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greytone · 08-22-2006, 05:10 PM

I have not posted much for the last year and a half because of work and schedule issues that have really kept me busy (and limited any exercise) but as a physician with a BMI of about 38 I feel like I have something to add to the discussion. I have always believed that people must have some size at which they say "This is it, I have to get serious about my weight." What is amazing is that this is so different for different people. I believe there are personal, psychological, and cultural influences on this for each of us. I think I am about there now, because I am at the cusp of having to go to the Big and Tall shops.

A lot of people talk about "metabolism" but we really do have a way to affect our metabolisms. The most important way is that our basal caloric needs are increased when we build muscle mass through resistance exercise. Thyroid disease has to go untreated for a very long time to have any effect. I see plenty of overweight people who are hyperthyroid (the disease should lead to weight loss) but manage to overeat their disease. A few lucky people have a lot of "brown fat" which wastes food energy as heat. We know of no way to make us grow more of this mitochondrial rich tissue.

The average person is woefully ill informed about how much they should eat and also about how much energy there is in various foods. Most people still think you can "get energy" from vitamins. People tell me all the time "I hardly eat anything." But if they are gaining weight, they are consuming more calories than they are burning. It really is as simple as that. The trouble is, it is really hard to safely get your calorie intake below 1200 Cal. When people accomplish that and still can't lose I am at a loss as to what to tell them.

People eat for all kinds of reasons. In today's world we rarely have hunger as as sole motivator. We eat because it tastes and feels good. We eat together as dining is central to so many social events. We celebrate holidays and major events with specific foods. Most of these are not very healthy. If we have a problem with eating too much, we can not simply give up eating. We still have to make constant choices about what and how much to eat; and we must do so in a social context that does not give offense to our hosts or family.

08-22-2006, 05:10 PM	#29 (permalink)
greytone Junkie	I have not posted much for the last year and a half because of work and schedule issues that have really kept me busy (and limited any exercise) but as a physician with a BMI of about 38 I feel like I have something to add to the discussion. I have always believed that people must have some size at which they say "This is it, I have to get serious about my weight." What is amazing is that this is so different for different people. I believe there are personal, psychological, and cultural influences on this for each of us. I think I am about there now, because I am at the cusp of having to go to the Big and Tall shops. A lot of people talk about "metabolism" but we really do have a way to affect our metabolisms. The most important way is that our basal caloric needs are increased when we build muscle mass through resistance exercise. Thyroid disease has to go untreated for a very long time to have any effect. I see plenty of overweight people who are hyperthyroid (the disease should lead to weight loss) but manage to overeat their disease. A few lucky people have a lot of "brown fat" which wastes food energy as heat. We know of no way to make us grow more of this mitochondrial rich tissue. The average person is woefully ill informed about how much they should eat and also about how much energy there is in various foods. Most people still think you can "get energy" from vitamins. People tell me all the time "I hardly eat anything." But if they are gaining weight, they are consuming more calories than they are burning. It really is as simple as that. The trouble is, it is really hard to safely get your calorie intake below 1200 Cal. When people accomplish that and still can't lose I am at a loss as to what to tell them. People eat for all kinds of reasons. In today's world we rarely have hunger as as sole motivator. We eat because it tastes and feels good. We eat together as dining is central to so many social events. We celebrate holidays and major events with specific foods. Most of these are not very healthy. If we have a problem with eating too much, we can not simply give up eating. We still have to make constant choices about what and how much to eat; and we must do so in a social context that does not give offense to our hosts or family. __________________ I was there to see beautiful naked women. So was everybody else. It's a common failing. Robert A Heinlein in "They Do It With Mirrors"