“A recent survey of North American males found 42% were overweight, 34% were critically obese and 8% ate the survey.”
Banksy
“However gnawing a deficiency, satiety is worse… We are meant to be hungry.”
Lionel Shriver
“Telling a fat person Eat less and exercise is like telling a boxer Don’t get hit. You act as if there’s not an opponent.”
Tommy Tomlinson
Last week’s blog mentioned that Phyllis and I had lost some weight. I received several requests for an explanation as to how intermittent fasting works. I will oblige them in the following paragraphs. I must warn you, though, that it has been 55 years since I started my medical education, and I still have not found the answer to obesity. Whatever I tell you must be assigned to the realm of well-informed
opinion. If there were an effective cure, I would not be writing about this, and you would not be asking questions on how to deal with it.
Remember that our primitive ancestors were hunters and gatherers. They almost certainly started out as gatherers, because it is much easier to hunt in groups, and it took hundreds of years for primitive humans to accept this rather obvious fact. Ancient man and woman lived off bugs and berries. If snow fell, they went hungry for a while. Same for flash floods, or strong winds. Those who were good at
storing what little they ate in the form of fat survived in larger numbers. We must accept that there is a good chance that we share those genes. We used to call it “metabolism,” but what it really means is that we are good at turning any excess food we eat into fat.
When we fast blood levels of insulin are negligible. Insulin is a storage hormone. After you eat a Twinkie your insulin levels rise almost instantly. The sugar in the Twinkie is pushed into muscle tissue. Some of it goes to supply our brains with much-needed energy. The leftover sugar is turned into fat by our liver. It follows that one way to minimize fat storage is to avoid foods that provoke insulin release, or to avoid eating altogether.
Low-carbohydrate diets, such as the Atkins diet, keep insulin levels low. There are numerous studies that show that people who adhere to this regimen lose weight. Although it is logical to assume that people with high cholesterol levels should avoid meat and eggs, paradoxically eating only bacon and eggs for breakfast will not increase your cholesterol. It will drop your triglycerides. Apparently, it is the pancakes and gravy (or syrup) that you eat with your big American breakfast what provokes weight gain and high lipids.
Drawing on this fact, dietary experts have tried intermittent fasting to induce our bodies to burn fat. I have read about two regimens:
- Fast every other day and feast the rest of the time.
- Fast for 17, or 15, or whatever number is popular, hours every day.
Most people find less inconvenience in eating a regular breakfast, a large lunch, and fast from 3PM until 8 the next morning.
The problem is: there is no magic attached to any of these regimens. If you gorge yourself twice a day, it is very unlikely that you will lose weight. If your exercise consists of reaching for the TV remote when you get home from work, you will not lose weight. If you adhere to the Atkins diet religiously, but you eat two pounds of ribs and six eggs every day, you will remain overweight.
The second of the quotes above is true. We are meant to be hungry.
It becomes a matter of realizing and accepting what kind of relationship you have with food. If you think of a large slice of apple pie as a reward for a job well done (like getting a raise at work, or passing a difficult test), you will have a heck of a time keeping your weight down. Food cannot be a reward, regardless of the many times that your parents presented it as such. Food is sustenance. Admittedly,
there are some ways to prepare food that make it a great experience to partake of it.
That brings us to Step Two: portion control.
I remember that after my mother placed a large plate of food in front of me, she sat across the table to watch me eat. Once I had cleaned my plate, she would tell me that it was such a pleasure to see how much her food was appreciated. By the time I was eight
years old I was obese. Many of the neighborhood kids did not know my name: I was “el gordo.” Look that one up. Of course, my mom thought I looked just fine. Many years later, when I told her how hard it was for me to be made fun of, she still told me that I had never been a fat kid.
The psychological damage that is done when people look down on and make fun of you because of your looks is devastating. To the point where people begin to believe that being fat makes them bad persons. They tend to give up on trying to solve their problem.
Peer groups are important. Once I treated a gentleman who weighed 320 pounds for knee osteoarthritis. When I suggested weight loss, he sneered at me. He explained that he was the skinniest member of his family. His parents and siblings were way heavier than he was. There was no way, in his mind, that obesity could explain the knee pain that he experienced.
Spain has a much lower rate of obesity in its population. Unfortunately, as average income increased, and people could afford to buy cars and reside in suburbs far removed, childhood obesity became a problem. This has happened all over the world. We have reached the point where the number of overfed people exceeds those who have too little to eat.
There is no shortcut. It took you months or years to gain that weight. It will take you as long to lose it. You will be hungry. Get used to it. I promise that you will not starve. You must move. If you hate to walk outside when it is cold, turn on your stereo and play something catchy. Dance. No one is watching.
There are strong anti-inflammatory effects associated with fasting. It follows that certain foods make you more likely to get sick. Try eating less. You will feel better. You will not be tired most of the time. You will need to take less medicine. It will become easier to laugh, even to make fun of yourself.
Your choice. Find a new normal way to eat, so you can enjoy the time you have left. It will not be easy: you are heading into the ring to face a heavyweight, and he will land some blows. They will not kill you. Breathe deep; meditate. You would not dream of treating the people you love the way you treat your body. We must learn, before it is too late, to love ourselves.
It is the only way.
