I attended a conference today about diabetes and obesity.

It was interesting, and one of the talks was about the prevalence of obesity in women of childbearing age and basically it was an overview of the obesity epidemic. The statistics are very scary. People are just getting bigger and bigger and it is causing all kinds of health complications that will create problems for future generations.

But, what made me mad was that the talk about obesity basically offered no solutions.

The main point was that "diet and exercise don't work," that "bariatric surgery is the only solution."

But recently, I've been giving a lot of thought to how people in the medical community talk the talk, but they don't walk the walk.

We wring our hands and talk about obesity, but we make absolutely no attempt to make common sense changes in our own environment.

For example, yesterday, I was at work, two hours into an on-plan day, when I ran smack dab into a party being thrown for someone on one of the units.

At 9:30 am, there were bagels, coffee cake, hot chocolate and whipped cream, waffles, and an enormous buttercream layered sheet cake.

I looked around the table at the fifteen to twenty people who were tucking into what amounted to 500-1000 calories worth of food-- I'm sure many of the people had already had breakfast.this was not a meal, it was basically an unplanned extra "snack." We were celebrating something. But was that really a good way to celebrate?

I just got to thinking about it. Almost every single person in that room probably had an overweight or obese BMI.

If we are ever going to get a handle on this obesity problem, then we, as a society, are going to have to decide that it's just not healthy to overfeed each other in the name of affection. Sure, you can pass up the cake and the bagels, but it's hard. Navigating my work day is a minefield-- I dodge between the cookie vendor whose smell permeates the hospital lobby and the seemingly constant round of celebratory cakes and pizza parties and people bringing in donuts, and etc.

I'm old enough to remember a time when doctors smoked and kept ashtrays in their waiting rooms.

I hope that ten years or twenty years from now, health care providers will not think that it's appropriate to serve thousands of calories worth of excess food in the name of "celebration."

Yes, diet and exercise are hard. But are we seriously committing to deciding that eating healthy is important? I'm not so sure.

I totally hear you! It's like the medical community just wants to prescribe drugs and medical procedures for things rather than good old healthy lifestyle. Nobody wants to take personal responsibility for anything - they just want to pop a pill to take care of it.

And as for food and celebrations, I work from home so I don't face that problem at the office. But whenever I go to visit family, it's like everyone has to make the most fattening version of the most fattening foods they can think of in order to make it "special" because we're in town. I mean, do we all have to gain 10 pounds every time someone comes to visit? Aren't there other ways to make people feel special? Food is not love, people.

Preach it, sister!

I've sat in a lecture where a surgeon said the ONLY way to lose weight permanently is through WLS.

And then there are:
McDonalds on hospital grounds
drug rep lunches and dinners
thank you donuts and cookies and cakes from families
parties for any and all other occasions

and, one of my favorites: a free cinnabon for nurses who go above and beyond.....

I whole-heartedly disagree. Just because some of us (like ME) cannot control ourselves, does not mean everyone has to stop celebrating life. We need to learn how to control our impulses. Most people eat something at a celebration and eliminate something else. Those of us with a problem usually eat something, something else, something else.....then go home and eat everything in sight.

I do not think NORMAL celebrations should be banned because some people (me!!) have a tough time dealing with it.

I kind if feel like there's two topics here.

1. WLS is the only way to lose weight being promoted by th medical community. Obviously I disagree with this as I and many others have dug in and done what needs to be done - a lifestyle change. It is quite frustrating though to see the numerous billboards for WLS.

2. Celebrating life with food. I'm not sure I have a real problem with this. What I have a problem with are the ridiculous portions that have become status quoe. I mean in all honesty, most things are just fine in...come on say it together - moderation.

You know, Monica, I WOULD have agreed with you a few years ago, and many people DO still agree with that kind of thinking.

But I'm going to go out on a limb here and say that I think that we need to really start thinking about what you just said.

Here's why:

Right now, in 2011, 2/3 of Americans are overweight or obese.

You heard me right: two thirds of Americans are overweight or obese.

So, it's not just "people like you" or "people like me" who have a problem controlling themselves. It's two out of every three people in the United States who are eating more calories than they need on a regular enough basis to become overweight or obese. That's MORE THAN HALF OF US.

That number gets bigger every year. That number has changed dramatically for the worse since 1994. Every single year more of us are overweight or obese. That is a fact that is well documented.

And the health consequences are staggering. It's scary. It's a public health catastrophe. Those of us who work in health care see those consequences every single day-- we see the prevalence of special equipment in hospitals to accommodate extra heavy patients. We see once simple procedures become complicated and dangerous due to obesity. We see people's health deteriorating and we feel powerless to help.

I think celebrating with food is a normal thing to do. But I'm almost fifty, and when I was younger, food-related celebrations were less common.

I'm not saying don't fix cakes and fancy food on holidays, but I'm saying that maybe we are celebrating with food too much.

As I mentioned, during the above mentioned butter cream cake eating extravaganza, I looked around the room (only doctors and nurses there) and noticed that only one or two of the people in the room appeared to have a normal BMI. None of those people needed to be fed a big extra meal at 9:30 in the morning.

Diet is hard. It's even harder when we are constantly being offered more food than we need, day in day out.

Two-thirds of us are losing the battle and that number gets worse every year.

It's time to really think about the this problem that we are all complicit in, and start to get creative.

ubergirl-I wholeheartedly agree!

I went to the movies tonight to see the one night premiere of the Run On movie. I ate no lunch so that I could indulge in some popcorn. I ordered a small popcorn and a small diet coke. The girl behind the counter spent several minutes trying to convince me to buy the larger sizes because, afterall, they were only a dollar more each, and more for my money. (Also more for my waistline).

Now, I realize that is what they're taught to do, it's part of their job description, etc., but this is an overwhelming theme in our society. I feel like we are caged bears in a zoo, being fed crap and in a kind of haze. So many of us just give up and roll with it. We need to break out of this. For the first time in our nation's history, our military cannot find enough young men and women who are physically fit enough (and not over the weight limit) in order to complete basic training. They are really struggling with this.

There are hundreds of examples, each a little worse than the one before. We have to break out of his haze and do this for ourselves and each other. Bravo for a terrific post!!!

2/3? I could have sworn it was more like 9/10 from the last time I visited home. Is it really mainstream now to promote WLS instead of advising a sensible diet and added exercise? I guess in my mind, WLS seems like a solution for people who have struggled with their weight for decades and decades to no avail, not for people who haven't tried to lower calories and exercise.

I agree with ncuneo and ubergirl that food as celebration isn't intrinsically evil, wrong or bad. It's part of every society in every corner of the world to host feasts and banquets when people win a battle, have a wedding, come together for holidays etc. The problem lies in turning EVERYTHING into an event to be celebrated involving food. How many times have you walked into work to be greeted by a dozen donuts for no apparent reason? How many TV shows have you watched where the main female character (always a thin, attractive person) cries after a breakup and eats ice cream? The link between "comfort" and "food" has become such that a person who eats a reasonable/modest amount of healthy food gets accused of being "anorexic."

I think about this every time I pack my lunch for work. Typical lunch for me is somewhere between 400-600 calories and fits into a small Tupperware or a Japanese-sized lunch box. I get anxious thinking about what people will say when I move back to the U.S. and continue to pack the same kinds of lunches. Will I be ostracized? Called out for humiliation? Told to "eat a sandwich?"

I wish more people knew about 3FC. There are thousands of success stories on here that might give them hope.

Celebrating with food is a tough one.

But I just wanted to say I was at the grocery store yesterday and a king sized twix bar was labeled as 110 calories with a VERY small (4 serving sizes / package) so ... 440 calories in a BAR of candy. That's 1/3 of my daily calorie allowance and wouldn't make ANYONE full but just craving MORE sweets. I picked it up just to show my bf how in the past I would have eaten this whole thing in one sitting as a mini-snack.

I'm not upset for myself because I do read labels now so if I ate the whole darn thing I can only blame myself but I think of kids who grow up without any health information. For me at one point junk food was like legal drugs, I was addicted beyond belief.

There is a "health" food craze going on but a big part of it feels like companies jumping on the bandwagon and exploiting people's weaknesses. It's not even THAT healthy half the time and multiple times more expensive.

A lot of this problem has to do with portion size. I was looking at the "cute" little retro bottles of Coke in the grocery store last week and DH told me that that is what the usual serving of soft drink used to be - 6 oz. Ditto cups of cofee, without all the latte, frappe, capuccino, etc. etc. stuff.

I baked muffins over Christmas and compared them to what are sold as 'regular" muffins in the store. Mine were 1/2 to 1/3 the size.

And what people perceive as one serving is also usually distorted. Take a bag of chips. The # of chips "per serving" is usually totally misleading, compared to the weight of chips per serving.

DH and I like chips. We counted out the # of chips per serving of a couple of our faves. Then we did servings by weight. The average serving by weight was less than half the # of chips the package said were in one serving.

And, barring any physical problem, IMHO most people can lose weight by exercising self-discipline, not by having an expensive surgery. Sure, the surgery is an "easy" fix. But it's not the only one.

And isn't it (mostly) much more satisfying to know that you created your new, much healthier body?

Dagmar

The problem is "normal" celebrations have become incredibly abnormal, and "learning to control our impulses" with sugar (especially combined with salt and fat), may be like learning self-control with "reasonable portions" of heroine. For some foods, there may be no "reasonable" portion.



We don't suggest that heroine, meth and crack be part of normal celebrations, and that people should learn to indulge in these substances in "moderation."

It may seem like an off-the-wall comparison, but it's not nearly as far-fetched as it sounds. A recent study found sugar more addictive than cocaine in lab animals. Not only did naive (untrained) rats choose sugar over cocaine - even cocaine-addicted rats chose sugar over cocaine.

We may be biologically hardwired to overeat some foods (foods that are normally exceedingly rare in the natural environment). Concentrated sources of sugar/carbohydrates, fats, and salt (and possibly even calories in general) are very rare in a natural world, and finding foods that combine all three (four) would be the equivalent of winning the ecological lottery. Studies of lab animals finds that most animals overeat this particular flavor combination. Something biochemically sends the message "Jackpot! This stuff is a nutritional goldmine, better eat as much as you can, while you can." The problem is we've engineered our environment to hit a jackpot every day instead of once or twice a lifetime (or never. I can't think of a single natural food that combines fat, sugar and salt).

Even singly, salt, sugar, and fat don't occur abundantly in the "natural" world, because competition for such resources is to great. Also the laws of nature (survival of the fittest, eat or be eaten) ensures overpopulation before widespread obesity.

We've altered our food to resemble very little that occurs naturally. Even our natural foods aren't very natural. Over relatively few centuries, we've bred more and more sugar and calories into our fruits and vegetables, and bred out more and more of the fiber. Even our whole foods, are less wholesome because of our preference for sweet, quickly absorbed carbs.

Until very recently in human history (the mid 1800's), sugar was such an exceedingly rare and expensive commodity that only the wealthy had any access to it at all - and it was treated like the precious substance that it was - kept locked in a piece of furniture designed to prevent theft. The housewife carried the keys with her wherever she went.

The thought of eating sugar every day, or even on a monthly basis (and by the poor) would have shocked our ancestors (even only a few generations ago).

I'm not saying that we need to ban sugar, but we have to learn to respect it's addictive and narcotic-like properties, and that included changing the notion that huge 1200 calorie pieces of cake and frosting icecream belong at every day celebrations (especially in a healthcare setting. Why not pass out cigars and vodka as well?)

If obesity rates were lower or equal to alcoholism and addiction rates, I would wholeheartedly agree that it's a "control issue." But less than 4% of our population is alcoholic, and yet 67% are overweight. That doesn't sound like a "just say no" problem, that sounds like a national health crisis.

It was easy to believe that I was lazy, crazy, and stupid - clearly defective in some way, but it's not as easy to believe that 67% of Americans are.

It's a wide-spread problem, and we need to begin looking to wide-spread solutions.

For myself, it doesn't matter any more. I've found what works best for me, and I'm confident that I will make it to my goal, no matter what anyone else does around me, but I'm shocked at how little we as a society value our health (even that of our young children).

I'm constantly shocked by what passes as a normal meal for even babies. Check out the baby food aisle some time and see how much of it is highly processed junk (with healthy sounding names). Check out a local school lunch program. I was impressed when I heard that school students needed to have 1.5 cups of vegetables in their school lunches - until I learned that most days french fries/tater tots made up most or even all of that 1.5 cups.

In 1972, when I was 8 years old (and joined Weight Watchers with my mother) I learned that potatoes, corn, and peas counted as breads/starches, not vegetables.

There's also the matter of the fat that comes with the school potatoes, even 1.5 cups of broccoli wouldn't be healthy if it came with the same amount of fat. You could dowse the broccoli in butter and not come up with the fat content of french fries.


95% of what we're eating, would have been considered "celebration-only" food even 75 years ago. We need to start celebrating a couple times a year, not with every bite.

Totally agree with this. Anymore we "celebrate" everything -- especially where I work. It's Friday! Yay! Donuts! It's Monday...Boo! Chocolates to make us feel better. Got that project done....pizza!

I'm constantly talked about at work (there's only three of us - I've heard them talk) because I don't join in the celebrations when they do. And it's a weekly thing, or more. Everything is about food, food, food.

I follow Dr. Barabara Berkely on this blog: http://refusetoregain.com/refusetoregain/ and she is on committee at hospital to change what they serve in their cafeteria and coming up against a lot of resistance to not offering junk food.

Years ago I noticed working in hospitals that were "the only game in town" that I could only make some pretty good choices but if I was working in a hospital in a city that had multiple hospitals to choose from they offered more junk food including fast food franchises as one of the counters in their cafeterias. Apparently part of their marketing plan to attract more patient families, employees who could choose another hospital?

The thing I keep thinking about is the amount of stress in peoples' lives. Do you think you are more stressed than you were 10 years ago? Do you think you are more stressed than your mother? Than your father? Than your grandmother?

I'm not saying that we have it harder than anyone ever has before -- especially in our affluent society -- but maybe we're subject to a different kind of stress & over a longer period of time now than what people have historically faced.

This is probably just the particular window I'm looking out of, but frankly, I do not see life slowing down or stress dropping over time. I just see a continual acceleration.

People aren't biologically built to withstand that pace. They just aren't. Our capacity is not limitless. We are not machines and we are not godlike and we are not evolving at a rapid pace to keep up with it.

I suspect obesity is part of the price we're paying for it. People are walking around with nerves jangled, feeling it's hard to keep up. More than ever, they need to be soothed & calmed. What accomplishes this -- quickly, quickly, because even relief has to be snatched quickly, between tasks?

So they keep grabbing at things that will keep them going. They want little moments of intense pleasure, to make up for all the demands on them, as a sort of private compensation. Little hits of oblivion & sensuality. In other words, they are seeking to be narcotized to get through this life.

And food is the easiest way. You get pleasure. You feel rewarded. You feel you've done something nice for yourself.

Think of it: Ask people what they do when they want to reward themselves for something.

How many people feel at a loss when told food is not an option? We see that a lot here. People lose weight, are happy, want to reward themselves. And are faced with having to decide what to do, since rewarding weight loss with food is sort of, um, counterproductive. And they just ... go ... blank.

One thing I am sure of is that the causes for overeating & obesity are myriad & complex, but I can't help but wonder sometimes if there is a general malaise in our society that leads to an unhealthy use & view of food.

Oh, Saef - you say it so well. I don't have the workplace issues, but at home, if something goes wrong, I have a cookie. If something goes well, I have a cookie. If I'm stressed, I have a cookie - it gives me a moment to pause and think while feeling "productive." It's so hard to find something else that is equally as pleasurable and rewarding as a quick cookie. If I could figure that out, weight control would be so much easier.