INTRODUCTION

I spent about 2 hours today writing an article about the extremely sensitive and difficult topic of Physician-Assisted Suicide. It is a subject that, as a young doctor, has been troubling me a lot lately because I know that one day I will have to decide on whether I should help one of my patients to end his life or not. But then I received a phone call which made my mind shift to another topic which actually troubled me even more, for about 10 years of my life. My uncle recently suffered a non-fatal myocardial infarction and my aunt, his wife, called me and begged me to have a talk with him and convince him that unless he does something about his weight, his next heart attack will also be the one that will most likely kill him. The reason that he called me is not only because I am the unofficial ‘family doctor’ but also because I have a first-hand experience with obesity myself. I was an extremely obese person for almost a decade of my life. After I spent about an hour talking to my uncle, I decided to postpone my original article for another day and write a different one, with all my thoughts on obesity and why it has become such a worldwide problem.

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It is often assumed that obese people are lazy, gluttonous individuals with no regards about their health and no intention or will power to take matters into their own hands and do something about the disease that is killing them. The truth though is much different. Fat people are probably the biggest diet experts that you could possibly find. In the era of broadband internet and abundance of information, I have never met a single fat person who was ignorant as to what is making him overweight. No obese person believes that their enormous waistlines are due to all the jogging they do and the big lettuce salads they eat every day. They know exactly what it is that is destroying their lives. I can guarantee you that I certainly did. As a medical student that I was back then, I knew all about the metabolic causes and risks of obesity. I was experiencing it first hand at the hospital every day. I saw my future in every necrotic heart tissue I had to dissect during my Pathology class and I saw my fate in every diabetic foot we had to amputate. Yet, I still allowed my obesity to take away my 20s, a decade that could have been the best of my life.

My weight was affecting all of my relationships: family, friendships and of course the intimate ones. I knew I was killing myself when I was running out of breath every time I climbed more than 15 steps. I had to shop my clothes from special shops because I was too fat to fit into normal sized jeans. I even got kicked out of a 4-D cinema once because I was too fat for their seats. I was aware that I was in a desperate situation, but nevertheless I could do absolutely nothing to stop myself from eating. Just like most fat people I had become a diet expert. Atkins, Paleo, Zone Diet, South Beach, Soup-Diet, you name it - I had tried all of them! After my last failure with dieting, I locked myself in my house. My social life was completely ruined, but at least I had all the time in the world to study deeper about the human nature, reflect on my own life more and finally to get to know myself better. That’s when I started the journey, at the end of which I ended up losing more than 100 pounds.

THE REAL CAUSE OF OBESITY

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Obesity is not a nutritional disease, or a metabolic dysfunction, not even a psychiatric illness or a hormonal imbalance. All the above are just manifestations of the disease. Obesity is a disease of the human nature, our way of life and our social environment. Evolution worked hard for tens of thousands of years to make sure humans became the ultimate survivors. It equipped us with an extraordinary reward centre in our brains which makes us feel good whenever we engage in behaviour that improves our chances of survival. It provided us sophisticated anti-starvation mechanisms which are able to feed on our own bodies if necessary to ensure that our vital organs continue to function. It gave us the body and brain which would allow us to search, work hard for and eventually produce our own food. For thousands of years this worked perfectly well. It allowed us to evolve from our primitive ape-like ancestors to the planet dominating species we are today.

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But one thing that we learn from human evolution and history is that where biology takes thousands or even millions of years to change, societies can be revolutionized and transformed in a matter of a few decades. Evolution could have never predicted that the finely tuned, biological survivor machine that the human body is, would end up living in an environment where food is a walking distance away from the nearest supermarket. It could have never predicted that our processed, sugar-loaded food would end up over-stimulating our reward centres so much that our dopamine receptors would be down-regulated and therefore making us addicted to fats and sugars. Our bodies were not designed for an abundance of nutrients and the sedimentary life styles we are living. Obese individuals are therefore victims of our current lifestyle and ultimately of their own nature. What triggers obesity exactly is different in each person. It is always though an event (or events) with an emotional impact. They don’t have to necessarily be any special, extraordinary incidents. They can be just normal, unfortunate events which can be expected in the average human’s life. Each person deals with these emotions in a different way. Some smoke, some drink, some become workaholics, others cry, some take it out at the local gym and some turn to food. Eventually they enter into a vicious circle of low self esteem, repeated depression and emotional eating which leads them to becoming morbidly obese. It makes them sick and unable to do much about it because their own brains and bodies are working against them.

A TOTALLY NEW YOU

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Treating obesity should have a holistic approach. If you are a fat person who is about to go on a diet to lose weight, I would advise you to stop. You may be lucky and be one of those 5% of dieters who will lose weight and keep it off in the long term. But the unfortunate truth is that you are most likely to be a part of that 95% who will eventually fail and end up putting back the weight and perhaps even more.

If you don’t change your entire way of life and behaviour you can never succeed in losing your extra weight. What exactly should you change? The answer is everything. Start by studying about the human nature and then using your knowledge to understand your own self more. Once you learn how your mind works, start to work on your own happiness and satisfying your own needs in this life. Keep yourself active. The only sedimentary moments in your everyday life should be the 8 hours you sleep. Don’t do any activities where your body and mind are passive. You should of course, fix your eating habits. Avoid sugar as much as possible and don’t eat processed foods. Buy raw, unprocessed ingredients and turn them into a meal yourself. Finally, your new, improved diet habits will probably create a lack of dopamine-driven pleasure in your brain. You need to keep your reward-centre satisfied by becoming addicted into something else other than food, something that is a much healthier alternative and stimulating enough to keep your brain ‘happy’. Learning about the human nature and how our bodies and minds work are vital elements understanding obesity and eventually succeeding in your weight loss journey and also every other aspect of your life.

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