Monday, July 13, 2009

The Big Fat Lie

I devoured it. I couldn't help myself. I tried to stop, but it was a futile effort. I just couldn't seem to get enough and I wasn't about to put it down. I'm referring to the powerful book, "Rethinking Thin", By, Gina Kolata, a writer for the New York Times. I found the book at once fascinating and disturbing. I don't often tear through books like I did this one, but once I started reading, I couldn't stop. Within a days time I had read, "Rethinking Thin" from cover to cover.

The premise of the book was very interesting to me because it delved into material that was touched upon in my college nutrition class. Years ago, there was a study conducted to discover what is the more effective route to fat release; a low-carb diet, or the typical low-fat approach. That study was very limited and in the end confirmed what we as intuitive eaters already know. Neither approach is ultimately effective, with any pounds lost quickly being retrieved by their owners.

This book follows a control group recreating the same study for a longer duration of time... two years. There were also more individuals involved in the study this time. There was much speculation surrounding the first go-around of this study. The goal was to definitively confirm which approach was more effective by concentrating on certain factors that were not addressed in the last run of the trials. What an unfortunate set of circumstances it was for all those who eagerly participated in the study, including the doctors, obesity researchers, and counselors provided to help the dieters through the process, to arrive at much the same conclusion as the last time. In the short term, both approaches were on par in terms of effectiveness. Long term results proved disappointing with all the individuals beginning to regain their hard lost weight. Some were able to salvage a few of the pounds they had peeled off. On average, this amounted to approximately 10% of the dieter's starting weight. Thus, the conclusion was reached that obese individuals can only hope for a 10% reduction in their current weight at best and society as a whole should work on fat acceptance.

To read information like this as an obese woman was extremely disappointing. I live life in a super-size body. I know personally how physically uncomfortable it is to lug around these extra pounds. When you are so heavy that it compromises the quality of your life, it is a bitter pill to swallow that the best you can achieve is a 10% reduction. For many of us, that is a mere drop in the bucket. While such a reduction may improve our health on a marginal level, it is hardly going to transform the quality of our lives. However, inquiring minds want to know and I could not help but ask myself, "Could this really be true, or is there a missing piece to this puzzle?"

The rest of the book was peppered with an in-depth history of dietary fads. I was amazed to discover that even intuitive eating is a concept that is being revisited. A man by the name of Horace Fletcher first introduced this approach to the world in 1899. In fact back then, if you were eating when hungry, eating what you wanted, eating with awareness while chewing your food slowly, savoring every bite, and stopping when satiated, you were said to be Fletcherizing. It is amazing how all of these approaches to food and bodily concerns have been recycled time and time again. I was enthralled reading about the history of dieting and body image concerns. Like the women of today trying to morph themselves into the likeness of the fashion models strutting the catwalk, or the Hollywood starlets making their way down the red carpet, the women of the early 1900's were corseting themselves and going through torturous contortions to emulate the image of the lithe Gibson Girl. The Gibson Girl by the way, being a fantasy... a product of the artistic mind of, Charles Dana Gibson, who gave her life when he first sketched her. Women have been at war with their bodies for as long as there is documented history.

I used to be one of these women. I wanted to shape my body into an image completely unrealistic for me. I longed to be one of the svelte girls, but that is not my body type. I've always been a curvy girl, ever since I hit puberty. There is a natural soft quality to my body. It is something I have fought for years. However, I have learned through trial and error that you can't fight Mama Nature. I have also learned through intuitive eating to make peace with where I am at. I am comfortable in my skin. I don't define my worth as a human being according to the size or shape of my body. I know that I am so much more. However, I also want more for myself in this life than existing for the rest of my days as a morbidly obese woman. The aesthetics aren't my primary concern, though I would be a liar if I were to say that I don't want to look my best. Although, I have come to realize that my personal best is unique because my body is individual. Being our best selves is not about looking like carbon copies of the celebrated body ideal at the moment, which by the way is fleeting. It is about being in a healthy space where you have a vitality that allows you to experience life fully. I cannot say that I have acquired that yet.

Sure, I've pushed myself out of my comfort zones. I go to belly dance rehearsal and devote myself to my craft, but I am limited in how far I can progress. I get worn out moving this body around. It's work, and at the end of every day, my back, knees, ankles, and feet remind me of the burden they carry. This is the aspect of being morbidly obese that has hurt me most... being restrained from pursuing my passions, most of which have a physical component. There are many hikes this body can't endure. There are times I have to beg out of activities that I used to love, but now, simply don't have the endurance to handle. Additionally, it is frustrating that every time I have visited my doctor with a sport injury; of which I have obtained many over the years trying to move this plus-size body in the manner I used to; I have been informed that I will likely end up in this same injured place until I have released more of the weight that is bearing down on me. My bone frame is slight and not designed to carry this load and as my doctor has explained to me, the weight is creating too great an impact on my frame which is causing misalignment. Certain bones are being pushed out of their proper positioning. Initially, I felt hopeless upon reading the scientific studies of obesity researchers that have been widely shielded from the public that were included in, "Rethinking Thin". Why would the studies be kept out of the public eye? In the end, it comes down to a business decision. The information obesity researchers have come across and have been aware of for years would not be popular in this diet-saturated market.

One such obesity study was prompted by the results of research that was looking into whether obese individuals were consuming higher quantities of saturated fats, as opposed to their naturally thin counterparts. What was unearthed was surprising. The researchers did not merely rely on the dietary reports of the obese individuals involved in the study because there would have been an inherent margin of error due to lack of consistent, factual disclosure. To prevent such inconsistencies, they actually examined the fat tissue of their obese subjects. It was discovered that not only are obese individuals not getting more saturated fat than the naturally thin across the board, their fat tissue was also radically different from those in standard weight ranges deemed as healthy.

The fat cells of an average sized person are compact and small in size, whereas the obese individuals had enlarged fat cells that were abundantly plentiful, greatly out-numbering those of the leaner persuasion. This information prompted Jules Hirsch, of the Rockefeller University Hospital, to conduct a study of his own. Hirsch was curious what effect weight loss would have on the fat cells of obese individuals. He wondered if there would be a decrease in fat cells as they dropped weight, as if they never existed in the first place, or if the engorged cells would merely deflate like an empty balloon.

A control study was formed involving four subjects who had struggled with obesity since childhood. They were to remain in a control environment, living at the Rockefeller University Hospital over a period of 8 months, during which time, they would be put on a stringent diet. First, the case study subjects went through a four week period where their basal metabolic rate was assessed. Then, for 4-5 months, the subjects were put on a rigid 600 calorie medically supervised liquid diet while remaining at the treatment facility. Following this period was a maintenance phase where the subjects were put on a dietary regimen to sustain their new lower weights. The subjects did release weight... 100 lbs. on average. However, disappointingly all of the subjects quickly regained all the pounds they had so suffered to lose, even with the maintenance plan in place.

Hirsch conducted this same control study many times over, trying to ascertain what was going awry. Why were these individuals experiencing this rebound weight gain? Sadly, for all the numerous times this study was tweaked, reformed, and conducted again, the result was the same. The obese subjects always had the fat quickly pile back on. One interesting development came out of all this research. Metabolic shifts, psychological conditions, and stats in the form of temperature and pulse had been monitored throughout the study and this brought some interesting information into the light. The common thread running between the obese subjects is that they all felt a powerful biological drive to eat after their weight loss; a drive so strong that the sheer force of their will could not overcome it. Their eating resembled the pattern of those in a state of starvation who were finally fed. This is what led to their subsequent weight gain.

This information caused scientists to believe that perhaps obese people just lacked will power and that they suffered from more of a psychological imbalance. However, this proved not to be the case. Psychiatric abnormalities were not any more prevalent in obese individuals than they were in naturally thin subjects. This was a turning point because finally, researchers were open to the idea that there may be a genetic component involved. This birthed the idea of getting naturally thin people fat in order to examine the physiologic changes that occurred in their bodies. It turned out to be a far more difficult task to get people recruited to become obese.

Eventually, they turned to prisoners. They felt they were the ideal candidates because they were in a controlled environment where they could be readily observed and would get limited exercise. They recruited naturally thin volunteer prisoners and set to work. They found it a challenging task to put weight on these individuals. Most did gain weight; an increase of 20-25% to be exact. However, it took 4-6 months to achieve this feat and some had to eat extreme amounts of food, up to 10,000 calories a day, in order to put on this weight.

From this study, it was clear to see that the bodies of naturally thin individuals are different from those of the obese. It was ultimately discovered that when the lean prisoners became fat, their metabolic rate increased by 50%. They were also extremely efficient at turning the extra fuel they were fed into lean muscle mass, as opposed to obese subjects who were efficient at turning over excess food intake to fat storage.

Some of the other information that was discovered by various obesity researchers was that in general, the obese do not tend to eat any higher quantities of food than the naturally lean. They also don't tend to have any more overeating episodes, or consume more 'unhealthy' foods than those who are thin. The final assessment of all the extensive research that has been conducted for decades now is that obesity is largely attributed to a genetic condition. In terms of weight release, obese individuals have the DNA cards stacked against them. On one hand, this points to the necessity for compassion on the part of society as a whole. The fat are considered the last acceptable population of people to discriminate against. This is evident in the way obese people are treated in our society. On the other hand, to hear that the best an obese individual can hope for is to release 10% of their weight seems rather dismal for those who suffer from this condition and experience every day the way it impacts their lives on multiple levels. But is it true? This question still hangs in my mind... provoking me to dig deeper.

Obesity rates have risen sharply since the early 1970's, particularly in America. This condition is now affecting our children, something that was rarely seen until recent years. The obesity researchers would have us believe that this is simply a case of genetic evolution. Does this even make sense? Evolution does not transpire overnight. This seems a flimsy explanation for the rapid spike in obesity we have seen over the past 39 years. Why is it then that this surge in obesity seems to impact Americans more than other populations, especially when our genetic heritage is so diverse? Why is it that countries that had relatively healthy profiles in terms of obesity rates are now seeing a rise in the incidence of this condition as Americanized food makes its way onto their soil?

I absolutely believe in the power of genetics. I agree that some individuals do have a tougher road to hoe in terms of addressing issues of obesity. However, I feel that the wrong questions are being asked. Why aren't these researchers asking what effect GMO's are having on us? Considering their infiltration into the American food supply in 1996, they seem a far more suspect source of concern than society as a whole going through a mass genetic evolution over the past three decades. What about all the man-made ingredients that are now in our foods... the high-fructose corn syrup, the trans fats, the multitude of preservatives and additives... so when you look at the food label it reads more like a science experiment than something edible? What about all the hormones and antibiotics that make their way into our food because they are being administered to our livestock? What about the insane break-neck speed of life that has caused stressed out families to rely on fast food, rather than preparing home-cooked meals in their own kitchens?

Doesn't it seem that we should be doing some research into what is going on with our food supply? Does this not seem logical considering how radically our food environment has shifted over the past 39 years? Don't we all deserve to know what is going on with our food? The food that we feed our families. The food that we put in our own bodies. I believe it is important to consider, but know that this is not an area that will be willingly researched because it is big business. It makes more economic sense for us to stay in the dark. A lot of major industries stand to benefit from our lack of awareness. It makes big business more money if we believe that the current rise in obesity is something we have to learn to live with and have no power over. After all, we have the experts we can turn to who will solve this problem for us, right? They'll perform their gastric bypass surgeries and have us pop a pill. Let us not forget that a large majority of obesity research is funded by pharmaceutical companies. In fact, when leptin was discovered, Amgen paid $20 million to Rockefeller University, where the research was conducted, in order to obtain the rights for pharmaceutical application. The current system is not set up for your empowerment, but for your reliance.

Additionally, if obese individuals are highly efficient at fat storage and the lean effective at muscle storage, does it not make sense to then work with the obese to help them create an internal environment that mirrors that of the naturally fit? Why not rehabilitate their biologic systems by helping them gain metabolically active muscle tissue through strength training? Viewing it in this light, it is clear how a genetic component does come into play. Unlike the naturally lean person, the obese individual will have to work a little harder by engaging in strength training in order to shift their metabolic profile. Does this make them doomed; only able to release 10% of their burdening weight? I beg to differ.

It also troubled me greatly that these obesity researchers arrived at these hopeless conclusions by putting individuals on what amounts to nothing more than a starvation diet before gathering their data. Of course someone who has been limited to a 600 calorie liquid diet for over 6 months is going to behave like a starved person when finally allowed the freedom to eat. This is a no-brainer. They acted starved because they were being starved! Of course the weight came rushing back on. These poor people had their bodies thrown into survival mode and biologically, their bodies had no choice but to store away in case of another food emergency. This isn't rocket science. Why is it so complicated to the 'experts'?

It got me thinking. Why haven't there been any obesity studies involving the use of an intuitive eating approach? What would happen if an obese person let their body lead the way in terms of when to eat, what, and how much? What would be the result if this was taken a step further and whole foods were utilized, while lessening reliance on processed foods, and incorporating strength training to bolster muscle stores? Would obese individuals using this approach be able to release their fat stores and maintain their improved body composition? I believe so. This is the basis of my decision to conduct my own 'case study'. I make an ideal test subject. After all, I am morbidly obese and have been so for over 10 years.

In order for my 'study' to stand up against the work of the obesity researchers, I would have to conduct it over a period of two years to demonstrate the effectiveness of maintaining the results achieved. Since I am on the intuitive eating path for life, I think I can devote two years to this cause. It is also more effective to have a study that includes multiple subjects. I encourage any other members who would like the opportunity to prove the 'experts' wrong and are willing to make a two year commitment, to step forward. I would love to gather my own 'case study' group. We could support each other through this process. I've already had one "Through Thick and Thin" member express a willingness to participate. Any other takers?

There has never been a documented study of the intuitive eating approach. I think it's high time there was one. Something needs to shift the present diet dogma. I personally look forward to debunking the big fat lie we have all been sold.