Sunday, November 17, 2013

Stop The Weight Loss Madness

This past week, I saw no less than ten patients who wanted to lose weight. Each described in their own unique way how the extra weight was contributing to some perceived problem they had with the weight's effect on their image, energy level, health, etc.

To each patient, I said the same thing. Stop focusing on losing weight and start focusing on what you can and cannot do to your body to help it function at its optimal level.  To each, I conveyed how the human body was developed over millions of years, with its most latest form, homo sapiens being around two hundred thousand years old. Over this period of time, human biology has evolved a full host of protective mechanisms to ward off disease. Of course, we all know these mechanisms sometimes fail miserably. It is very unfortunate when it does, and my heart goes out to those who suffer seemingly happenstance illness. Nevertheless, these mechanisms work for most and that is why the human body can usually protect itself fairly well against poor eating, lack of exercise, inadequate sleep, mounting stress, etc. for at least the first five or six decades of life.  It's not that damage isn't being done, it's just that the damage isn't always so obvious until later.

I often share with patients the story of the my growing up in Brooklyn, NY and how one day the red lights turned on in on the dashboard of my father's old car.  I share how my father drove it to a nearby gas station and spoke to the attendant and asked if he could help with the red light, to which he replied, "yes, I can disconnect it."  Now even to a young boy that was a ridiculous statement. Little did I realize that during medical school and my residency, my teachers and mentors would primarily educate me on how to turn off patients' red lights. As doctors have become successful in eliminating symptoms without addressing the underlying problem, akin to turning off a red light warning of problems, patients have been confused into thinking they don't really have a problem. A case in point is a patient this week telling me that he was very healthy with normal blood sugar despite the fact that he was a diabetic on high blood sugar medication and nearly morbidly obese.

For some reason, Americans seem to disassociate the reasons they gained the weight with the effects such reasons have on their health beyond the number on a weight scale.  They gain weight because they ate too much, they ate the wrong food, they barely moved, they slept poorly and were always hungry, etc. That is why I tell people to stop worrying about the numbers on the scale and to start paying close attention to the details of their lives. Although there is no perfect plan for staying healthy as the old Yiddish saying goes, mensch tracht un Got laft, men plan and G-d laughs, it still pays to plan. Therefore, by focusing on those elements of your life that you do have control over, you can shift the odds of staying and getting healthy in your favor. By doing so, one of the benefits is usually weight loss.

I have always believed that for virtually all problems, there are solutions.  Over the past three years, by investing the time and listening carefully to what patients are telling me, in partnership with them, I have helped them identify such problems and come up with workable solutions.  It has been a three year whirlwind and I am so grateful that I had the opportunity to so positively effect so many lives.  However, as clinically successful and emotionally rewarding this endeavor has been, the time has come for me to move on to my next challenge. I will always be grateful for all that my patients have taught me and the wonderful personal stories they shared.

I know that those who embraced my philosophy about taking care of the one body they had by eating healthy foods in moderation, avoiding unhealthy foods altogether to the extent possible, physically staying  active over the course of a day as much as possible beyond simply going to a gym for a specified work-out, improving sleeping habits, managing stress more effectively with good meditation and relaxation techniques, nurturing relationships and being grateful for the good things in life, have and will continue to reap great benefits from developing such good health habits.

To the rest of you I say, while good health is never guaranteed, a healthy lifestyle can shift the odds in your favor. Choices do have consequences so please choose wisely. Stop chasing weight loss like a lost puppy and focus on what really matters--your overall well-being.

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