A weighty issue indeed

A weighty issue indeed
By Anne Moore
Copyright © 2009, Chicago Tribune
September 13, 2009
http://www.chicagotribune.com/news/opinion/chi-perspec0913fatsep13,0,6756160.story


Fat consumes 10 percent of our health-care dollars. That's $147 billion we spend, as a nation, treating diseases caused or exacerbated by too much fat on our frames.

We spend even more -- 50 percent -- on aging. But aging is natural. We fight it, we deny it, we postpone it. Still, all of us age and die: It's worth shelling out for a comfortable end.

Fat, on the other hand, is a preventable expense.

So for a nation roiled by the cost of expanding health care, a soothing solution presents itself: If we slim down, we'll need less care, we'll spend less money, avoid disease, and maybe even save our lives.

Know what happens to your body when it's weighed down by fat? After it settles in the usual places, like your hips or your butt or your arms or your gut, fat invades and settles in your organs. Havoc ensues. Hearts get too big, arteries clog, organs falter and then fail. Diabetes, stroke, heart attack, heart failure, some cancers: all caused by or linked to fat.

"We're not set up to store excess fat in a harmless way," says Dr. Robert Kushner, a professor of medicine and director of clinical programs at the Comprehensive Center on Obesity at Northwestern University.

Fat kills. And before it kills, fat makes you miserable. For every pound overweight, three pounds of pressure falls on your knees. Ten pounds overweight? That's -- ouch! -- 30 pounds of pressure. Twenty, that's 60. Fat puts pressure on your hips and lower back too. Joints become arthritic. "Pass the potatoes" becomes "Pass the ibuprofen."

Ignore the fat advocates: This stuff is deadly. And it costs all of us: Half of that $147 billion is paid by Medicaid and Medicare, funded by Social Security taxes. Disease and disability, prescription drugs, heavy-duty hospital beds, extra-wide wheelchairs, bariatric lifts, extra-wide cuffs to measure blood pressure: That's the cost of fat.

If we get the fat off and out of our bodies, we can get the fat out of spending.

How did we get so fat? Two-thirds of Americans are overweight or obese. Thirty years ago obesity was a blip, at 15 percent of the population. We're among the world's most educated people, and the formula for staying slim is simple: Calories in, calories out.

If we're so smart, why are we so fat?

Throw a dart, you'll hit a reason: fast food, skinny models, towns without sidewalks, excess wealth, urban poverty, working women, farm subsidies, sugared cereals, school lunches, high-fructose corn syrup, deep-fried candy, television, the Internet, desks.

Did my desk make me fat? Sitting too long at it played a part. But it's not my desk's fault I put on weight. It's mine, it's yours, it's ours. We got off the scale and turned a blind eye to the kinds and amount of food we put in our bodies.

We became a fat nation. Race, age, income, sex, geography; fat does not discriminate.

Should government fix our fat? Employers? Insurers? Should our sodas and bags of chips and candy bars be taxed?

I don't think so. We made ourselves fat, one by one, and we can make ourselves slim again, one by one. After all, we became a nation of savers again.

Last summer in New York, my sister turned to me and said, "What happened? You were always so slender."

My sister has the looks and manner of the actress Amy Adams in "Enchanted." Everything that comes out of my sister's mouth sounds kind. Hers was a statement of fact, delivered sweetly: I was fat.

When I got home to Chicago I resolved to become the slender person I used to be. How? I like to eat, and I cook for a family of five; a diet wouldn't work. A lifelong swimmer, I already exercise more than most people. I needed a plan I could live with forever.

Smaller portions, no seconds, more fruit, less bread and cheese, longer walks. (I hate running.) A friend's trainer told me to swim faster; I swapped sprints for laps.

I started losing weight right away.

It's been a year; I've lost 10 percent of my body weight and two dress sizes. Friends and acquaintances stop me all the time: "You're so slender!"

Would I have changed if my sister hadn't said anything? Maybe what we all need is a gentle nudge.

Dana Joy Altman, 44, is a slender beauty whose expertise is culled from daily living. She writes about food and markets and cooking on her Real Food Rehab blog. (Preparing meals at home is a key to weight management, studies show.) With beautiful graphics, and humor, Altman steers readers to affordable, quality ingredients. Those who need a push instead of a nudge hire her for a "pantry makeover" that includes shopping and cooking instruction. Chicagoan Leslie Bodenstein, 45 and lean, rearranges her own busy schedule to take friends and acquaintances to a Bikram yoga class. She's not a teacher; she wants others to experience a practice that results in well-being. So when she hears someone complaining about fatigue or poor skin or weight gain, she pipes up. She nudges gently, she says, but sometimes resorts to text messages. "Everyone has their excuses, but you've got to start."

To fix our health-care system, we have to fix ourselves.

So get to it: Declare yourself the "Biggest Loser" on your block, in your town, in your city. Dance your butt, your thighs, your back, your belly off. Join a friend for a walk, a swim, a bike ride. Cut your meals in half. Skip seconds. Spread the word: Fat kills.

Borrow my sister's sweet tone and turn to someone you love: "What happened? You were always so slender."

Anne Moore is a Chicago journalist.