Obesity

I have a friend who is extremely obese. I say friend, even though we spend no unstructured time in each other's company. I use the term loosely, then. It will have to do -- it is not after all a technical term. We allow ourselves such informalities of speech. How else can we communicate? This friend, then -- a dear man, who has cracked through even the barriers of social indifference that I have erected -- has a simply out-of-control weight problem, that to my objective eyes seems not to be changing. So it seems to me.

Let's look at the issue. A fair bit of this will be me covering ground I've been over before. But you, foolishly -- inexcusably, really -- don't study these pages with the diligence you should. Your loss, but I hate to see it. I'm very compassionate. So.

Hardly anyone eats to satisfy hunger. Hunger is the craving for nutrients, including but certainly not limited to calories. We do, almost all of us, have weeks and weeks worth of extra nutrients stored in our tissues -- minerals and vitamins, essential fats and amino acids -- and of course plain old calories. Calories are the least of our worries. I can say this from personal experience. My longest water fast was 10 days. No adverse affects at all. I lost some weight, not much -- five six pounds -- and was active, and felt fine. Stopped being hungry after a few days. But eating is such a habit, you know -- we miss our habits. Which is the point. We don't eat from hunger. Hardly at all.

Fat is about stored energy. This energy is represented by calories, a unit of heat measurement. So it's about heat. We maintain our temperature by balancing heat production with heat loss. Much of our heat comes from deep tissue organs -- brain, liver, heart -- and skeletal muscle. Some thermogenesis takes place in fat cells -- one of the reasons we call ourselves warm blooded. We preserve our heat with skin, and fat, and subcutaneous-tissue. Insulation. We lose that heat through the metabolic reduction of heat generation, through perspiration (evaporation cools), and through vasodilation (widening of blood vessels). We increase our temperature via the hypothalamus, which causes vasoconstriction (tighter blood veins means more friction), shivering and piloerection (goosebumps).

Why am I talking about body heat? The majority of our daily calories go, generally, to generate body heat. Body heat body heat body heat. So what we eat turns either into work energy, heat or fat. Speaking simplistically. The food choices we make, then, would be important. Some will tend to make us fat. Some will tend to make us healthy. It's not always about nutrition. Sometimes it's about energy efficiency.

For comparison, cars are about 21% fuel efficient -- the amount of actual BTUs that are used to turn the wheels. Electric power plants and the grid distribution system has about 13% overall thermal efficiency. Plant photosynthesis is 1% to 2% efficient at using sunlight as energy. Humans have an average of up to about a 25% maximal work efficiency usage for their total energy intake. But of even that small percentage, only a few percent are devoted to the actual work -- most goes to body temperature and other metabolic functions. Just keeping us alive.

Obviously there's a lot of waste. In terms of food, we digest different foods differently, and some are just more calorically available. Sugar should have about a 100% thermal efficiency rate. It just pours into the bloodstream. Genetics plays its role of course, but the foods themselves are determinative. Some of us might recall the ghastly kindergarten discovery that corn needs to be thoroughly chewed or it shows up whole in the toilet. Brrr.

There is little, perhaps no systematic scientific data on the actual usage-efficiencies of various foods. We know the number of calories in foods because those foods are burned in a crucible and the released heat is measured. It seems reasonable to suppose that the crucible of digestion burns with a more variable efficiency. No? A hundred calories of sucrose and a hundred calories of broccoli won't show up in the body as the same hundred calories. So it seems to me. But we can see the results. Simple carbohydrates are called simple because they turn into sugar quickly and easily. Complex carbs are harder, slower to digest, and much of their actual caloric value is lost as cellulose and fiber. This is actually a good thing. Bulky. It fills you up, supplies essential nutrients, and provides a steady supply of energy rather than an overwhelming surge. A good thing.

As for heat, some black body radiation calculations tell us that an average of 20 square feet of skin (200 pound male) under normal (cool, sedentary) conditions will radiate about 25 calories per hour. All those precious calories, wasted. Such a pity. Under windless and otherwise normal conditions, convection will remove, say, 60 calories per hour from a clothed body. Ball park. Heat loss purely through exhalation is negligible, but the vapor in breath loses about 10 calories per hour. Call it 100 calories per hour of lost body heat; sleeping, say 75 calories per hour. There are oddments, of course. For an hour or so after eating, you generate about 10% more heat than with an empty stomach. Shivering burns up to 400 calories per hour. But no one should shiver for an hour. That would be torture, like water boarding.

Ah well. That was a lot of boring information. So dry. People are so much more interesting. Yes. People. I've said it before. Some vices show. You can't hide an eating disorder that has led to obesity. It is an addiction. It is an out-of-control behavior. It's not a function of will. It's emotional. Emotions are not rational. And up to a point it's so innocent. Just 100 too many calories a day, and in a year you're 12 pounds fatter. No biggie. We see the dysfunction, the addiction, when it continues, year after year, for 15 years.

How much easier it is for us, whose vices remain entirely hidden from public scrutiny. Our secret drinking. Our sexual excess, or perversions. The bitterness of our spirit. We can hide these things. We can pretend to be virtuous. The fat guy is the clown we can laugh at. He has a pleasant smile. He takes up a lot of space, where ever he is. Sometimes he sucks the air out of the room. But we only have to look at him, to make our judgments. It's so easy.

My buddy, though, could severely restrict his caloric intake and not lose one single ounce. He's got 200 pounds of insulation wrapped around him, complete with a prodigious panniculum. Figure it out, all that talk about body temperature. His hypothalamus reads the insulation as not having to send out any signals to generate extra heat, burn extra calories. Plenty of heat there already, and it's not radiating, not convecting -- hardly at all. It's very calorie efficient that way, no? He gets to keep his fat even when he eats less. Hurrah for him.

And then there's that psycho-physical gauge located somewhere no doubt in the limbic system -- everything we don't understand is located there -- that has this image, this mental template about what he should look like. A very conservative process, so that if anything threatens that unconscious self-image, why, the brain knows simply to lower the temperature. Turn down the thermostat. Save on energy. Save those calories. Keep the weight up. This is how we have to look, after all. See? Your body knows its outline, its waistline, and thinks that's how it should be.

That's why I generally keep my mouth shut. Even encouragement isn't enough. As for constructive criticism, what good would a vocal observation of those extra globs of sour cream do? He'll leave them on the plate now, but when he gets home he'll eat twice as much. Because what he's feeding is not about hunger. It's not hopeless, because there are remediating behaviors. But it is profound.

The problem isn't really calories. The problem is fat. How to get rid of it. The easiest way, of course, is to eat fewer calories. But that's the hardest easy thing there is in the world. We all have our compulsions after all, so we understand. The harder way is to increase activity. Exercise. A little isn't enough. Breathing hard for a while isn't enough. It's not about lung capacity or fitness level. It's about burning those calories that the body wants to save -- there might be a famine, after all. What kind of exercise?

Walking. Two hours a day. Three 45-minute sessions. Too much? Fine. Do less. But do something that approximates it. It's not like there aren't iPods and radios and books on tape and just plain old books. Two thousand calories is enough to generate three horse power for an hour. Do you do the work of three horses? Cuz you eat that much.

And strength training. Every pound of muscle you add burns an average of 100 calories sedentary per day. It's only a pound a month, or 12 pounds a year. But the walking will make that extra pound burn hotter for those couple of hours. Not to mention the hormonal benefits. Muscle is good.

And meditation, or visualization, or self-talk or whatever technique you choose to use, that will reset the brain-gauge. Rework the template. Reshape it. Recreate yourself. Wanting it won't do it. Dreams only reinforce existing conditions. Apply the technology of the mind. Use it, instead of being used. There are victims, but most of them volunteer for the job.

And a few supplements. CoQ 10 actualizes our mitochondria, the little cellular power plants that do the actual calorie burning in our bodies. The energy that becomes available is then used either to generate heat or to synthesize ATP (which lets us think, exercise, repair, etc). Sounds like it would be really good to have high-functioning mitochondria, right? Omega 3. Alpha lipoic acid. Because even an excellent diet can use some help -- and you don't have an excellent diet.

And keeping a written record. Otherwise you're trusting emotion, and remembering what you feel like remembering. Write it down. Maybe it will help and maybe not. But it will remove doubt, and if you're doing lots of right things and still not getting where you want to be, you can figure out what other things you need to start doing. Cuz what you're doing isn't enough, if you're serious about making a change. If you're not serious, well, you must understand that for all the talk, there are very real benefits and advantages to being the biggest man around. You can always embrace that fact, and live with it, for a while. Life is after all a banquette.

And food selection. Sour cream? Good lord. I've never tasted sour cream. Why would I put sour cream in my mouth. I'm sure there's a difference between sour cream and rancid fat. A chemical difference, I mean. There's not a difference in terms of calories. I've never in my life used salad dressing. First of all because it looks like something that's already been inside someone's body. And it seems sort of redundant. I'm already eating good food. I need to add something more, out of a bottle from a factory?

But tastes are what they are. You can't use less? I'm sure it's possible. The compulsion isn't about salad dressing, is it? But go ahead and fill up. Eat absolutely as much as you want. But make most of it the sort of nutrient-rich, calorie-poor foods that will not only make you slimmer, but really, really healthy. Maybe you'll click on that little "health" label at the bottom of this post? -- and skim through all my pathetic self-important scribblings and cries for attention until you get to some of the specifics about vegetables? It's called an education, mate. Look into it.

The point is, food is either for nutrition or for emotion. If it's for nutrition, we call it health. If it's for emotion, we call it slow poison.

Here endeth the lesson.


J