Obesity Is The New Smoking

            

She wasn’t supposed to have a heart attack.  I mean, she was only 42, but the EKG didn’t leave anything to the imagination.  There it was, clear as day, an elevation in the ST segment, a STEMI in doctor jargon, a classic sign of a heart attack.  She didn’t need this right now, with the new job and all.

            Even though Carol was not the classic heart attack victim: relatively young, female, normal blood pressure, she was 35 pounds overweight, had increased inflammatory markers and a lousy family history.  She is a perfect representative of the new wave of cardiac patients that are literally reducing the lifespan of US citizens for the first time...ever. 

            And one of the big culprits is excess weight.  A whopping 74% of adults over 20 are either overweight or obese.  Excess weight is a precursor for a variety of problems including type 2 diabetes, hypertension, fatty liver and senile dementia.  Obesity is the new smoking when it comes to public health issues. The successful anti smoking campaigns of the 70s and 80s reduced this form of slow suicide fairly successfully, and there was a corresponding drop in deaths due to cardiovascular disease. However, with the rise of obesity and weight issues, the likelihood of heart attacks and strokes also increased, to the point of offsetting deaths from cancers and other maladies.

            The most frightening statistic is that much of this rise in heart disease is in younger folks, mostly women.  Elevated body fat creates a number of scenarios that lead slowly to heart problems.  Elevated blood sugars and increased inflammation set up a process that ultimately results in blocked arteries and disease.  This doesn’t happen overnight.  Carol didn’t just wake up one morning and have a heart attack.  The process had been building for years.  With 45% of children being overweight, and 70% of overweight kids becoming obese adults, it easy to track why younger and younger people are experiencing problems.  The damage begins early.

            The good news is that if the weight issue is addressed early, the less damage is done.  And this is truly a case of it’s never too late.  Studies indicate that losing weight and adopting a healthy lifestyle with exercise, no smoking, and healthy eating can actually reverse damaged vessels.  

            So why is losing weight so hard?  Because in many instances it’s not so much about the weight but everything surrounding the weight.  By that I mean your stress level, how well you sleep, your home environment, social interactions and stories you tell yourself about your abilities. Nutrition and activity level are, of course, important, but weight control is much more complicated than simply calories in versus calories out.

            Michael Jordan, even at the height of his basketball superiority, had a coach.  He knew a fundamental principal about human nature, we have a hard time seeing ourselves. A coach can look from the outside, see things we miss or ignore, and make suggestions as to how we can better achieve our goals.  So it is with weight loss.  A trusted coach can be the key ingredient in any program and the difference between success and frustration.  As a bariatric trained physician working with hundreds of folks losing weight, one thing I can say with great confidence is that if you want to lose weight, working with a knowledgeable, caring partner will increase your likelihood of success immensely.  This is not where you want to “pull yourself up by your bootstraps” because those straps are likely to snap leaving you frustrated, confused, and probably at the same weight.