The unbearable vulnerability of eating enough.
6 years ago
Tuesday, February 10, 2009
Not much to report from medical school lately. There's an interesting study described in the NYTimes about how "health scares reduce smoking but not obesity": http://www.nytimes.com/2009/02/11/health/11smoking.html. It's interesting how they ignore the obvious conclusion: smoking is a modifiable behaviour; weight isn't.
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Not only that, but it's not at all clear that heart patients who lose weight do better than heart patients who do not. Some studies actually suggest the opposite, in fact.
Losing weight is not going to change the condition of your arteries, and certainly not in the same way quitting smoking will change the condition of your lungs. In fact, pretty much no non-surgical treatment can do that; the best "behavior mod" and medication can do is to slow down the progression of further atherosclerosis. It can't even prevent more atherosclerosis from taking place altogether, because that's going to happen to just about anyone who lives long enough.
Changing diet and starting an exercise program might help, but that in and of itself is not going to cause most people to have major weight loss. And getting people with heart conditions to undertake drastic measures to lose more than their bodies want to give up is just asking for trouble.
Am I right, doc?
Oh THANK YOU. Seriously, I've been trying to rationalize to certain "health" fanatics I know why smoking is not healthfully equivalent to being fat. A few of these people claim that both display an "obvious" addiction (obviously). One is an addiction to food, the other an addiction to nicotine. Of course, I must have been lying when I told them that my boyfriend who's been told by his doctors to lose weight eats no more than I do (sarcasm).
I don't know...sometimes if I've been really sick I just go "Augh!" and the weight falls off.
If it's not obvious, that is dripping in sarcasm.
good luck. I left a career in medicine, and looking back now I think how helpful the HAES approach would have been in my daily practice. One model of health that is not fear-mongering and actually helps motivate positive behaviors would have helped. I didn't hear about HAES ever in med school. The treatment of children with weight concerns terrifies me. I believe there is absolute proof that when we put kids on diets it has negative consequences, and most often results in more rapid weight gain. Are you familiar with Ellyn Satter? I found her and it drove my career shift. Check out www.familyfeedingdynamics.com and my blog www.familyfeedingdynamics.blogspot.com I have lots to say about the conventional approach to "treating" obesity in children. Keep up the good work!
Joanne Ikeda asked that I make sure you know about ASDAH. (Association for Size Diversity and Health - an organization that supports HAES professionals.)
http://www.sizediversityandhealth.org
Have a nice round day!
Nicole Bliss
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