At one time I weighed 225. I am a 5’8” female. According to my BMI dial, I fell into the category labeled the word we dare not speak. I now weigh 163 and the dial sits on the line between normal and overweight.
I don’t watch Mike and Molly. Two overweight people starring in a sit-com diminishes the serious nature of a condition that threatens world health. I wonder if all the time viewers are laughing are they becoming desensitized to the fact that these characters have health issues. In an era of political correctness, to describe someone as obese (There. I’ve said it.) might, by some, be called a hate crime. As a health care professional, failure to address a life-threatening health condition feels like a different kind of slight. Current media focus suggests our country needs a more open discourse about race. This nurse proffers it is time to have an open, pointed discourse about obesity and accountability of both the individual and the health care system.
Years ago I attended a seminar by Dr. Lawrence Barzune, a doctor at the forefront of bariatric surgery. In quantitative cause-effect terms he described the toll obesity takes on the body. Joint degeneration, skin problems, incontinence, and sleep disorders top the list of the most obvious problems. Consider that a pound of fat contains 7 miles of capillaries. If you are 100 pounds overweight, your heart has to pump that much more roadway. Your heart is almost running a 10K with every beat.
There is the school of thought that insists a person can be fat and fit. Perhaps that is true just as it is true that there are some people who are metabolically or genetically programmed for obesity. There are those who simply make bad choices. Either way people who are overweight confront unique and disabling challenges.
Perception of weight and size is like viewing the self through a maze of fun house mirrors. When I first gained weight, I lived a comfortable, busy routine of work and single parenting and never noticed how I changed. This is what I told myself. I wore what was comfortable: sweatpants, t-shirts, long skirts, and scrubs at work. I didn’t care what size scrubs they were as long as I could lift and bend without splitting the seams. Mirrors were not a part of my home landscape. I avoided weighing myself.
Having lost 70 pounds in six months, I discovered my perception of my body did not keep up with reality. I bought new clothes to fit the person I had been for several years and couldn’t understand why they were too big. A friend sent me one of her sister’s skirts, a hand-me-down. I took it out of the package and shook my head. Only a Barbie doll could wear that. The skirt fit. I began to try clothes on before I bought and waited for the mental “me” to catch up with the physical one. I put up the mirror that attached to my chest of drawers and saw a stranger.
Because of this body-image-perception dysfunction, I understand why a 300 pound man has no qualms about using me for leverage to pull himself up to a sitting position on the side of the bed. What I can’t understand is a middle-aged woman sitting at the bedside of her seventy plus year old mother being told a bigger bed is being ordered for her mother’s comfort, and without batting an eye, this same woman asks for a bigger chair because she can’t fit into a regular chair. The disconnection between mind and body prevents the daughter from seeing a very possible future for herself. Nor does she perceive the plethora of weight related complications her mother must overcome to recover from surgery.
From my personal experience, dieting represents a misnomer, a poor term when used in relation to weight management. Weight loss and concomitant health maintenance requires a lifestyle change that must become as routine and necessary as brushing your teeth. The goal must lean toward fitness rather than a number on a scale. The tools to accomplish the goal include commitment, diligence, and forgiveness. Commitment makes you integrate healthy choices into your daily life. Diligence inspires you to create a way of tracking your commitment be it a journal, meditation, or a support group. And forgiveness allows you days when you just can’t get it done without the guilt that might make you fall out of your program altogether.
Dr. Kenneth Cooper stated: “Fitness is a journey, not a destination. It must be continued for the rest of your life.” Weight control is just one leg of the journey.