Over the last 6 months or so, I have been battling a new phase in my life. It’s a deeply personal one, and I didn’t want to write about it here at first because it is so private and, frankly, a bit embarrassing. It will not be news to those that know me well, but I now have a few readers who don’t know me at all, so revealing something like this about myself in such a public place is more than a little scary. However, the more I think about it, the more I think I may be on to something here, something that has the potential to help other people: it seems I have to go public.
If you don’t have an issue with your weight or struggle to stop eating, this post will probably not be of much interest to you but, if you do, or you know someone who does, stick around[1]. Please bear with me, I don’t know how writing this is going to go but I’ll give it my best shot. It’s far too much to fit into one post, so this will be a serialization.
Part 1: Framing the problem.
I am a big person from a family of big people. My BMI has been hovering around 30 for ever and recently went as high as 32 (or possibly higher, I stopped weighing myself). You can rest assured that, as the fattest child in the playground, my school life was exactly as much fun as you might imagine. I don’t tell you this to ask for sympathy, but to explain that I’ve known I have a weight problem my whole life, and I hate it. I did not choose to be this way and, had there been a cure available to me, I would have taken it at once.
Wherever I looked the only solution I saw was the standard mantra of “diet and exercise”. I say “solution”, but our raising obesity epidemic makes it quite clear that it is not one; I don’t think I have ever met a single person for whom it has really worked. When I say “really worked”, I mean people who have lost all of their excess weight and then kept it off for the rest of their lives. You’d think that medically supervised diets would work better than most, but Dr’s waiting rooms are full of people who have not been able to stick to the scheme laid out for them; people who are being suffocated by their own bodies and who will die very young simply because of the food they have eaten.
I used to think that this wasn’t the real me and that one day I would find the key to solving the problem. I think that’s common; that there exists a thin person waiting to get out of every fattie is a cliche for a reason. The countless people who have already died from their obesity never found their inner thin person, so why continue to think that I would? I stopped.
I am not a yo-yo dieter; faced with the mountains of evidence that diets simply do not work and that oscillating weight can be worse for your long-term health than steady obesity, I chose instead to try and accept my body the way it was and get the most I could out of life. Those of you who share my experiences will know that sounds great on paper, but society makes it rather more difficult in practice. All the same, I avoided all diets until a routine medical check a few years ago threw up a minor problem exacerbated by being overweight and the Dr referred me to the dietician. I embarked upon a medically supervised diet, which worked for a while. I was utterly miserable and hated having to count every calorie and I resented the gym visits, but the pounds started to come off. I achieved a modest loss (perhaps 4% of my body mass) and then a hugely stressful event (writing up my PhD thesis) derailed my efforts. To my surprise, my new pizza and Dr Pepper diet did not cause me to balloon and I continued to slowly lose weight until the stress was gone. I maintained my weight until a new job in a new city left me lonely, unhappy and comfort eating. After about 18 months I realized I had put everything I had lost back on, plus another half stone. My first ever proper attempt at a diet and I had yo-yoed. I know I said I don’t believe diets work but still this came as a shock. This was no crash diet, I wasn’t following Atkins out of a book; I had been following a program recommended by a professional and still I had failed. I’d lost some weight, true, but it was a paltry amount. Anxiety had done far more to shift the pounds than the regime had and I hadn’t been able to stick to it once I was in an emotionally difficult situation.
You may say that it wasn’t the diet that failed, it was my will power[2]. You may well be right, but there is absolutely no doubt that I am very far from alone in my experience and if will power is the problem, it is one shared by every single fat person across the entire globe. If a diet regime is going to work, it needs to be realistic and to cope with emotional difficulties that lead to comfort and binge eating: this one didn’t and I strongly doubt that any of them do. I will be doing a review of the academic research relating to obesity and diet in a later post, so, if you are interested, stay tuned, but one thing seems clear: the medical establishment don’t know how to solve this problem either.
Lately, I have been following a new series on the BBC called “Big Meets Bigger”. It’s just one in a long line of voyeuristic programs that give us permission to be horrified by the eating habits of others. Don’t think for one moment that fat people don’t enjoy that sort of titillation just as much as everyone else. In fact, we may even enjoy it more because for us there is the added thrill of knowing “I may be bad, but I’m not that bad!”.
This sort of programming has shifted its emphasis since its inception ten or fifteen years ago. It is no longer acceptable to ridicule or bully the fat person (too many of us now have first hand experience of howthey feel), now the program is about shocking the participants out of their bad habits. “We are doing this for their own good” the programmers seem to say, “it’s ok to enjoy the guilty pleasure of enjoying an other’s misery because we are helping them”.
So here we have, once again, the all pervasive idea that people who cannot lose weight lack will power. After all, what is a shock tactic other than a way of increasing motivation? But fat people are surrounded by shocking truths, believe me. We all know we are giving ourselves an increased risk of diabetes, heart disease and cancer; we know we will struggle to have children and our quality of life will suffer; we know we are probably going to die young (some of us may already have lost family members and friends or be watching them suffer); we have all seen the pictures of 60 stone Americans who have become fused to their sofas and we know that, if we continue the way we are going, things are going to get a lot worse. Most of us also know the diagnostics as well as the medics do: we know a healthy fasting blood sugar (4 – 6 mM) and a borderline diabetic one (6 – 8 mM); we know that fat around your waist is far more dangerous than fat around your hips; we know what constitutes a healthy BMI (and ocassionally how to calculate it from first principals) and we probably know the calorie values of any of the foods you are likely to find in a run-of-the-mill supermarket.
I doubt many of us chose to have all of this information at our fingertips: it has been thrust upon us in an attempt to push us into changing our ways. It hasn’t worked. I also doubt knowing that information has directly led to the sort of permanent, life changing weight loss everyone (ourselves especially) would like to see for more than a miniscule proportion of overweight people[3].
So why is will power alone insufficient for pretty much all overweight people? I suspect the reason is that the vast majority of such people are actually food addicts. The title of this post should have left you in no doubt that that was the conclusion I was heading for, but perhaps you didn’t expect me to suggest that all overweight people fall into that category. The truth is they won’t, there are always exceptions to every rule and I have no idea what percentage of people who struggle with their weight are actually addicts but I am increasingly convinced that the scale of the problem is far FAR FAR more widespread that any one has so far suggested. We do not have a global obesity epidemic, we have a global food addiction epidemic.
The reason all these gluttons cannot stop eating is because we are asking them to leave aside their cigarette, or their crack pipe or syringe of heroin, or whatever addictive substance you care to replace food with in this analogy, and just sample tiny amounts of it once or twice a day. I defy any addict of any substance to exercise that level of will power; it is simply impossible.
If I believe it is impossible, then you may be wondering why am I writing this lengthy blog post that I said from the very beginning was the first in a series. Put very concisely, the reason is that I do not believe food addicts are addicted to all food, rather, they are addicted to a limited number of “trigger” foods. That changes the problem from an insoluble one to one that is merely very difficult. What I will be writing about in the future is very far from a quick fix, but it might just be a painfully slow one and, frankly, that is by far the best we have at the moment.
Good stuff – keep with it.
Bx