5 Things Patients Have Taught Me About Obesity

Don’t get me wrong, I love education, research, and scientific discovery. But many of my most valuable insights during my career haven't come from a symposium or a journal article--they've come from my patients. These experiences put a face on a theory or provide meaningful context to scientific principles. Sometimes my patients just teach me life lessons that I relay to future patients--no data required.

Obesity is a Chronic Disease

Working with both adults and children has confirmed my belief that obesity is a disease. “Chunky” kids often have few medical conditions related to their weight. But the more excess weight they gain over time, the more medical problems they acquire. It's comparable to precancerous skin cells that are never addressed. When the condition goes untreated, the consequences are often dire. Even though The American Medical Association categorized obesity as a disease in 2013, some folks are still skeptical. They argue, “How can a lack of willpower be classified as a disease?” Many of my patients have as much will power as skinny people--blaming obesity on personal faults is an extreme oversimplification of the problem. Sure, managing weight often requires a degree of self-discipline, but obesity is a genetically influenced, metabolic condition. And anyway, unhealthy behaviors often contribute to many diseases--heart disease, lung cancer, and type 2 diabetes--it doesn’t make them any less of a disease. It is a disease because it interferes with the vital functions of the body--blood sugar regulation, heart health, breathing when we sleep, and the function of the musculoskeletal system.

Commitment is More Important Than Motivation

I’ve been working in weight management for several decades and I’m still terrible at predicting who will succeed. My tendency is to expect long-term success from those who declare the highest levels of motivation at the onset of treatment. But in reality the achievers are the ones who commit to the process. They mess up repeatedly but they continue to schedule appointments, attend group meetings, step on their scale, and walk on the treadmill like they are taking a daily medication. Sometimes they are frustrated with the process or are even a bit bored, but they remain committed. They decide the sacrifices are worth it and they persist. Their journey reminds me of couples who have been married for 50 years. The honeymoon has been over for a long time and some days are better than others, but there is no serious consideration of quitting.

Exercise is the Positive “Do”

Actually a professor of mine, Bud Getchell, used to repeat this phrase in one of my classes back in the late 80’s. My mullet allowed me to hear clearly (hair up over the ears—get it?) without truly understanding. His motto took on new meaning when I started working with people who wanted to lose weight. The dieting mentality is overflowing with ideas of restraint, restriction, and resisting temptation. Exercise, one of the best predictors of long-term weight loss, is just the opposite. It’s something you do. Although we can feel a sense of accomplishment from choosing broccoli over potato chips, it’s just not the same as completing a challenging workout, running or walking your fastest 5K, or hiking to the bottom of the Grand Canyon.

Don’t Judge

It sometimes hard to imagine how someone can gain weight until they reach 400, 500, or even 600 pounds. I have worked with many of these individuals and I am often saddened by their stories. Abuse, poverty, neglect and isolation are common themes in their lives. When I ask myself, “How would I have responded to the same environment as this person?” I am filled with empathy and a desire to help them change their life.

Forgiveness is Powerful

Carrying grudges, hauling around anger, and pushing people away takes a lot of energy. It’s exhausting. Weight management is hard enough when we are devoting all of our energy to the process, but almost impossible if we are distracted or emotionally tapped out. A client of mine once told me that she forgave an abuser knowing that his actions were a result of pain he was experiencing. She didn’t excuse his wrongdoings but she forgave him. As a result, she was eventually able to focus her thoughts and energy on her health. Another client expressed the importance of forgiving himself. During a group session he said “We often look to God for forgiveness and that is important, but we also have to learn to forgive ourselves. Everyone who is overweight messes up sometimes, forgive yourself and plan to do better next time.”