Oh, to be young again.
I was 25, a first year surgery resident. I had trained hard to get to this point, and now I was applying all I’d learned in medical school. I enjoyed and appreciated the complexity of the human body. Yes, the long hours were keeping me away from my young family, but I knew that with just a few more months of tough schedules and hard work, things would get better.
Coming out of surgery one day, I heard an announcement over the PA, “Doctor Peters, line seven. Doctor Peters, line seven.” This was back in the days before cell phones, so it wasn’t uncommon for hospital operators to make an announcement when we had a call. Usually, the call was related to a patient or a schedule change.
I made my way to the nurses’ station, reached over for the phone, pressed the flashing button, and answered,
“Warren Peters.”
“Is this Dr. Peters?” the voice asked on the other end.
“Yes.”
“This is Dr. Wilson. I’m at the Auburn Emergency Room. I’m sorry to tell you, but your father has died.”
Still in work mode, I paused for only a second, not long enough to take in the full weight of the message. “Dead? He’s only 54 years old.”
I knew he was hypertensive and under a lot of stress. And that he always struggled with his fifty extra pounds of weight. But how could he be dead?
The moment I replaced the receiver after hearing the particulars, my mind raced forward and backward. How could such a man be dead so early in life? He was a vegetarian. He didn’t drink caffeine or alcohol. He didn’t smoke. Yes, he did fry most of his food, and he loved sugar, but in the scheme of what is considered “bad” for us, he shouldn’t have been at risk for dying in his 50s.
It was then that my personal and professional life changed, standing at the nurses’ station, staring at the phone. At that moment, I wanted to know more about why my dad was dead, what contributed to his passing, and what could have been done to prevent it.
Sadly, my experience wasn’t unique or even rare. Over 300,000 people will die this year from obesity related diseases like diabetes, heart disease, and cancer. They will leave family behind, just like my father left me, my younger brothers, and my mother.
Think of it, 300,000 people every year! That’s 822 people every day. It’s like two large jets crashing each and every day for the whole year.
If that many jets were crashing, and that many lives lost every day, you’d think we would notice. Would we do things today to prevent another large jet from crashing tomorrow? Would we help our loved ones avoid being on one of those jets?
Obesity killed over 300,000 Americans this year.
That’s 822 people every day
When my dad died, I was preparing myself for a life of fixing people’s health in a mechanistic way. My surgical training taught me that when something is wrong, you either cut it out or repair it. When arteries were obstructed or damaged, I’d cut out the bad sections and replace them with a Dacron tube.
But after a few years, I realized that what I was doing wasn’t solving the problems. My patients would return with new obstructions in their Dacron arteries.
One day, I took my frustration out on a patient, Sarah.
She quit smoking following a major aortoiliac bypass
graft. Back then, this was a major surgery that involved bypassing the blocked arteries in her lower abdomen. She ended up with an incision running from the base of her breastbone to her pubic bone.
At her follow-up exam three months after her surgery, I knew the minute I walked into the room that Sarah was smoking again. I could smell tobacco smoke on her clothes and hair.
After all that she had gone through with the surgery, how could she be smoking again? I had told her how her obstructed arteries were directly tied to her smoking. I had even given her educational pamphlets on the dangers of smoking. Irritated, I said, “What are you doing smoking again?” Her response shocked me. She became intense, and pointed her finger in my face, “You don’t even know me. You may know about my arteries, but you do not know me! How dare you tell me to quit smoking again after all I have been through?”
She was right. I didn’t know her or about her life.
Sarah told me she lived with an irascible man who was verbally abusive. Whenever he began his verbal tirades, she would light up and blow smoke into the space between them. It was her coping mechanism. Cigarettes helped her get through difficult times.
Sarah will never know how much she affected me. Her outburst caused me to question what I was doing, and my approach to people and their health. I began to listen to my patients.
What I learned is that people are amazingly complex. So much goes into who we are and our health. I couldn’t simply cut something out or prescribe a medication without addressing the person as a whole. In the process of listening, I began to truly care about my patients.
Introduction
From their stories and from interacting with forward thinking clinicians, I began to apply these principles to my overweight patients and I learned that these people are not heavy for the reasons we’ve assumed. Instead, there are very real genetic and biological reasons for obesity, including brain chemistry, hormones, and even how our bodies deal with glucose. None of these contributors involve laziness or a lack of willpower. Instead, very real biological processes clash against an environment we didn’t choose.
The following pages summarize much of what I’ve discovered over the years about why obesity is such a problem in our society. It reveals how myths about health continue, even among health professionals. And it exposes the problems that ignorance has caused. The good news is there is hope. We can adapt to our environments, and we have methods for accommodating our biology to deal with this new environment.
It is my hope that in reading these pages, you will better understand why we struggle, and you will have an understanding of how to improve your situation. But even more important, we all will have compassion for those who biologically struggle to adapt to the current environment. It is time to bury the old myths and embrace those who struggle in our society, including ourselves. I look forward to our journey together. I’m excited about the success you are about to have. We can do this!
Courage!