Treatises on fixing our Dysfunctional Relationship with Diet, Exercise, and Health

The Issues:

1) Mind
over Matter? As many of us know from
countless attempts to lose weight, only to regain it later, the goal of losing
weight and keeping it off is a very challenging one. For those who haven’t had to deal with
obesity, a very easy assumption may be to blame the dieter for simply being too
“lazy.” There are certainly those who
can overcome the desire to slack and keep weight off for extended periods, so
these exceptions to the rule are held up as the paragons that everyone could
and should strive to emulate. However,
despite the desire to simplify issues (which I’ll examine more closely below),
it’s not always simply a matter of personal responsibility or will power. This isn’t an effort to make “excuses” but to
look at the reasons why things have become so difficult. 

a. One
part of this is the so-called evolutionary argument that it is in our genes to
overeat whenever possible.  Hunter-gatherer ancestors dealt with a
constant threat of starvation. Up until
the agricultural age when humankind learned to preserve food with salt, and
eventually bottling, canning, refrigeration, vacuum packing and irradiation,
the only way we could “store” food was to eat it and have it accumulate in our
personal biological “stores” of fat tissue. Because of this, some would say, we are compelled to eat as much as we
can even though there is no threat today of starvation. Some of us have been able to override this
urge most of the time, but given the opportunity, as with the “all you can eat”
buffets, it can often be incredibly challenging not to stuff yourself.

b. Part
of this may be due to simply not doing it “right.” In other words, the effort to work hard at
losing may be there, but the results do not show. This may be because the dieter is doing
something that they were TOLD was the correct way to eat and/or exercise, but
it turns out to actually be deleterious to their goals.

c. Yet
another issue is societal and cultural realities. Current U.S. (and perhaps at least some other
westernized countries) suburban culture creates lifestyles that make it
extremely hard to eat healthfully and get a decent amount of exercise. The car culture of the U.S. makes regular exercise something
that one has to make time for instead of being an integral part of one’s day,
and the busy lives of many makes this increasingly difficult. The prevalence of fast-food makes it much
more appealing than the more time-consuming method of preparing one’s meals
from scratch from whole foods, and such meals are not readily available ready-made,
or when they are, they are considerably more expensive than the less healthy
alternatives. Finally, while we have
come to have a much greater awareness as a society of dieting these days, there
is still a great adherence to eating things based only on what tastes best
regardless of how healthy it is, and this can help erode the will of any
dieter.

2) Simplicity

a. We
crave simplicity – easy answers to complex questions. We hear about laziness a lot when it comes to
people not wanting to do the “hard work” of exercise and eating right that are
supposed to make weight loss possible. While there may be a very small subset of those who simply don’t want to
do anything “hard,” I think much more prevalent is laziness when it comes to
thinking about how to lose. Part of this
is an educational issue where people unquestioningly accept whatever crap they
read, whether it’s in a supermarket tabloid or the New York Times, without
doing any critical thinking of their own. Many simply don’t have the tools to go about such thinking, but others
do and simply decide to believe in one dogma or the other without questioning
it or trying different approaches.

b. One
Size Fits All – thankfully this attitude is slowly starting to change, but it
is still something that most people believe applies in one way or another. Certainly we can agree that there are some
universal truths that certain things are healthy for 99.9% of us and other
things are unhealthy for a similar percentage. But the field of genetics has shown us that people do metabolize foods
differently and have sensitivities and other issues particular to their
ethnicity/genetic makeup. Instead we are
given guidelines that are supposed to work for everyone. Even given one individual, they will react
very differently to the same diet and exercise plan at different periods
throughout their life based on many factors, such as how many times they have
dieted in the past, what kind of health issues they have developed or haven’t, or
simply their age. These concepts seem to
be too confusing for many, or at least those who write books or articles have
decided that they are too confusing, and so they dumb everything down into
simple rules that over time harden into unchallengeable “fact” when they are
really nothing of the kind.

3) Business
and Government

a. We
exist in a capitalist society where the “free market” reigns. Many of the large companies in such a system
operate with the goal to get bigger which increases their stock and makes them
and their stockholders wealthier. In
doing so, altruistic motives often become of secondary concern and then only
when they can coexist with the goal of making more profit. This situation can lead in more notorious
cases to companies like the cigarette companies that profit on the addiction to
harmful substances, but just as much to food and beverage companies that profit
on the addiction to sugar, fast food, and junk food. 

b. The
U.S. Government is seen by those on the right and the left as being a spoiler
in this area and others. For the right,
the Government should have no place in telling people what to eat or how to
spend their money. It should not be a
“nanny” because it should be up to the individual to exercise their free will
and be responsible for their own decisions when it comes to diet and health. For the left, the government is little more
than a facilitator for big food companies, giving them corporate welfare and subsidizing
huge factory farms that produce way more in the way of food then we can eat or
even give away to countries in need. The
smaller farmer interested in sustaining the land, producing a product that is
healthier and more humane, gets marginalized if not eradicated.

4) Medicine
and the Medical Industry

a. Pharmaceuticals
have become a huge sector of the economy and due to the realities of the
healthcare and insurance industries, the marketplace, litigation, and
government regulations; they have turned into monstrosities of a sort. At the same time that they create drugs which
prolong life for cancer patients, and even so much as cure other diseases,
their drugs are increasingly seen as not having been adequately tested. They basically bribe doctors into prescribing
as much of their drugs as possible with the unspoken threat that perks of free
dinners and vacations will go away without high enough sales numbers. They need these huge sales numbers in
combination with high drug prices that are ultimately paid for by health ever
increasing health insurance premiums and the government (and thus your tax
dollars), in order to make up for the huge costs of developing drugs and the
potential risk of having a dud, or worse something that ends up eventually
harming people and thus causing countless legal expenses.

b. Doctors
have been accused of not understanding nutrition, and not wanting to pressure
patients into eating healthy because they feel their pleas will be ignored. While there are certainly exceptions, many
doctors have expectations for patients that are so low, they would rather prescribe
drugs or even surgery over really urging a patient to eat better or
exercise. Their slavery to the
pharmaceutical industry makes it even harder for them to resist the temptation
to simply prescribe a drug for a given symptom. Many patients are afraid to do the hard work of figuring out what the
underlying cause of a symptom is and experiment with possible solutions
(although this is getting easier with the internet and being able to
communicate quickly with those who have similar issues), but doctors have much
more background in science that should enable them to do this work faster and
more efficiently. However, again the
realities of the profession mean that it is a lot easier and more profitable to
see a patient for a few minutes and sign a prescription for something that will
allay some symptoms for a while as opposed to getting to the bottom of the
problem.

5) Dieticians,
Nutritionists, and “Experts,” oh my!

a. Our
growing problem with obesity and obesity-related health issues has not only
created a huge market for what most recognize as the today’s charlatan snake
oil salesman equivalent of this diet pill or that fad diet, but it also creates
a market for those with more recognized certifications and ostensible respect
in the professional community. These so
called experts dole out advice with confidence and do this in the place of the
medical doctor who has largely given up this role.

b. Dieticians
and nutritionists, and even personal trainers have generally been giving the
public what they have been asking for. An expert to tell them what to do and how to do it. Unfortunately, these professionals practice a
“science” which is not hard and fast the way, say, physics is (quantum
mechanics not withstanding!). The
theories behind weight loss and healthy eating aren’t as simple as these
experts make them out to be. Very little
if anything has been “proven” in studies, but these studies all the same are
used as “proof” to back up the standard party lines. These lines become more solidified and more
rigorously defended over the years. As
it’s been said, if you repeat anything for long enough, it becomes accepted as
fact. When dieters follow the advice of
their “expert” but do not see any improvement, the patient is often the one who
is blamed for doing something wrong, or even for cheating. Even if the patient convinces their expert
otherwise, instead of causing the expert to question their foundation of
knowledge (assumptions), they patient is labeled an anomaly (usually
genetically speaking these days) and told to pursue a remedy in prescription
form. Since their standard advice is
useless and they cannot suggest something that goes against that advice.

Solutions

Ok, so, as
you can see, the situation is a complicated, convoluted mess. Can we make any sense out of it? As cynical as I may sound above, in the sense
of the upcoming New Years’ resolutions, here are just a few personal and
collective goals I can suggest. Some of
them will be hard, if not all but impossible but I don’t see anything wrong
with having such goals as long as there are others that are more achievable or
achievable faster. The harder ones give
you something to work towards after all the easy things are out of the way!

Suggestions for the
individual:

1) Stop
following and start thinking. 

a. This
really relates to a lot of the issues above. Really all I mean is to not just listen to what the so-called “experts”
are saying, but to do your own thinking. Think about what makes sense regarding what they tell you, and what
doesn’t. You’re smart enough and at
least have common sense to know that some things that “experts” tell you to do
don’t make sense, or at least don’t for you. 

b. Get
other opinions. Just as with politics, diet, nutrition, and exercise have their
fare share of differing camps. Low carb
vs. low fat vs. calorie counting, aerobics vs. weights, etc. Read about the different approaches, but more
importantly try them out. If something
doesn’t work, after giving it a fair chance, try something else. Is this going to be hard for some
people? Sure! But there are plenty of communities on the
internet that will help you understand the different issues. Instead of relying on a “expert” to tell you
what to do because that’s been drilled into them as a party line, talk to your
peers and ask them what works for them. Get suggestions and have a dialogue, not a one-way list of orders that
you can’t stray from at the risk of dire punishment.

2) Don’t
listen to the Government.

a. At
least don’t listen to what they tell you as far as dietary advice. Our society, economy, and government are
centered on money and commerce. Officials
rely on campaign contributions from wealthy individuals or large companies in
order to get reelected and so are lobbied incessantly and successfully by
factory farms and big food companies, and even by non-profit special interest
groups, who all have their own agendas. The part of the government that currently makes dietary guidelines (the
much-maligned food pyramid included) is the USDA. That is the US Department of Agriculture. Agriculture as in farmers. The USDA’s raison d'etre is to promote the
interests of farmers and the agricultural industry in the U.S. There seems to be an inherent conflict of interest here!

b. The
current administration is very pro-big-business at the moment and so they have
a bias towards promoting things that help those big businesses, whether they
are big food and beverage companies, pharmaceutical companies, or fast-food
chains. So we will necessarily see
recommendations and even laws supporting these businesses right now. That doesn’t mean you have to support them as
well.

3) It’s
not simple!

a. It’s
not all about weight. Most experts would
have you believe that weight is the paramount issue here, but that simply isn’t
the case. Excess weight may be perfectly
healthy if it is in the form of muscle and not fat. Most scales only measure total weight, at
least until recently, and that one measurement has also been simple and
convenient for the “experts” to obsess about. Body fat percentage is a much more telling measurement. Even with excess fat, there’s some evidence
to suggest that maintaining a steady, albeit above average weight (with that
excess weight being fat) over the long haul (especially if regular exercise is
part of the picture) is much healthier than gaining and losing over and over
even if half of your time is spent at some mythical “ideal” weight.

b. Don’t
let the scare tactics get to you when it comes to cholesterol. Very often doctors will urge their patients
to go on cholesterol medication because their LDL is too high or even just
their total cholesterol is too high. However, there are pleanty of layman, scientists, and even doctors who
have come to the conclusion that the current standard methods of measuring
cholesterol are at best misleading, and at worst completely meaningless. Given the risks of taking serious medications
like the cholesterol-lowering Statins, it’s extremely important to know whether
there is a really good reason to take these.

Suggestions for the medical
industry, dieticians, etc:

I’m not
sure whether such suggestions (even coming from someone other than myself who
has credentials and real influence) could ever affect significant numbers
within these professions because of the inherent forces within them that have
caused the current status quo. Perhaps
the only way of changing things in some cases would be to create competing
bodies or professional associations that could somehow challenge the more
mainstream ones. Such bodies exist
currently in some forms, but sometimes these have their own issues because they
are blinded by their own ideology as opposed to real science. In any case, here are my suggestions:

Look at
the opposing point of view and look at it dispassionately. Those in the medical industry are supposed to
be practicing science, but like scientists in other fields, a status quo is
developed and anyone who challenges the ideas of that status quo is ridiculed,
but, if their ideas truly have merit there may eventually be grudging acceptance
and finally adoption into the accepted tenets of that science. Scientists are supposed to weigh (no pun
intended) things dispassionately, but they are still human and as such
unavoidably have biases and turfs they feel they need to defend. The growing amount of litigation and cost of
insurance only make it harder for Doctors to go against the grain, and the
“standard of care” solidifies this practice. But I would argue that doctors also need to look really hard at their Hippocratic
Oath and ask themselves whether doling out pills and not suggesting anything
that goes against standard orthodoxy is really helping patients, and if it’s
not helping patients are you are in fact hurting them because you are
preventing them from getting the advice that really would help? 

Likewise,
nutritionists and dieticians need to look beyond their training which accepts
only a narrow dogma with little flexibility. Admitting that things we thought were true are subsequently shown to be
false is much less painful than clinging to an argument that has really been
proven false over time. It smacks of
fear of losing one’s place as an authority and one’s job. With adherence to dogma comes inevitability
of obsolescence since with progress we often learn new things that contradict
what we thought we knew. Refusing to
accept new evidence staring one in the face will only worsen an individual’s or
entire profession’s reputation and hasten it’s demise. An old guard defending itself is never to be
trusted to advance the interests of anyone but its own.

Finally,
to the medical industry, I would suggest creating studies that actually mean
something. So many of the “studies” that
come out today really don’t prove anything. Part of the fault here goes to the mainstream media who sees a
preliminary study on mice and extrapolates it to be proof or at least a strong
suggestion of how things work in humans. But scientists should know this and refrain from talking to the mainstream
press about studies they know are only going to get hyped into ridiculous
simplified generalizations. Even aside
from animal studies, there is simply a lack of good human studies especially
when it comes to diet and health. Many
of the studies I’ve seen are with very small groups for short periods of time,
or they aren’t even studies themselves but rather “meta studies” which simply
look at other studies and try to argue a point based on hand-picked literature
that supports their cause – while ignoring those that don’t. If we really and truly want something
approaching objective “proof,” we need to spend lots of money, and not the
money of special interests. Perhaps a
large fund, like that of Bill and Melinda Gates, could support something that
would not allow for special interests to influence the results to any
significant extent. Doctors would have
to resign themselves to any conclusion, instead of starting with a conclusion
in mind and writing off an unexpected result as some anomaly. The numbers of participants should be very
large – in the thousands or even tens of thousands. All variables should be plotted, not just
weight, height, gender, and age, but body fat percentage, previous dieting and
exercise experience, ethnicity, medications, smoking, etc. Ideally participants would have to be
confined to an area where there would be a fair degree of confidence as to what
the participants reported were true. In
other words, all exercise could be monitored and all food intake as well. Not just monitored so much as allocated. Different levels of macronutrients would be
allotted to different groups. There
wouldn’t be just a “standard group” and a group that differed to a moderate
extent in one of their macronutrients like carbohydrates. Instead you would have a group that took in
80% of their calories as carbs, 10% as protein, and 10% as fat, another group
which took in 5% of their calories as carbs, 65% as fat, and 30% as protein, and
all the different combinations in between. The study would also follow the individuals over at least a three year
period, but as many as seven years. As I
implied, this would not be an easy or a cheap study, but satisfying all or most
of these strictures will be the only thing that will convince the majority of
people (experts and laypeople alike) that a particular method of weight loss
works best for a person given their very particular makeup (ethnicity, dieting
experience, medications, etc.). Perhaps
computer modeling and genetic profiling will take a lot of the work out of this
in the future, but for now, anything short of this full-on approach will be, as
it has been in the past, meaningless except as something for scientists,
doctors, universities and/or hospitals to get their names in print.

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