A new approach to the topic of obesity is necessary for the modern world.
Let’s start this article by saying what obesity is NOT.
Obesity is NOT a moral failure, obesity is NOT a weakness of character, and obesity is NOT a lifestyle choice.
Stay with me here.
Obesity also is not a number on a scale.
What is obesity?
Obesity is related to pathophysiology.
“Obesity is an exaggeration of normal adiposity and is a central player in the pathophysiology of diabetes mellitus, insulin resistance, dyslipidemia, hypertension, and atherosclerosis, largely because of its secretion of excessive adipokines.”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104148/
To say that body fat is valuable for humans is an understatement. Fat in our bodies is extremely necessary for survival, let alone healthy normal function.
Benefits of fat:
* Fat is important for survival during times of starvation or under-nutrition.https://pubmed.ncbi.nlm.nih.gov/9376885/
* Fat storage and distribution is linked to onset and maintenance of menstruation, mate selection and sexual signalling, and with favorable pregnancy and lactation outcomes.
* Work metabolism, bone health, immune function, and energy balance are related in functionally beneficial ways to fat content and distribution.
More benefits of fat:
- Essential fat is in your brain, bone marrow, nerves, and membranes that protect organs.
- Supports normal temperature regulation
- Hormone levels
- Vitamin storage
With inadequate fat, your health will suffer.
Without any fat at all, you will die.
So yes, fat and the balance / distribution of fat is extremely important.
Obesity relates to the type of fat and how fat cells interact with the immune system, causing inflammation.
Updated approach for treating obesity published recently in the CMAJ, August 2020.
Recently, the Canadian Medical Association Journal published updates to their guidelines on obesity and it made international headlines around the world.
What’s different about the Canadian approach?
For one, it says that doctors and practitioners should ask permission to speak to patients about their weight, thus getting consent and buy-in. That is literally the first step — take the unique, individual patient and treat them as a person first.
Ask, “Would it be alright if we discussed your weight?”
If consent is given, then assess their goals. Many people have had past goals or have current goals so it is valuable to know where they are coming from.
Understand what matters to this person.
Focus on patient centered health versus weight loss alone. Treat the root causes by supporting the foundations of health.
Promote healthy food choices, utilize evidenced based nutritional therapy and engage in one hour of exercise, most days of the week.
I don’t think that we can expect doctors to be experts in nutrition because they already need to know so much clinically. While I do think that registered dietitians are the most legitimate nutrition professionals out there, I also think there is a lot of room for others to promote healthy lifestyles in the name of service.
For example, while I am not a board certified R.D., I do believe strongly that I can provide effective nutritional therapy services as long as I make no claim to treat obesity. My education focuses on identifying nutritional imbalances and promoting normal function of all systems while being a supportive presence.
With obesity on track to reaching 50% of the population in coming years, it’s clear that we need all the help we can get.
Agree on goals; collaborate on a personalized, sustainable action plan.
This is where the patient becomes empowered. Now the opportunities lie within them. It won’t be easy, but it will be worth it. Even trying and failing has its benefits. Effort is what you can control.
Assist with drivers and barriers
I’m not exactly sure what the drivers and barriers are, but they are likely unique to the individual. For some, it could be mental support, for others it could be financial barriers to healthy food.
People need to know that somebody is on their side. People also need to do it for themselves instead of others.
Some people will be driven to lose weight in an attempt to look better — but will they be healthier overall? It’s a valid question.
Other people will be driven to lose weight to appease their family members or other influential people, but will they be happier?
It’s okay to admit that you might be sick and accept that it is okay to be sick.
If it takes me 15 years to admit that I’m an addict, that’s 15 years I could have been using to get help or accept healing. Part of the shame is that I have a self-concept where I want to project an image and present myself as a successful, wise man who has his life together and that was just making it worse because it made authenticity impossible.
The shame surrounding sickness must be overcome by accepting that it is okay to be sick. It’s not your fault. And even if you are sick, you are still a whole person and that’s what matters most.
Forgiveness is a true path towards healing. You can forgive yourself for eating a pint of ice cream. Even more challenging is to forgive other people for shaming you and making you feel bad about your body. It’s so hard to let go of resentment and yet letting go of resentment opens up life-changing healing opportunities.
Focus on non-scale victories and reinforce your own positive virtues.
I detest the way that seeing the numbers on a scale can change the way I feel about myself even though nothing changed except that the dial moved a certain way. So I stopped weighing myself.
When you do something that is virtuous, then you have overcome the grasp of vice — if even only for a moment. Start with a minute of virtuous behavior daily and then over time, you can fill your day with virtue. As a result, you will likely serve the community and make the world a better place.
When you feel better about yourself, it is much easier to eat those unexciting vegetables waiting for you in the fridge.
You’ll never be another person, but there is already a version of yourself that is doing the things that you want to be doing.
I use this as a mental exercise. All you have to do is imagine a version of yourself in some parallel reality living the life that you want to be living. What does that look like, what does that feel like? The more you envision this version of yourself, the more you will be able to manifest it into your own reality.
Pain is inevitable, but suffering is not.
We need to experience pain because of the valuable feedback that it provides. If something is hot, you won’t want to touch it for long because the pain lets you know that it will burn you. When you emotionally eat the ice cream, the pain lets you know that something wasn’t quite right there. It’s useful to fully experience that pain, instead of drowning it out with instant pleasure or substances.
Pain is informative.
On the other hand, suffering is something that endures because we want something that is out of our control. We suffer because we become attached to an outcome that never becomes a reality. We suffer because we take life for granted.
In order to heal the suffering, you can consider what actually is in your power. You can get up and go eat the dang vegetable. That’s something you can do. Even though you can’t take a pill and magically be lean, you can still do something. You can walk up the stairs of your building. What can you do?
When you focus on the things that you can actually control, you inspire action.
You take a step towards your ideal self.
There is no easy answer.
Even if you only lost 10 pounds, but your health drastically improved, wouldn’t that be a success?
I wish I had all of the answers to helping people live healthfully in their own bodies. I will never give up and I will never stop in my mission to serve you, even if I doubt myself.
We only get this one life, this one time.
Let’s honor that.