How Do You Solve A Problem Like Obesity?

It's time again for the annual ranking of states by percentage of the population that's obese. Typically, this is reported with breathless headlines like "Fattest State!" or "Is It Time for (insert state name here) to Go on a Diet?" The story dominates the news cycle for a day, as horrified newscasters show disturbing images of overweight people (zooming in on their midsections, of course). The concern lasts all of 24 hours before we all move on to the next looming crisis.

Here's what I'm wondering, though: if the statistics are so disturbing (and yes, I think they really are), shouldn't we focus our time and energy on trying to do something about the problem instead of wringing our hands and shrugging our shoulders helplessly? I need to add a disclaimer here: I'm one of the statistics, because I'm overweight, too. So I say these things as someone who is fully aware of the problem, because the problem is me. Still, the numbers I'm reading are certainly something to be concerned about. My home state of North Carolina, for example, reports that 28.3% of the adults are obese, and 33.5% of the children are either obese or overweight. Those stats represent a rank of 12 and 14 in their respective categories. I'm struck by the fact that 1/3 of our children are overweight or obese, and nearly as many adults are obese. That, by any definition, is a lot.

The study outlines a number of areas for concern, and several are worthy of note. Anytime we talk about obesity, we tend to quickly focus on weight, and particularly diet. A study like this has the potential to serve as a wake-up call, but only if we look at all the pieces. What I mean, I guess, is that the solution to a problem like obesity, particularly where children are concerned, is bound to be complicated. We won't be able to decrease obesity levels quickly or easily. That's not to say it can't be done, however, or that we shouldn't try. Anyone who's been successful at losing weight can attest to the fact that it's possible, and that it's worth it. But if we really want to do something about our national obesity problem - and it really is a national issue - we have to think broadly. Obesity isn't just about the food we put in our mouths. It's about how we take care of our bodies; how we think about health care. Are doctors the people we go to in a crisis, with whom we rarely interact otherwise, or are they the ones we collaborate with in order to reach a better, healthier lifestyle? At a time when the economy is suffering, how do we think about where and how we spend our time and our money? Do we go for the easy, cheap options, or do we think beyond the processed food choices so readily available to us and search out other possibilities, such as buying from local farms? Instead of spending inordinate amounts of time glued to our TVs, computers, and video games, or riding in cars to destinations we could easily walk to, do we make an effort to spend time being physically active each day - and trying to set an example for our kids and families?

We didn't get to this point in our lives quickly, but through a long history of choices we make individually and corporately. That also means we won't make changes easily, nor without a concerted effort. But it is possible; I truly believe that. I think it starts with 2 important steps: first, by the choices I make as an individual to lead a healthier, more active life; and second, by talking about those choices with the people around me, in an open conversation about what our shared goals are and what we can do together to make things better for all of us. That's how we can begin to solve our obesity problem, with small steps made consciously.

Is Red Meat Really That Bad for You?

It seems like there's always some new warning about something we need to avoid eating. A recent study continues that trend, with the results showing an increase in the risk of death from cardiovascular disease and cancer among those who ate more red meat. I'm not sure if that's such a big surprise, since we've been told before that there are heart risks related to eating red meat.

To me, though, there were a few interesting items of note from this study. First, in spite of all the money that's been spent on "The Other White Meat" advertising campaign, pork is still considered red meat, and that means switching from beef to pork doesn't necessarily reduce your risk. Second, it wasn't only red meat that caused health problems in study participants: those who consumed processed meat products like cold cuts and hot dogs (including reduced-fat hot dogs) saw an increased risk of mortality, although the risk was slightly less than those eating more red meat. Third, I was surprised by the amount of red meat considered to be a risk: about 1/4 pound (or 4 ounces) daily.

I'm generally not a big eater of red meat, but that doesn't mean I'm off the hook completely. For one thing, I do eat some, and the message from this study is for me to pay attention to that "some" and make sure I'm within healthy limits. I'll also confess to enjoying the occasional hot dog, and I had convinced myself that by buying the reduced-fat version, I was okay. I don't know that I need to swear off hot dogs completely, but I do need to pay attention to how many I eat, and how often I partake.

I also believe there's a helpful message here about portion control. What I know about nutrition is that a serving of meat (or protein) should be about 3 ounces. That's not too far off the 4 ounce red meat threshold in the study. But honestly, how many of us really limit our meat portions to a mere 3 ounces? (For reference, that's about the size of a deck of cards, or the palm of your hand.) A lot has been said and written about increasing portion sizes, but consider the size of the last steak you ate and ask yourself: was it anywhere close to 3 ounces? I'm not one to advocate swearing off red meat completely, or at least not for everyone. Each person needs to make his or her own choices about what and how much to eat. And there are some nutritional benefits to red meat, including B12 and iron. But on the other hand, there certainly are benefits to using more plant-based sources of proteins (like beans). Swapping out beans or other legumes for meat (even white meat like chicken breasts) can improve your health as well as your budget, since you'll most likely save money by buying less meat.

For me, I don't know that there are easy answers. I definitely need to pay more attention to portion size, both in terms of red meat and everything else I eat. I also could stand to look for ways to cut back on the amount of animal protein I eat overall, since I know it would help both my diet and my wallet. I think that ultimately it comes down to balance and moderation. I don't know that it's possible to eat perfectly all the time, but if I eat pretty well most of the time, I think I'll be on the right track.

Paying Our Way to Better Health?

The state of North Carolina announced recently that it was considering a change to how much its employees will pay for health insurance premiums, and the potential change has caused quite an outcry. The basic problem with the state employees' health insurance plan is that it's losing money, and the primary reason is that it is insuring too many sick employees. The costs are high enough that younger, healthy employees can often find cheaper insurance for themselves and their dependents by opting for private insurance.

The solution, according to the state: charge higher premiums for those employees who are smokers and those who are overweight. Not surprisingly, the suggestion met with almost immediate opposition. How could the state know which employees smoke on their own time? And how would they determine if an employee was overweight, without raising enormous privacy concerns? I'll leave the debate about insurance costs for smokers for others, but I am curious about the notion of making people pay more for insurance because they weigh too much.

Obviously, I've had my own struggles with my weight, and my bias would generally be in sympathy with the overweight. It is an interesting conundrum, though. The reality is that for the most part, people who weigh more also have more health problems, including issues like diabetes, heart disease, and breathing problems. Those health issues often translate into higher health costs, so the insurance companies and those who provide insurance (both government agencies and private employers) have a vested interest in how the health of their employees translates to the bottom line. At the same time, it's hard to avoid the sense that people are being punished for something that may or may not be within their control. In this particular case, the standard for being "overweight" which would trigger higher premiums equated to weighing 35% more than normal (and I recognize that "normal" can be difficult to define). The state would also provide a method of exemption for those who are medically unable to lose weight. Still, it does raise the specter of a clash between our public and private lives, where our employers would be interested in the number on the scale, and would be able to, in essence, reach into our pocketbooks to make us pay the price for our unhealthy choices.

And that right there is the main issue, as far as I'm concerned. What is the right approach to encourage people to strive for a healthy, active lifestyle? It seems to me like this is basically a "stick" approach; in other words, punishing people for not eating good things or being physically fit by making them pay more money for health insurance. But I have to wonder whether a "carrot" approach might be more helpful. I'm not sure if I want to advocate for paying people for good behavior. But I also might be more motivated to lose weight if I knew that doing so meant a financial payoff in the form of perhaps a cash bonus or a rebate on my health care expenses. Maybe that's greedy or mercenary of me, but I'd prefer to think of it as being practical. If there's a tangible benefit to staying on the straight and narrow when it comes to eating healthy - money, in this case - then I'm much more likely to stick with it. The end result is the same: I'm healthier and don't need to visit the doctor as often, and that's what will make me and my health insurance provider happier - and maybe even for some of the same reasons.

Staring Down Temptation

I typically spend my lunch hour in our company's break room. What can I say? I'm too cheap to eat out every day, and it's better for me to pack my lunch and exercise some control over my meal planning. It's not a bad place: there are tables where I can sit and read, write, or watch the news on the nearby TV, and they recently painted it in what I believe is supposed to be a cheery shade of yellow (but instead is so bright that it only serves to keep me wide awake - which may be the point, I now realize).

But I digress. I spend parts of many workdays in this room, and I'm starting to think it may prove to be my dietary downfall. The culprit? Vending machines, with their bright, shiny exteriors, luring me with a veritable plethora of beverages and snacks. The chocolate I'm trying to wean myself from? Taunting me from across the room. Potato chips? Winking at me from their place on the rows and rows of choices.

It's like driving by an accident on the highway: I try not to look, but I can't help myself. Yes, I can, I tell myself, trying a pep talk. I have nice, healthy snacks at my desk and at home. But the treats look so good, arrayed in the display case in all their calorie-laden glory. Colleagues line up to make their selections, exchanging their coins for the promise of quick energy and comfort food. I could just go with the flow and join them. But no, I have a nice salad waiting for me at home, along with yummy leftovers from last night's Mexican fiesta (otherwise known as a burrito). What time is it again? How many hours until I'm far away from this Shangri-la of sweets? I change seats, moving farther away from the temptations and facing a different direction so I don't have to see them. I distract myself with a book, and within a few minutes, I've mostly forgotten about the chocolate. Crisis averted, at least for the time being. Now if I can just avoid the 75% off Valentine's candy at the grocery store...

So Far, So Good

I'm 4 weeks into my attempt to get back on the healthy eating wagon by doing the math. The plan seems to be working, since I've lost 4 pounds in the first 4 weeks. That's actually 1 pound short of my goal of 5 pounds per month, but I'm counting this as a success anyway.

What I've learned so far:

- As expected, the first couple of weeks were the most painful. I went from eating whatever I wanted whenever I wanted to being hungry all the time (and more than a little cranky). The hunger pangs have finally tapered off now. While I'm still often hungry and craving things I can't let myself eat right now, the fact that the pounds are starting to come back off is helping my motivation level.

- Weekends, when I'm home and around food more, are hard when it comes to avoiding temptation. I need to do 2 things: first, use a more structured approach in planning my meals on the weekends instead of grabbing snacks here and there; and second, get out of the house more so I'm not around food and tempted so much.

- Food in social situations can be difficult to manage. Whether it's a family dinner or a visit with a friend, I know there are times when I'll have less control over what my food options are. I don't want to be anti-social, so I need to be willing to make a compromise once in a while and make up for it later. If I want to think about this as a long term plan, then I need to find a way to handle these kinds of situations. Otherwise I'm never going to get completely off the diet merry-go-round.

Here's to the next 4 weeks!

Saving Calories, Not Dollars?

In addition to eating better, this month I'm trying to keep an eye on my grocery budget (like many people, I'm sure). I'm starting to wonder if following a healthy diet and spending a reasonable amount on food are mutually exclusive goals. I bought a bunch of produce (fruit for snacks and salad makings), and that alone was about half of my weekly budget, which didn't leave a lot of room for anything else. It's frustrating to think that I might be able to eat more cheaply off the dollar menu at the fast food joint than I can at home or by bringing my lunch to work.

I think part of the problem is that I don't always buy seasonally. What I mean is that, according to what I've been reading anyway, I should buy the fruit that's in season right now (say, citrus) rather than the grapes and cherries I love. But it seems like whenever I buy the things I think I should be eating rather than what I want to be eating, I end up not eating the "shoulds" and going back to the store for the "wants." And clearly that's not saving me any money, not to mention it's incredibly wasteful.

There has to be a compromise somewhere. First off, I'm not advocating visiting McDonald's for lunch and dinner every day (although I might be tempted). I'm willing to perhaps pay a little more to be healthy. I do think there's a way to buy the things I know I'll eat and be smart about it. Buying on sale is a good start, and trying some seasonal produce can't hurt now and then. It seems to me that it eventually comes back to moderation (there's that word again). I can splurge on a healthy item or two I want and know I'll eat, while being careful about my spending on the rest of my groceries. Life's all about trade-offs, I think, and I'm willing to give a little on the grocery budget here and there if it means I'll make good choices about what I'm putting into my body.

Going Bananas?

There's a new diet craze that's apparently sweeping across Japan: the bananas diet. As I understand it, the idea is to replace breakfast each day with bananas and water. The diet has become popular, at least in part, because of a celebrity who has lost weight on the plan. Somehow it all feels familiar. Almost like every other fad diet I've heard of. I seem to recall a grapefruit diet; wasn't that supposed to be fat-burning or some such thing?

Here's my frustration with these diets: they promise great results, usually quickly, and sometimes they even deliver. But they're not sustainable for the long term. Think about it for a minute: do you really want to eat bananas for breakfast for the rest of your life? Or even for several weeks? And that's the problem. I need a plan I can stick with for a long time to come, probably years. I need a lifestyle, not a diet. And I need at least a little variety. Bananas are just fine, and there are some great nutritional benefits to including them as part of a larger healthy diet. But as far as I'm concerned, this bananas diet is nothing to go ape about.

Five Years Later

It was 5 years ago today that I started on this journey toward a healthier life. I was seriously overweight, with sky high cholesterol, and it was a visit to the doctor (and those scary numbers) that prompted me to do something about all of it. It's been a hard road at times, and not always a straight path. My weight has bobbed up and down, and right now I'm not where I want to be permanently. But I'm nearly 80 pounds lighter than I was 5 years ago, and I think that's something to celebrate. I'm also capable of walking a heck of a lot farther than I did then. That first day I'm not sure I even walked a mile, and today I went for a total of over 5 miles. I've also completed 5 half-marathons, something I never dreamed of when I was overweight.

I did it all one step at a time. And I think all of us who love walking do that every day. One step, then another, until we get where we're going. The journey never really ends, so instead we keep putting one foot in front of the other, walking toward a healthier life.

Who Knew?

A funny thing happened at work the other day. We have a communal candy bowl that people fill up from time to time. I found a sale on Easter candy over the weekend, and combined with some coupons I had, I was able to get several bags of candy for free. I brought them into work to fill up the candy bowl. I know of one or two other people who are also trying to eat healthy, so at the last minute I threw in a box of low fat granola bars I had at the house. I added them to the bowl along with the candy, but I figured the granola bars would still be around long after the candy had been eaten. By lunchtime, though, I was surprised to see that they were gone, and several people asked where they came from and commented on how good they were. Who knew? I had no idea anyone else would eat them. Just goes to show me, I guess, that there are a lot more people trying to be healthy than I realized. I'm planning to bring more granola bars to work today, and now I'm thinking that my next big contribution to the candy bowl will be healthy snacks instead of candy.

So here's to tryng to eat more healthfully, even at work!

Back in the Saddle... Again?

Well, I got some not-so-great news from the doctor on Friday: my cholesterol is back up, way up, close to what it was 3 years ago when I decided to get healthy, lose weight, and start walking. All this despite having lost 90 pounds (and kept most of it off for 2 years) and working my way up to walking 20-25 miles per week.

The moral of the story? Diet matters. I admit it; I've been bad about my diet. I convinced myself that I could eat semi-healthy: low fat and low cholesterol some of the time; high fat stuff a lot of the time, and not just during the holidays. Not exactly practicing what I've been preaching. It's frustrating, because I feel like I worked awfully hard, and I don't have a lot to show for it. Sure, I've lost a bunch of weight, but to see the cholesterol numbers almost back to what they were in the beginning feels like a slap in the face.

So what to do? I don't know if I can go back to the life of deprivation I used to lead. But at the same time, I can't keep doing what I'm doing if I want to get - and stay - healthy. Moderation has never really worked for me (despite the fact that I tell everyone else to do it). I'm sort of an either/or kind of a person: either I'm totally disciplined and healthy in my eating, or I'm off the charts with high fat junk. I can't seem to eat just a little bit of the bad stuff once in a while but keep on track with a healthy diet the rest of the time.

It's the reality I don't want to face: I have to go back to the low fat, low cholesterol diet, and sooner rather than later. This time, though, I have to commit for the long haul, and look at this as a lifestyle change and not a temporary thing I have to endure. Somehow, I have to find a way to make this work for the rest of my life, and I'm not sure that I know yet how to do that. Meanwhile, I'll do my best to plug along, one day and sometimes one hour at a time, trying to make changes I've made before, only this time doing it for keeps. So come January, I'll be among the hordes promising to eat better and be healthy. Only for me, I'll know that it has to last more than a few days or weeks. I have to do this for real, for a lifetime, and most of all, for me.

Wish me luck!

Peggy

Staying Healthy in the Holidays

It's a challenge for everyone: how to stay healthy and active during the holidays. Thanksgiving week can be difficult for those of us who try to make good choices about what we eat. Here are a few things to keep in mind...

• Go for the healthy alternatives. Try to load up on fruits and vegetables, as well as whole grains.
• Turkey is actually a good option; it generally provides lean protein. Well, at least without the gravy :-).
• Don't make yourself crazy by depriving yourself of treats. Simply aim for smaller portions of things like desserts and heavier dishes.
• Try to incorporate some activity into your holiday celebration. Round up the family and go for a walk if the weather's nice. This can be an especially good option between the main course and dessert.
  
• Above all, enjoy the holiday. Appreciate the time you have with family, friends, or even restful time by yourself, depending on your circumstances. Thanksgiving only comes once a year; make sure you take advantage of the chance to have some fun!

The things I like to remind myself of, particularly this time of the year, are balance and moderation. Enjoy the things you like, hopefully in smaller quantities. And balance the good food with fun activity to get your heart moving. Your body (and maybe even your family and friends) will thank you for it!

Happy Thanksgiving!

Peggy