80 Can Be Weighty

On the health front, it can be hard to know what to do sometimes. Confusing and often contradictory studies that can influence lifestyle choices seem to abound.

For example, I’ve always understood that, as you get older, a big part of maintaining good health is working to keep your weight down, because excessive weight is associated with many problematic health conditions that can affect mortality–not to mention causing trouble for aging joints. Now I’ve seen a study that suggests that for people over 80–a group the study, incidentally, refers to as the “oldest-old,” which seems a bit harsh–maintaining more weight and a higher body mass index number is associated with decreased mortality risk.

So, what’s a person who’d like to make it to that “oldest-old” category to do?

Apparently successful, long-term aging is an exercise in threading the needle. In your 60s and 70s, stay focused on the scale and the beltline, and keep that weight off. But, at the same time, don’t get too weak and scrawny, either, because if you make it to 80 you might need to bulk up a bit more. But if you do make it to 80, let the party begin!

It also means you should keep both the “fat clothes” and the “skinny clothes” in your closet, because you’re probably going to need them all at some time or another.

The Trump Weight Bet

It’s pretty much impossible to get away from Donald Trump these days, no matter how much you might really try to do so. What with various indictments, raids, investigations, lawsuits, and the former President’s evident narcissistic desire to be the center of attention at all times, the news websites these days seem to be all Trump, all the time. Some people apparently can’t get enough of this guy.

Recent evidence of this is that some bookmakers are taking bets on various aspects of Mr. Trump’s arraignment in Georgia, thereby combining two of America’s obsessions–gambling and Trump. You can bet on whether Trump will smile or scowl in his mugshot (or wear a MAGA hat), as well as the color of his tie, or whether he will be wearing a tie at all. And, since the booking process in Georgia apparently involves stepping on the scales, you also can bet on the former President’s weight.

The Trump weight over/under currently stands at 273.5 pounds–a number that has increased because 77 percent of bettors have chosen the “over,” causing the bookies to raise the target number by eight pounds so far. (As gamblers know, the betting lines shift as bets come in, to protect the bookies from losing their shirts.) That weight is well above what the former President has disclosed as his weight in the past, when Mr. Trump, who is 6′ 2″, has reported that he weighs about 240 pounds.

It’s weird to think that people are willing to bet about this kind of stuff. Wagering on a person’s weight is pretty embarrassing–if that person is capable of embarrassment, that is. But if you care about how much Donald Trump actually weighs, we’ll find that out this week, as he apparently won’t have the option of handing authorities one of those “please don’t weigh me” cards. Some bettors will be happy, some will be disappointed, and then, regrettably, we’ll no doubt move on to focus on a new Trump-related fixation.

Analyzing Healthy Weight

What’s the “right” weight? It’s a question that doctors and their patients have wrestled with for years, and it’s clear that the standards are changing as human diet, nutrition, activity level, and general health are changing. Humans during the 1400s, being subject to periodic famines, plagues, and disease that stunted their growth, and engaging in day-long physical labor to put modest amounts of food on the table, probably looked a lot different from modern Americans. Even in the last century, the standards have changed. Consider, for example, that the average G.I. in World War II was about 5′ 8″ and weighed about 150 pounds. These days, you don’t see many 150-pound men in the average American city.

So what’s the “right” weight now, in an era of relative food abundance and modern medical treatments for human disease, where many people work at sedentary desk jobs?

For years, the accepted method for determining health weight has been the body mass index. The BMI was simple: it took your weight in kilograms and divided it by your height in meters, squared. The target zone for a healthy you was a BMI between 18.5 and 24.9. Now there is a debate about whether the BMI is really an effective tool, because it doesn’t consider where human fat cells have accumulated. That’s important, because the location of fat cells matters to human health and is related to conditions like diabetes, heart disease, and some forms of cancer. Abdominal fat–that “stubborn belly fat” that clickbait articles claim you can melt away with some “weird trick” or special drink–is more unhealthy than fat that accumulates around the hips, and “visceral fat,” the abdominal fat that builds up around the internal organs, is especially harmful.

As a result, some researchers are urging that use of the BMI be replaced by a focus on the waist to hip ratio. The waist to hip ratio is easy to use, too–you apply a tape measure to your waistline and your hips, and determine the ratio between them. Lower waist to hip ratios mean lower abdominal fat accumulation. And a recent study found that the waist-to-hip ratio was a better predictor of early mortality than the BMI.

There’s no doubt that losing excess weight is helpful to overall health; your hips, knees, and ankles will thank you. But the distribution of weight also matters. We’ll probably never avoid the scale at the doctor’s office, but the predictive value of the waist-to-hip ratio may mean your doctor will be taking out a tape measure, too, at your next exam.

A Five-Pound Cell Phone

The other day I had a doctor’s appointment. As the nurse led me down the hallway to my assigned exam room, she weighed me on the doctor’s scale, which is located along one of the hallway walls. I obediently stepped up onto the platform, wearing my suit and tie and shoes, as I always do. After the nurse registered my poundage, I headed to the exam room.

When I mentioned this incident later, I was told that my approach to the doctor’s scale is all wrong: you are supposed to at least remove your jacket and shoes and, ideally, strip down to your skivvies. I wasn’t going to do that, obviously, because the scale is in an open hallway, rather than in the exam room itself. I also figure that so long as I am consistent, and always am officially weighed when fully clothed, the doctor’s office will get a sense of whether my weight is dramatically up or down, which should be sufficient.

The clad approach to the doctor’s scale has another advantage: it leaves an open field for rationalization. When I stepped onto the scale, my pockets were full, with cell phone, wallet, and keys. I’ve never weighed these items, independently–meaning it is at least possible that my cell phone weighs five pounds. I haven’t weighed my shoes, either, but I’m pretty sure that I was wearing an especially heavy pair that day. My jacket and tie were feeling pretty hefty, too. All told, my accoutrements easily could have accounted for a sizeable percentage of the weight registered by the nurse.

If I’d shed my garments and shoes, we would know for sure–but that didn’t happen, did it? Thanks to my five-pound cell phone, ponderous keys, and Frankenstein-like shoes, the precise dimensions of my physical self remain shrouded in mystery and the subject of vigorous internal debate. .

“Please Don’t Weigh Me” Cards

I happened to see a news article about these “please don’t weigh me” cards that some people apparently are using with their doctors. One of the cards is pictured above.

The cards are being offered by a group called more-love.org. Its website indicates that it has sent out thousands of the cards. The website explains the cards as follows:

“Because we live in a fatphobic society, being weighed and talking about weight causes feelings of stress and shame for many people. Many people feel anxious about seeing the doctor, and will avoid going to the doctor in order to avoid the scale.

We want to support you in requesting healthcare that is free of weight bias. Getting weighed is an informed choice that we get to make with our doctor. We don’t have to automatically step on the scale just because someone asks us to.

Our “Don’t Weigh Me” cards are a polite and respectful way to assert your preference at the doctor’s office and seek informed consent if weight is deemed necessary for care and treatment. It’s OK to not automatically step on the scale when asked.”

Perhaps I’m insensitive and “fatphobic,” but this concept seems strange to me. First, there’s a passive-aggressive element to it that doesn’t seem particularly well-suited to a positive doctor-patient relationship. Why do you need pre-printed cards, rather than having an honest conversation with your doctor, and his staff, about your feelings? If you can’t have candid communications with your doctor about your issues, you’re probably not going to get the best health care.

Second, what is this about “healthcare that is free of weight bias”? Numerous studies have shown that weight is directly related to health care, in that obesity increases the risk of conditions like diabetes, heart disease, joint problems, respiratory problems, and other significant health issues. Even if you don’t currently have one of these conditions, excessive weight is likely to cause you to develop such problems in the future–which means weight logically is a focus of any doctor who is interested in preventive health care. Asking your doctor not to weigh you is like asking him to not take your pulse, conduct a blood test, or perform a physical examination. You are depriving him of information that he can use in prescribing appropriate medication, treatment, or other activities that can produce better health and avoid future problems.

Third, isn’t it odd that people are concerned about living in a “fatphobic” society, and what really worries them is getting a metric from a scale, rather than how they look, or how they feel, or how their clothes fit? What is it about the act of getting on a scale that makes it, specifically, the focus of a pre-printed card?

These cards seem to be a new development, and it isn’t clearly how common their use is. It would be interesting to know how doctors are reacting to being handed one of these cards.

Overweight Ohio

Some entity I’ve never heard of came out with their list of the fattest states in America.  Of course, I checked to see where Ohio ranked, and found that we’re at number 12 on the portly parade — not quite cracking the Top Ten of Tubbiness, but definitely up there farther than we want to be.

An outfit called WalletHub (has anybody heard of these guys?) supposedly looked at three factors — “obesity and overweight prevalence, health consequences and food and fitness” — to determine their rankings.  By their analysis, Mississippi, West Virginia, and Arkansas rank 1, 2, and 3 in overall corpulence, whereas Colorado, Utah, and Hawaii, respectively, are the top three at the slender end of the spectrum.  And notwithstanding all of the lobbying fat cats who prowl the halls of Congress, the District of Columbia is found to be one of the slimmest jurisdictions in the U.S.

I’m always skeptical of these kinds of rankings of states, but the news stories never get into the details of how they are developed that would allow proper analysis.  Precisely how was the “obesity and overweight prevalence” factor in this study determined?  Is there some kind of secret federal blubber database that was consulted?  And does food and fitness just look at the availability of food and workout facilities, or the kind of food that is consumed, or the use of restaurants and fitness outlets, or something else?  How in the world would you determine, for example, that Ohio is marginally fatter than That State Up North?

All that said, it’s clear that Ohio has work to do.  We don’t want to crack the Top Ten on the State Stoutness Scale and be known as Obese Ohio.  It’s time to put down those delectable Buckeye candies, push back from the kitchen table, hop on the elliptical or the bike, break out the weights, and start turning blubbery Buckeyes into buff Buckeyes.

The 160-Pound Me

Last week my doctor’s assistant had me stand barefoot on a scale-like contraption and hold a metal bar that was linked to the scale so that the fingers and thumbs on both hands were touching the metal.  The device, she said, would measure my muscle-to-body-fat ratio and also give me an overall weight goal.

I eyed the contraption with skepticism and trepidation.  More than a year ago I made a concerted effort to lose weight through a low-carb regimen and lost about 20 pounds.  I was happy with the results and decided to stop at that point, and I thought I had been pretty successful in keeping the weight off — but I don’t weigh myself regularly.  The scale/handle device therefore would be the acid test.

I followed the procedure and waited for the results.  The good news was that my weight was within a pound or two of where I was when I stopped the low-carb approach last year, and the device concluded that the amount of muscle was where it should be, too.  The bad news, though, is that the device said that I needed to lose about 25 pounds and get below 160 on the scale.

160?  Seriously?  160?!?  That’s less than I weighed when Kish and I got married in 1982, which was the skinniest I’ve ever been as an adult. If you wanted to find the last time I weighed less than 160 pounds you’d probably have to go back more than 40 years.

I get the need to watch your weight, and I understand the different health problems that can be caused by excessive weight.  But getting below 160 pounds seems like a pretty outlandish goal.  Presumably it would require a radical change in diet and exercise efforts, and I wonder if it would be sustainable.  I don’t want to lose two stone eating twigs and raw lettuce, buy an entirely new beanpole wardrobe, and then see my weight pop back up.  And yo-yoing on your weight doesn’t seem like a particularly healthy thing, either.

I’m rationalizing here, I’m sure, and I’ll talk to my doctor, of course.  But for now I’m thinking I’ll just take things one step at a time, and try to get down to the 170s and see how I feel about it.  I’m having a really hard time envisioning the 160-pound me.

Popping A Button

Last night I had a very good Italian meal. Some fine ravioli for an appetizer, a veal entree, a little wine, and a cup of black coffee. In a nod to notions of physical fitness, I even skipped dessert and walked a number of blocks from the restaurant back to my hotel.

Yet, when I returned to my room, I popped a button on my trousers — and all illusions of trim physical fitness vanished.

Let’s face it. Popping a button on your pants is a tangible, irrefutable demonstration that you need to hit the gym, and hit it hard. It tells you that pants that fit properly once really don’t fit any longer.

The humble button will remain comfortably attached to its binding threads, happy to permanently serve its designated function of keeping items of apparel attached. Buttons become uncomfortable and call attention to themselves only when they are put under enormous tensile strain by expanding human girth. They feel their threads loosening with growing trepidation. The final snap and pop is a button’s last, desperate bid to get the pants wearer to pay attention to the truth about his personal circumstances.

Sigh. A button is telling me it’s time to think about a workout regimen.

Squeezing Into “Skinny Clothes”

Conventional wisdom dictates that, if you haven’t worn an article of clothing for a year, you should just get rid of it.  If twelve months have passed without it being taken off the hanger, the reasoning goes, issues of style or fit make it highly unlikely that you will ever put it on again.

I disagree with the conventional wisdom for two reasons.  First, I’m cheap.  Second, I think that, if you haven’t worn that jacket or pair of pants for a year due to weight gain, you should keep them around as a tangible reminder of how far you’ve let yourself slide.  Stepping on a scale, unpleasant as it might be, is an abstract exercise.  What difference does six pounds make, really?  But if you try to put on trousers that you haven’t worn since last fall and you realize the waistline now cuts off your circulation, you’ve got a powerful, concrete, and embarrassing indication of where you stand.

I have a sport coat that is about 30 years old.  I know this because I have a picture of me, UJ, and Dad taken in 1986, and I’m wearing it.  It’s been hanging in my closet since, donned with decreasing frequency until all wear stopped during the 1990-2010 interregnum.  At that point, my packed on poundage made any effort to struggle into the jacket look like the scene from Tommy Boy where Chris Farley rips David Spade’s jacket to shreds.  It was humiliating — but I resolved to keep the sport coat, anyway, as a reminder and a goal.

At the start of 2012, I decided the time had come to get back into “jacket shape.”  Nothing extraordinary — just trying to eat a little less, drink a little less, and exercise a little more.  I’ve made progress, and recently I took the plunge and tried on the jacket.  Happily, I was able to put it on without spraining a shoulder or sending a button rocketing into the bathroom mirror.  It’s still a tad snug, but I felt a real sense of accomplishment.  I’m glad I’ve kept it around.

Stigmatizing The Super-Sized

Georgia is running a controversial ad campaign about childhood obesity.  It features black and white photos of fat, unhappy looking kids with messages about the dangers of being seriously overweight.

Some people object to the campaign, saying it stigmatizes obesity and poses risks to the psyches of overweight children.  Others contend that the ads amount to a form of bullying, and play into stereotypes about size and weight.

Isn’t this typical?  We often recognize that a condition that is produced by some form of unrestrained, voluntary behavior — in this case, obesity caused by overeating and lack of exercise — has severe health consequences and vow to do something about it.  But every effort to address the problem brings arguments by the self-esteem police at advocacy organizations.  And, ultimately, we end up paralyzed and incapable of taking effective measures to deal with the problem and truly help the people who need the help.

I think the notion that the Georgia ad campaign is harming the psyches of overweight kids, who otherwise are perfectly comfortable about their weight, is ludicrous.  Speaking as someone who was a fat kid — and who will always need to watch it — I am confident that most overweight kids are acutely aware of their weight and are embarrassed by it, ad campaign or not.

I don’t know whether these ads are a good use of public funds — but if they are going to work, they need to be hard-hitting.  We can’t effectively address childhood obesity through school lunch programs or food labeling campaigns; we need to reach the kids and their parents.  If tough ads can shame parents into better regulating their obese kid’s diet and exercise, or motivate the kids to quit overeating and get some exercise, that would be a good thing.  And if we can avoid paying for countless future bariatric surgeries and treatments for weight-related diabetes, or for intrusive government programs that check what’s in school lunch bags, through a few hits at the self-esteem of heavy kids, I think that’s a price worth paying.

Shame and embarrassment can be powerful motivational tools.  Why not use them?

Killer Yoga And New Year’s Resolutions

Most of us tend to think of Yoga as a New Wave, gentle, and physically safe form of exercise.  The New York Times magazine has an article that reminds us that isn’t always the case.  In fact, yoga can cause serious injury.

The article notes that yoga has been associated with lower back, shoulder, knee, and neck injuries and even more serious problems such as stroke, ruptured Achilles tendons, and nerve and brain damage.  It appears that many of the injuries come from overdoing it, by trying to achieve even more contorted positions, or holding poses for extreme lengths of time, or maintaining a neck-based position on a hardwood floor.  Some of the more extreme forms of “yoga” that are offered these days — like the “hot yoga” classes that one of our good friends takes — are an example of how Americans often try to push the envelope with exercise regimens.  Sometimes, unfortunately, we push through the envelope and cause serious injury and long-term physical damage.

The lessons of yoga injuries are especially pertinent now, with New Year’s Day just behind us and many of us having resolved to lose the weight we gained over the holidays and a bit more, besides.  There’s nothing wrong with that, of course, but easy does it is a good rule of thumb — particularly for those of us who are older and have been desk-bound for years.  Rather than trying to immediately run five miles, or to achieve yoga positions that master yogis can only dream of, why not focus instead on eating and drinking less, cutting back on fatty or calorie-laden foods, and lengthening that morning walk and adding a short evening walk, too?

 

Taking A Stand Against “Manorexia”

In England, there is concern about “manorexia” — that is, males dealing with anorexia and bulimia and other eating disorders.  Apparently statistics show a 66 percent increase in the number of hospital admissions for males with eating disorders in the last decade, and it is now thought that one in five people experiencing eating disorders may be male.  The experts believe that males are feeling increased pressure to look like male models and work out for hours every day to acquire “six-pack” abdomens.

In America — where I don’t know anyone who pays any attention to male models, much less wants to look like one — we don’t seem to have this concern.  In fact, from the examples of manatomy I’ve seen walking around lately, I’d say we are dealing with the mantethesis of the problem.  Sure, you see sweaty, shirtless guys running at lunch hour trying to showing off their ripped physiques, but for every one of those there are ten or twenty seriously overweight dudes huffing and puffing as they walk by.  We could use more attention to diet and exercise, not less.

Nevertheless, if “manorexia” is a problem, I will do my part to fight this scourge.  I will stoutly resist any impulse to look like a pale and underfed pencil-necked geek.  I will work to maintain a beefy, florid-faced appearance.  I pledge to forgo that leafy plate of greens in favor of a loaded meat and cheese pizza from Joe’s Place.  I will sacrifice a gut-crunching two-hour daily workout in favor of more time in front of the home computer screen and TV set.  I promise to drink beer and eat Frosted Flakes and cheeseburgers and fries in order to do my part.

Is anyone with me?