to be delayed. It allowed my body about a month to readjust and gave my clothiers time to take in the waist on my slacks by a couple of inches. I will have no difficulty removing the remaining 5 or 10 pounds when I return from my summer vacation. Losing weight is simple, even if it isn’t easy.
Searching the archives in my study, I found an audiotape from 1985 titled, Diets Don’t Work by Bob Schwartz (Breakthru Publishing, $9.95). Schwartz owned 16 health clubs at age 30 when he put on an extra 40 pounds. Ten years and 100 diets later, he had lost more than 2,000 pounds – and gained back 2,001 pounds. He decided it made as much sense to study fat people if you’re interested in losing weight as to study poor people if you’re interested in making money. So he began to study the club members who seemed to stay thin without any effort.
He came up with a number of tips. Eat only when you are hungry. Stop eating when you’re no longer hungry – rather than when you’re full. Don’t dine out more than once or twice a week; restaurant food is usually higher in fat, calories and salt. Avoid sweet rolls, donuts, pastries, most desserts and candy.
He points out that people exercise for the wrong reason–to lose calories. Exercise is important in the overall health program, but it takes 30 minutes of aerobic exercise to work off 12 corn chips. Very few exercise enough to even work off one dessert. The slowest eater can eat more calories than the most vigorous exerciser can lose.
According to Schwartz, the diet industry was spending $33 billion in 1985 to convince us that the only way to lose weight is through dieting. He cited a statistic that 190 people out of 200 do not meet their first goal in the weight reduction programs. Of the 10 that do, nine regain the weight lost and only one of the 200 maintains the weight lost. This, he felt, proved that diet’s don’t work. The diet industry countered that all 200 had lost weight, 10 reached the first goal and, therefore, diets do work – it’s people that don’t.
I’ve had many patients who have joined various programs, lost an expected amount of weight and then are rewarded with a “decadent dessert,” which, of course, perpetuates the industry and keeps half of Americans overweight.
This idea was highlighted in a book which appeared about the same time, Does Dieting Make You Fat? by Geoffrey Cannon and Hetty Einzig (Simon & Schuster, $15.95). It pointed out that, all too often, dieting contributes to the very condition it is meant to cure. Many people think of diets as a temporary unpleasant experience before they can return to their previous eating habits.
More recently, patients turn to the web for diet information. Email comes in weekly offering free diets, how to lose weight while eating everything you want, or even ow to get paid for dieting and losing weight.
The Tufts University Health & Nutrition Letter, in a recent supplement, rated the weight-loss web sites. Of the free sites, Tufts chooses the easy-to-use “Shape Up America” site, www.shapeup.org, operated by former Surgeon General C. Everett Koop, MD, who also operates the fee-based “Shape Up and Drop 10” site. However, of the fee sites, Tufts recommends the “eDiets” site, www.ediets.com.
Brown University researchers found that people who had regular online interaction with a dietitian lost more weight than those who simply down loaded a weight-loss plan to follow themselves.
There is a lot of misunderstanding about diets. For instance, a retired bank executive recently couldn’t understand his 18-pound weight gain over the previous 12 weeks. He had obtained dietary counseling and was told that fruit was a free addition. We determined that the fruit he ate contained 750 calories per day, or 5300 calories a week.
Some people wonder how they are supposed to know what to eat if their doctor doesn’t tell them. So I gave my largest diet (2000 calorie) to one of my sleep apneic patients whose weight has always been above 350 pounds. Her initial response was that she doesn’t come close to eating that much. However, within one month, my scale weighed her at 344 pounds. I guess we’ll see if diets sometimes work.