Obesity: The New Smoking

It makes me crazy when I see diabetes labeled as a "lifestyle disease." To the numbnuts who coined that term, I guess it means that it results from poor lifestyle choices and can be controlled with better choices. To me, it's an oversimplification that really doesn't help.

There is a vast array of medical conditions that can be impacted negatively by lifestyle choices -- cirrhosis of the liver and pancreatitis are two that come to mind. They are associated by the general public with alcohol abuse. But there are many sufferers who have never used, much less abused, alcohol. There's a connection, certainly, an association if you will, but not a strict cause-and-effect situation.

Lung cancer. Emphysema. COPD. Yes, they're often associated with smoking but not always. Breast cancer. Yup, most breast cancer patients are women, but not all. (Hmmm...can we call gender a lifestyle choice? Maybe not.)

But breast cancer is sometimes associated with weight, or to use the O word, obesity. In fact, the National Cancer Institute correlates obesity with cancer in general. But for some reason we don't talk about that.

Diabetes patients often have an imaginary asterisk by their diagnoses, like Barry Bonds' record in baseball statistics:  Diabetes* (obesity-caused). But there are many cases of diabetes that have no relation at all to obesity--they may be caused by genetic factors or by pregnancy or by acts of God, whatever they are, or some combination.

All those pink ribbons for breast cancer are for breast cancer awareness. There's no asterisk that says "*hey, if she'd laid off the butter, maybe she wouldn't have this crappy disease."

Anyway, obesity has become the new smoking. It used to be that smoking was accepted as a lifestyle. Check out Mad Men if you don't believe me, or any Humphrey Bogart movie. (Hmmm...he did die of lung cancer ... connection? Let's not go there.). No longer. Now we ban smokers from public places like restaurants and within 50 feet of public buildings. I saw in the paper yesterday that Georgia is going to ban smoking in prisons. Now a guy doing four consecutive life sentences will also be forced to give up his cigarettes. The needle might look like a better option to those guys.

Smoking is accepted as a negative lifestyle, one with deleterious effects not only to the smoker but to those who might be in his path. When I was a young girl, my mother smoked herself but she considered a woman who smoked on the street to be no better than a prostitute. Now we consider that woman to be one step above a child murderer -- after all, she's potentially harming all of us with that cigarette, isn't she? Kill her!

And fat's going in that direction. You'd think that obesity would be a personal problem but no, now it's a public health issue. All the debate on health insurance coverage is spawning discussions of whether there should be higher premiums or penalties for obese people, because their medical costs are potentially higher. I'm picturing a bunch of actuaries sitting around a table discussing whether that apple-bodied woman should be allowed to have insurance or not because she might get diabetes if she continues to ignore her growing waistline.

Will food be labeled?

SURGEON GENERAL’S WARNING: Consumption of this product may harm your health or that of future generations.

Will we have separate seating arrangements on planes and in restaurants for those who are slim (read, healthy) vs those who are overweight or ... the dreaded obese? Will your child be rejected from that tony nursery school because you're carrying an extra twenty pounds?

As a society, we overlook all types of risk factors when we see them among our friends -- drinking too much alcohol, abuse of prescription drugs, maybe a little recreational pot-smoking among friends -- but God forbid we should see someone abusing an ice cream cone!

I'm not suggesting that obesity, especially among young people, isn't a huge issue. All I'm saying is that I'd like to be able to say "I've been diagnosed with diabetes" without feeling like I have to add "yes, I know, I really do need to lose weight -- I'm working on it." Is it really anyone else's business?

And, yes, I know, I really do need to lose weight. I'm working on it. But don't label me, or my disease, please.

Dinner Out

As part of my (new) commitment to a healthy lifestyle including (1) weight loss and (2) improving my BG levels, I'm really trying to do better with eating out.

As the term "drive thru" might imply, I have led a lifestyle pretty much committed to fast food. Two reasons for this: First, time management. Second, I love the stuff! There's really nothing better than a Big Mac! And those fries ... well, nuff said.

This has led to poor results generally (100 extra pounds for a start plus the fact that I'm writing this blog at all). So, I'm really trying to do better with eating out. But the fact is that I eat at restaurants about 50-60% of the time.

For instance, probably 3 of 5 days, I go out for lunch. A couple of friends and I usually hit the local sushi buffet, Mexican, maybe Mediterranean, Chinese. Pizza not so much, but once in awhile.

Twice a month there's a meal at work that is provided by my manager. She's a vegetarian (with chicken and fish) and a longtime Weight Watcher so the lunch usually has some healthy elements, but occasionally there's a cream sauce and there is ALWAYS, always a tempting dessert. (One of her favorites is Krispy Kreme bread pudding, a Paula Deen recipe that Teresa has amped up with extra butter and some rum.) See the problem?

On the days I'm on my own I might remember to bring a frozen Healthy Choice meal but more likely I just hit the McDonald's or the Zesto's next door or Wendy's. Whichever, the results are usually a Fatburger of some kind, with fries.

I've also gotten into the Very Bad Habit of grabbing breakfast at McDonald's on the way to work -- either the sausage biscuit meal (with hash brown) or, on days when the guilt is higher, the chicken biscuit meal (with hash brown). I'm asking you ... why is a fried chicken breast better than a sausage patty?

Okay, I've traded that option as of this week for breakfast at home: whole wheat reduced fat bread with a tablespoon of peanut butter and a fruit, or Uncle Sam's cereal with fruit and some 1% milk. Not perfect, but a big improvement! (About that cereal ... there are beavers chewing on trees down by the river that have a better dining experience than me eating Uncle Sam's cereal.)

Finally, there are the every-so-often "fine dining" experiences with friends or the SO. Like last night--we took our grandson to Olive Garden for his birthday dinner. In the past I would probably have opted for a pasta in alfredo sauce, lots of salad, breadsticks, etc. I'm not sure how much better I did last night, but not as much as I should have, that's for sure.

According to Olive Garden's own nutritional information, my minestrone soup (one serving) wasn't too bad--100 calories, 1 gram of fat, 18 carbs, but my three (!!!) servings of salad with dressing cost me 350 calories EACH, 26 grams of fat EACH, and 22 carbs EACH. That's a grand total for the meal of 1150 calories, 79 grams of fat, and 84 carbs. Could that possibly explain why my BG level was 149 this morning instead of 129 yesterday? 

Finally, once a week I eat dinner with knitting friends. Tonight it's Ted's Montana Grill. So now I'm checking out Ted's nutritional information. Ted's even has suggestions for diabetics and for weight loss. (My suggestion would be: avoid Ted's!)

Anyway, it's eye-opening. Typically, when I'm eating whatever I want, it's a burger with cheese and fries. Let's not even go there. But when I'm being "good," it's caesar salad with chicken or salmon, including croutons, dressing, and parmesan. According to Ted's site, that salad with cedar planked salmon (good for those Omega-3's) is 1280 calories, 109 fat grams, and 32 carbs. Holy shit, batman!

Need to rethink, obviously. Could any of this explain why I've been getting fatter and fatter over the last few years, even on the days when I think I'm behaving myself? There's clearly a badly needed education component in this whole diabetes-management thing!

Okay, tonight's plan: A cup of tortilla soup (160 cals, 8 grams fat, 12 carbs) plus an appetizer shrimp cocktail (170 cals, 1 gram fat, 14 carbs). Total 340 cals, 9 grams fat, 26 carbs. For another 10 calories, I could have a bowl of chicken noodle soup instead. I'm still way ahead of that fabulous caesar salad with salmon that I always thought was so healthy.

Well, I'm aiming for improvement (what the 12-step programs call Progress Not Perfection), and I can see that I'm going to have to do some serious planning if this is going to work. Baby steps, baby steps!