Why I Wrote This Book: FAT – what a scary word. It was for me anyway. I feared this word for most of my life – probably for as long as I knew what it meant. I no longer fear most aspects of this word, but I’ll get to that shortly. During the course of my life so far, the word fat has taken on many different meanings. If you are or have ever been overweight, the story I am about to tell will really hit home.
The first meaning of the word fat that I can recall was that it meant me. That is how I identified myself. I was a fat kid – no getting around that; the largest boy in my class. Therefore, fat was simply a descriptive of who I was. Everyone in my life was fat: both parents and both siblings and most of my extended family. Being fat was normal, so at that time, the word wasn’t really a problem for me.
Food held a very prominent role in my life. Meals were an extravaganza – and not just dinner. I grew up in New York City. Since it is such a food town, my parents didn’t rest until the best of everything was found. They thought nothing of going to four or five boroughs to find the right ingredients for a meal. Food was bought because it was on sale, because it had just arrived, because it will be out of season, because we were in the neighborhood and finally I realized food was bought simply because it was there. Each meal was thoroughly discussed and finishing everything on your plate was not only expected, but encouraged. Leftovers were not really allowed as we couldn’t let the food go to waste.
During this time I learned that a pint of ice cream was a single serving. It wasn’t until college that I found out that other families do not start each meal with a pasta course. I was in shock when I found out that pasta in and of itself could be a meal. This was also the time in my life when I was beginning to understand the power that food could have. Food could comfort you, be your best friend, take the edge off the day, go to the movies with you, and just plain be an activity all to itself. Food was my favorite companion: watching TV – eat; listening to the radio – eat; lying by the pool or at the beach – eat; reading a book – eat; doing homework – eat. The list is endless and you probably have many of your own. All I can remember is that I used to plan activities around what foods you could get doing that activity. I associated events with food. For example, going to the ball park meant hot dogs; going to Little League meant ice cream. I participated simply for the food.
The next meaning of the word fat that I can recall was a harsh one – I was being ridiculed for being fat. Schoolchildren can be especially mean. I was insulated from this for a while because although I was fat and not athletic, I was the smartest kid in the class so that got me by for a time. Once later grade school hit, that wasn’t so important and the teasing really began. I was called every name you could imagine. I wasn’t athletic, wore glasses, was brainy and most of all – fat. You could just imagine the ridicule I had to endure.
You could also imagine my surprise at this because although I was fat, I had always thought that to be a good word – my family was fat and so was I. What was I doing wrong? Please recall that this was some years back so there were not that many overweight kids in my class – just two of us in a class of 44. Nowadays, one in every three children are overweight so perhaps I wouldn’t have stood out so much; but, then again, that experience would not have shaped my destiny like it has.
After several years of this and all through high school I began to examine an alternative lifestyle – being thin. What did this consist of? Would my family shun me if I told them I wanted to be thin? Where would I turn for advice? Who would my role models be? Would I have to hide this from my family? Where did you go to meet other thin people? Did thin people want to hang out with fat people or hopefully, a former fatty? Did former fatties know each other? Was there a secret code or a secret handshake? Fatdar? And most importantly, whatever would I eat?
While contemplating all of those questions, the meaning of life, and adolescence all at the same time, I came across the next meaning of the word fat. Fat as an ingredient. Fat as part of the food chain that is to be avoided. That seemed to make sense to me. If a food has fat and I am fat, then not eating fat should make me thin. Right. Wrong. As it turns out, I gained weight when I tried to eliminate all the fat from my diet. Pasta had no fat. Pasta sauce has very little fat if you don’t make a meat sauce. Italian bread, bread crumbs, stuffing and any other carbohydrate I could consume was mine for the taking – no fat and eat as much as you want.
This entire experience never felt right to me but I stuck with it for two months. Something that I talk about a lot in my medical practice and in my books is to always be comfortable with your choices. Our gut instincts are powerful and once you make a decision, believe in it and it will be the right one. When I was doing low fat, it didn’t seem right to me but I stuck with it anyway – I was a kid and what did I know?
So, low fat didn’t work. I didn’t eat any fat and I got fat-ter. Now even my own fat was taking on a modifier. However, I was soon to realize that I wasn’t alone. The time period I am talking about for this revelation on my part was about 20 to 30 years ago. In that time frame, the numbers of overweight and obese people has grown exponentially.
In fact, the numbers are staggering. 80% of all Americans over the age of 25 are either overweight or obese. 33% of all children are overweight or obese and when you factor these two together, the total figure for all Americans is 60%. That is frightening enough until you look at the actual figures. This translates into 18 million children and 145 million adults. Unfortunately, by the time there were so many overweight people, I had become thin – again in the minority – what is that all about?
From a strictly medical point of view, it is necessary to consider the public health costs for this epidemic. Since obesity is responsible for four of the top ten leading causes of death, the health care costs are staggering. With the population rapidly getting older, this is only going to get worse.
Heart Disease – Obesity affects 70% of those diagnosed with cardiovascular disease and costs $22.2 billion
Type II Diabetes – Obesity affects 80% of those diagnosed with NIDDM at a cost of $11.3 billion
Breast and Colon Cancer – 50% of breast cancer patients and 42% of colon cancer patients are obese at a cost of $1.9 billion
Hypertension – 26% of high blood pressure patients are obese at a cost of $1.5 billion
Despite these alarming statistics, I wasn’t comforted by the strength in numbers theory. I was not getting dates and I wanted to be thin. All my thin friends were dating so I had to be thin if I wanted to date too. So, I couldn’t figure out what to do, so I decided to give up food altogether. If you didn’t eat, you couldn’t gain weight. So, I ate nothing for 40 days. Some of the commercial programs where you count points or something like that can certainly feel like you are eating nothing, but I literally ate nothing. It worked – I lost 60 pounds, but the price has been unforgiving.