A Weighty Issue

I cannot describe how pleased I am that so many of you are heeding my call to wedge yourselves into your running bras and get out on the pavement.

But I am dismayed to see how many of you immediately started talking about your weight—that you wanted to lose some, that you did lose some, that you weren't losing any.

If you go back to my original post, you will see that never once do I mention weight loss as a reason to run.

Whaaa--? I hear some of you thinking. Why would I do something so unpleasant if I'm not going to get skinny?

Sigh. OK. I will tell you why you should later. But first let me tackle the topic of getting fat.

You probably already know that the country is experiencing an obesity epidemic. The majority of adults in the U.S. are above a healthy body weight. This in turn has caused an epidemic of Type 2 diabetes. And diabetes is the number one cause of 1) blindness 2) amputations and 3) kidney failure requiring dialysis. How great would it be if we could avoid all that? So doctors are desperate to find a way to get people to lose weight. Fat people are also desperate to lose weight, because even as everyone has gotten fatter, discrimination against fat people has not decreased at all.

So if everyone's on the same side, what gives? Why is everyone getting so big?

It's tempting to say that it's the fault of the fast food chains. And they do play a role, but I would argue a small one. The problem is multifactorial. There are several important differences between the U.S. now and forty years ago (or the U.S. and some other countries where people have not yet started to expand). First, people no longer have to move. Most people can now do their jobs by lifting only their fingers; correspondence, chatting, ordering, everything can be done by computer. (Being a physician is one of the few professions where we must keep moving — from room to room, down the hospital hall, to the front desk.) Second, people and jobs have moved away from the city centers, so almost everyone commutes by sliding their padded butt into a carseat and driving to a parking lot next to their job. People don't even expend the energy to shift their own car gears anymore. Third, food is now available everywhere, at any time of day or night. Not just at fast-food joints; everyone has a vending machine no farther than an elevator ride away from their desk, a 24-hour convenience store (with a parking lot) on the corner down the street from their house, and a huge refrigerator stocked with goodies.

Humans are genetically programmed to eat when we can and rest when we can, because we evolved during a time when if you passed up a meal or a rest stop, you were that much closer to being the weak one who got left on the rock to distract the saber-tooth tiger. (This programming is not uniform; some of us are jittery and jumpy and more easily distracted and tend to stay naturally slim. It was probably an advantage to a tribe as a whole to have a few people like this, so as to be able to alert the calm ones to danger and to run really fast if need be.) It probably didn't happen often that anyone got fat back then, but even if a tribe were so lucky, the consequences of this—premature death—were not, evolutionarily speaking, undesirable; these folks had already had their offspring, who cares if they lived to be 90? It's not just humans who are like this, either. I used to feel really sorry for birds in cages, because flying seems like such a wonderful thing, and they're being prevented from doing it. Then I learned that when birds live in a place where there are no predators on the ground, they give up flying. They get fat and lazy and waddle around, just like humans.

So when you pass up running and instead pull your car into the 7-11 for a Slurpee, you are simply heeding your DNA. That's right, it's not your fault. So quit feeling guilty; it's unproductive. But do realize that you are not in the environment your DNA thinks you are, and it's now up to you to adapt yourself.

It's been shown over and over again that if you put people into a controlled environment, calories in minus calories out equals weight gained or lost. No one is immune from this law of physics. What can't (yet) be measured, though, is just how hungry a person gets when they take in less than they put out, or how unpleasant a person feels when expending calories. You may suffer more when trying to lose weight than I would, I can't deny that.

Which brings me to the running thing. Simply running will not cause you to get skinny. Running more and eating less will. The running part is simple; the eating less, harder. But I'll give you a rough idea of what has been shown to be helpful (and in fact, I follow most of the rules myself):

1. Eat breakfast. People who put off eating until late in the day tend to be fatter.
2. Avoid simple sugars. This includes, but is not limited to, soda, juice (yes, even 100% fruit juice), candy, cakes, pies, chips, and white starchy foods. Simple sugars go down easy, then shoot your blood glucose up, which shoots your insulin up, which makes your blood glucose plummet, which makes you hungry. Hello, vicious cycle!
3. Make it a rule to stay away from the vending machines, the corner store, and the coworker offering donuts. Fast and easy snacks result in fast and easy pounds.
4. Don't keep bad food you can't resist in your house. What's that? You need to keep stuff around for your kids? Why on earth would you want your kids eating crap either?
5. Get enough sleep. Sleep-deprived people tend to get fatter; it's not known why.
6. EXERCISE. Exercise alone doesn't guarantee weight loss, but it does seem to prevent weight gain. Over the years, I have watched everyone I know slowly, slowly expanding, with the exception of those who get regular exercise.

But please do not run for the weight. Run because a fat runner is much healthier than a skinny couch potato. Run because it makes you strong. Run because it makes you happy in your own body, whether it's lumpy or flat, tall or short, square or round. Run because you'll live longer (and no, you won't wish you were dead, ha ha). Run because when you're out there running (as slowly as you can stand to, remember), you will have the experience of being alive in the world with your body doing what it was designed to do.