April 26, 2010:
Frances is trending:
"Lost Pounds Lead to Burst Fantasy" on msnbc. Here's my response:
The C.D.C. and other government institutions have declared a "war on obesity". I would propose an accord with maintaining. It is harder for a formerly obese person to maintain weight loss than it is to lose that weight.
Sadly, once obese, always obese. The deprived fat cells of a formerly obese person never go away; they hang out screaming to be filled up again. As well, I argue, no one becomes obese out of simple laziness or even genetics. Gain = pain. Part of the way many people deal with pain is by eating. A four-year-old doesn't go out and score crack and she probably doesn't think, "I'll go burn this off with a brisk walk around the block." She reaches for what is available -- food. Probably sugar and fat loaded food. That sugar increases both serotonin and the dopamine in the brain in EXACTLY the same way cocaine and morphine do. It makes that tot feel happier and calmer.
If this affect on the brain was grown in Mexico and came in powdered form, it would be illegal.
More significantly, however, is that that kid -- and all the adults battling the bulge -- probably have a deficit of both those brain chemicals that keep them emotionally balanced. Deprived of that, even with the help of anti-depressants, and past the excitement of watching the numbers drop off, when the going gets tough, most formerly obese people are going to eat because it restores that sleepy, satisfied downer that makes real life so much easier to take.
The reason I argue for an official pact with maintenance is that it's not only the last frontier (90% of all dieters will gain back their weight, and something like 95% of the regainers gain more) but it's applicable to everybody.
Maintaining 240 pounds is an incredible feat -- as difficult and praise-worthy as maintaining 130 pounds. It can only be done through old-fashioned methods (which include surgery, the success of which depends on the patient's adherence to a strict food plan) and maybe, for the 240-pound person, that breathing space of "hurrah! I haven't gained weight!" will allow for mental adjustments. From there, a slight tweaking will result in weight loss.
But who can blame the fat person for thinking life will be different? First readers scold the obese for bringing the insurance industry to its knees (which is nonsense) and then readers scorn the disappointments of all those government and media promises not coming true. Shame on you.
Self-motivation, not external motivation, is at the heart of creativity, responsibility, healthy behavior, and lasting change...