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A sobering look at America's health

Over the weekend I watched several episodes of a very moving series called My 600-Lb Life. Each hour-long episode covers one year of the life of a person who is morbidly obese and their struggles to take that weight off. They work with a bariatric surgeon whose name I could not find on the TLC website, but his practice is in Texas. His name is difficult to spell and I want to get it right.

I watched all the episodes that were on the other evening because I was looking for more than just an exhibition or emotional porn, which you could say this series is. But I was looking for patterns, and I found some.

The first thing these people have in common--the most important thing--is their ignorance of nutrition. They do not understand what is and is not good for them; some of them confessed a "liking," not to say addiction to sugar and/or carbs. But if you have that kind of problem there are things to do about it. For example, some of the commercial weight-loss diets that send you prepared meals have gone into low-glycemic-index ingredients, which enable a person to enjoy their carbs.

Frequently I heard allusions, many humorous, to the fact that the clients know that some foods are not good for them. But like many Americans who are not as fat as they are, their understanding can be stated as: if it tastes good, it is good. But you can be sick even if you are not fat, and if your guide is to eat what you like, it would then become crucially important to understand what ingredients are in food and which are dangerous. The fact that conventional soda is both carbonated and loaded with high-fructose corn syrup is probably the most important thing to know about it. The HFCS has much more impact on blood sugar and sugar addiction than conventional sugar, and the carbonation wreaks havoc on your internal organs, bubbling all the way through your system right down to your bladder.

The next piece of the puzzle is so-called fast food. Not every client was eating fast food, though, and many of them depended on relatives to prepare food for them. This brings me to my opinion on why their doctor located to Texas to practice weight-loss medicine. The poorer and less-educated environment of the South combines with the fast-food emporiums to produce suicide-by-food. It may well seem to the people living in poverty-stricken states that they have little to expect in life, and little to lose. The Southern states fall into another pattern: that of receiving more money in aid than they contribute in tax revenue. Their elected representatives are caught up in obstructing efforts to rebuild the economy because of Obama Derangement Syndrome and the people who live in poverty today in America are also faced with congresspeople who simply do not care what they need, especially if it involves agreeing with the President.

When you look at one particular client of this program, it is absolutely chilling. He was a member of a family--in Texas--in which his father had died of complications from obesity. Then his older sister had died of the same cause. Now he was near death with extreme morbid obesity, and all the while his also-obese mother was cooking for him, and had been cooking for this family of doomed food addicts all along. The woman seemed to be at a loss for anything to cook other than what she must have grown up cooking. She was watching her family die, one by one, and apparently she had no idea of the contribution she made.

Of course she didn't set out to cook bad food, but she did enable them by encouraging them to eat anything, including fast food, without showing any desire to make a diet-oriented meal. And if she did somehow decide to do it, she didn't know how.

Never in all the episodes did I hear one of the clients opting for a salad instead of a sandwich. One woman I remember had finally switched to a fresh diet heavy on vegetables after her surgery, but before that she never considered ordering a salad at the drive-through, even though they are available.

The doctor reminds them and the audience continually that certain preparations such as deep-fat frying, and certain beverages such as regular and sugar-free soda, produce obesity. Once you go on a diet, you must eschew these things. It seems obvious to me that a burger on a bun, with catchup and mayo, would be an okay midday meal--just leave off the fries and soda. Get water instead and don't make it a habit to order super sized full "meals."

The clients are a cross section of the South in many ways, except that some of them come from other sections of the country, such as Maryland, where they fell into the pattern of substituting food for other comforts and found fast food the easiest to get. Not only can they get the food for themselves or from family members, they can of course order it out and have the meals delivered. When you are fat, tired and sick it does seem easier to feed your children this way.

This brings me to the doctor's term, "enabler," which he uses frequently to describe the people who cannot find a way to help their family member limit their food intake. Mothers, sisters and brothers keep asking if they would like more. They keep ordering fast food for the clients. They prepare high-fat and high-carb dishes, never offering a salad or even a banana instead of the fries.

You have to ask yourself how much you love the obese person if you cannot stop yourself from providing them with unhealthy food. What are you getting out of having this sick person dependent on you? What does it mean to you if they were to leave and get their own life? Many of the characters in this reality show are being forced to confront these questions as they find that the obese client is demanding help, not comfort. If they are unable to be helpful in whatever way, it is up to the client to distance themselves from the enabler.

This is also a hard situation that addicts have to deal with: the alcoholic often comes to the realization that a divorce is the first step towards sobriety. After a stint in rehab, the addict finds that the environment they were living in will lead them right back to recreational drug use or other addiction.

I watched these programs and realized how much some people have it in them to fight for their health and a normal life. They undergo multiple surgeries, spend time in hospital away from loved ones and in some cases seek therapy. I admire them for this. I have tried to rebuild my health from a complete collapse over acute pancreatitis; no matter how hard I struggle, my efforts are nowhere near as hard as theirs.

Drama queens, cowards or food addicts, they are an inspiration to those who see their struggles for what they are. After all, they could have kept eating and gotten sicker. They are motivated by their children, by the desire to live a normal life, by being "sick and tired of being sick and tired." I wish every single one of them the very best.

An unexpected postscript to this story came about when Manuel Uribe, who was once the heaviest human being on record, died the other day. He was only 48 years old and did not choose to attempt a gastric bypass or other bariatric surgery. He succeeded in losing a lot of weight, but one cause of his death was reported as possible liver damage, which prompts me to wonder what diet he was on. He did reduce his weight from 1,316 pounds, his record weight, to 869 pounds, the weight at which he died. That is a weight loss of about 400 pounds, which I cannot criticize. I am only sorry that he didn't do weight-loss surgery.

Uribe was much heavier than any of the clients on the TLC series, and the toll that weight took on his body ended his life. My ultimate response to this news is to remind myself, and everyone with health issues, that we are not going to be exceptions to the rule. People who eat unhealthful food will not be healthy. You can be thin and still have diabetes or high blood pressure. My health issues are never going to go away; the best I can do is try to control rather than cure.

Maintaining a healthy diet is, ironically, easier to do than sticking to a regimen of medication. Hard-boiled eggs, bran muffins, fresh fruit and coffee will help your health rather than hurt it. I don't know when the public will be liberated, if ever, from the propaganda of advertising from the food industry. Take care of yourself; no one will do it for you.

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