Thursday, May 20, 2010

Guest Post: The Real Cost of Being Overweight.

Thanks to Jackie Dee for the guest post.  I'll be back tomorrow with my usual nonsense.  Enjoy.

Andrew asked a few days ago for volunteers to guest post for him this week. I thought, as a dietetics/nutrition student studying to become a registered dietitian (R.D.), that I'd throw my hat in the ring and talk about something related to nutrition or obesity. Andrew gave me the go ahead, and I went into work Tuesday mulling the topic over.

When you work in a hospital, even as a lowly diet clerk (moi), you are sometimes confronted with death. It's sort of surprising, really, how invested you can become in the lives of those people with whom your life intersects for only a short time. The woman on bed rest with twins, the stroke patient, the guy recovering from surgery. And the severely obese woman with acute kidney failure. The one who died Tuesday evening.

I'd seen Celeste* a few times a week for the past month or so. She was just 50 years old,  with a sweet, breathy voice and pretty brown eyes. I often saw a young man visiting with her, himself painfully obese, who I assumed was her son. Lying in bed, unable to move, clean or dress herself, she relied on her nurses and caregivers for everything. She was on a strict protein count, not because they were trying to get her to lose weight, but because they needed to make sure her kidneys weren't further taxed by eating more protein than the organs could handle.

Her death surprised and shook me more than I would have expected, given that I barely knew her. As I walked past Celeste's room that evening on my p.m. rounds, I whispered, “I'm sorry” under my breath, knowing that this woman had died not from an aggressive pathogen or an unpreventable trauma, but from conditions directly and preventably associated with obesity. For the first time I truly understood obesity's cost.

I'd never really grasped what they (“they” being politicians, health care providers, etc.) meant when they'd talked about obesity costing this country millions in health care, or about how obesity leads to disease. I myself have been overweight nearly my whole life, but I've never been acutely sick. Many of us think only of heart attacks when we think of death related to excess weight but really, there is a laundry list of diseases and conditions caused by obesity. Most of them become progressively more damaging with time. Among them are:
                  hypertension (high blood pressure),
                  high cholesterol,
                  coronary heart disease,
                  chronic kidney failure,
                  obstructive sleep apnea (OSA),
                  degenerative joint diseases (osteoarthritis),
                  Type 2 Diabetes

We can treat the symptoms of most of these conditions with drugs or surgery; diuretics, antidepressants, insulin/metformin, statins, chemotherapy, antacids/PPI's, fertility drugs, bypass surgery, reconstructive surgery, etc., etc., etc.,  but at enormous cost to ourselves and our fellow taxpayers, and without addressing the root cause. But what if we never had to have these conditions to begin with? What could we possibly do to keep ourselves from getting this sick? The 4 little words that no one really wants to hear or heed (at least at the beginning of their journey): eat right and exercise.

I'm as sorry as the next person. I too wish that I could unlearn this truth but the fact remains that eating right and exercising is the best and most cost effective way to prevent or reverse chronic disease. No....seriously..... reverse it. GERD/OSA/Type 2 Diabetes/PCOS/high cholesterol/hypertension and depression can all be improved or even go into remission with significant weight loss. Even small changes have big impact. Did you know that exercise can increase insulin sensitivity in the body within 15 minutes?! Decreased insulin sensitivity is one of the hallmarks of Type 2 diabetes. Did you know that a weight loss of only 10% of body weight has a greater effect on lowering blood pressure than salt restriction or even drug therapy?

Unfortunately, I also know how hard it is to make the right choice. Remember, I mentioned being overweight myself? It's something I've struggled with for nearly 20 years, always thinking, “It's not fair...” while eating the better portion of a pizza for dinner, failing to grasp simple cause and effect.

However, becoming an adult means coming to terms with reality. The reality is that if I want to be healthy and happy into old age (barring catastrophic circumstances), I have to make the decision, or rather the commitment, every single day to get up, get moving, and consume foods that serve me rather than hurt me. The most wonderful part of this for me is that I LOVE food; every new texture, every new taste is an adventure and an experience for me. I've learned to love to cook, to cultivate food, to trace a food from the exact spot on earth where it grew to the plate in front of me. Learning about and experimenting with good food gives me such a high. On the other hand, motivating myself to exercise will, I fear, never stop being a struggle.

And that's where others come in. That's where this blog, this community of supporters, comes in. We all have our strengths, we all have our stumbling blocks, but we all need each other; to remind us of our goals, how far we've come, and what's really important,  because at the end of the day, at the end of a life, obesity isn't about any one thing, whether looks or will-power,  respect or cost, but about the quality and value of each individual existence.

*Not her real name