Willpower and Weight Loss (Part 3)

Well... here we go again.

In a Fox News article, Former Half-Ton Man Still Has Weakness For Cigarettes, Chips, we find a tragic example of the cluelessness of the medical establishment and the American public at large. This is the guy who had to be cut out of his bedroom to be taken for medical attention.

Times are tough for the Nebraska man who once weighed more than 1,000 pounds, but Patrick Deuel says he’s trying to keep a positive outlook.

Really? Poor guy. (Do you hear the tiny violin music?) As you learn from Dr. Laura Schlessinger, you don’t get self-esteem first and then behave differently – you behave differently, and then get self-esteem... so a positive outlook is exactly what he does not need. He need a negative outlook. He needs to know that he’s killing himself and absolutely must change if he wants to avoid it.

“Oh, I’m still breathing,” the 46-year-old Deuel sighed before suddenly letting out a hearty laugh.

Yeah, this is really something to laugh about, huh? Huh. Maybe, but for how long? I don’t think he mentally accepts the gravity of his situation.

Deuel weighed 1,072 pounds in 2004, and in order for him to have lifesaving gastric bypass surgery, a bedroom wall had to be cut out so he could be extracted from his home in Valentine.

I honestly don’t know how a person can allow themselves to get this way. What was he thinking when he hit 300? 400? 500? What was he thinking when he couldn’t find a household scale to weigh himself any more?

For my money, I suspect depression. I don’t see how an energetic and vivacious person could get that way. A sedentary, depressed person, who works in the food industry? Yeah. If it’s depression, I do empathize. He should be treated. And, many medications for depression make it difficult or impossible to lose weight – even if you correct your food choices – by (this is my theory, based on extensive research) antagonizing the Beta-3 receptors responsible for the release of fat from your fat cells when your body needs to burn fat for energy. (In medical parlance, antagonizing receptors means blocking the normal chemicals from activating the receptor, while not activating it in the process.)

Oh, but it gets so much better. You know I’m already down on all the gastric surgeries... after all, what do they accomplish? They make you eat less. That’s it. I know eating less is not easy. I know exercise is not fun. Most importantly, I know that neither of these things, alone, is going to help you lose any weight.

After getting down to 370 pounds in late 2006, he was up to 540 in May, the last time he stepped on a scale.

Lifesaving gastric bypass? More like life-lending – he will pay. And what about now, that he’s gaining it all back? He can’t exactly have another one. It must be something else, huh?

“As far as being able to go out and do the things he wants to do, he’s been able to do that,” said his wife, Edie. “That’s so much better than a number on a scale.”

Um... okie dokie! That’s pretty weak in my own humble opinion. The number on the scale tells you more about your general state of health than whether you can do the things you want to do.

Let’s be generous and assume this fellow is somewhere between 6’ 0” and 6’ 6” — a Body Mass Index of somewhere between 62 and 73. Morbidly obese is anything over 40. And you note, he hasn’t even been on a scale in 3 months.

Though Patrick Deuel has put on about 100 pounds in the past year and remains morbidly obese, his health is generally good, said his surgeon, Dr. Fred Harris of Sioux Falls, S.D. If a patient loses 50 percent of his or her excess weight after surgery, it is considered a success, he said.

Sorry? I’m glad the doc considers it a success... but that’s a pretty low standard, considering that he’s gained a significant portion of it back.

I don’t know this fellow, but would love to talk to him, and teach him, that he can control his appetite – notice I said “appetite” – not his “eating.” And there’s no so-called “willpower” involved.

“Patrick’s still ambulatory. He can still drive a car,” Harris said. “Last I heard, he can still ride a bike, as opposed to being a week or 10 days from dying.”

Yeah, now probably what -- 14 days out?

Deuel acknowledges willpower is not his forte. To the chagrin of his wife and Harris, he still smokes a pack and a half of cigarettes a day. He also has a weakness for chips and salsa.

[emphasis added by me – A.P.]

AHA! Here we are with willpower, again.

Nope. I say that’s not it.

It’s his appetite -- he has an intense craving for carbs, and cigarettes... and in my mind, the craving is the same.

“I notice that stress eating is something I do well,” he said.

They really do call it comfort food for a reason.

Deuel is unemployed. He said he’s been going through vocational rehabilitation to determine the type of work that would best suit him. The former restaurant manager said he definitely won’t work in food service again. There’s too much temptation, he said.

Yep.

The couple’s only income is Patrick Deuel’s monthly Social Security check of less than $600.

Running errands, cleaning house and helping his wife find a job occupies much of his time, he said. As for his diet, he said: “Whatever’s in the refrigerator is what gets put in the tank.”

Yep, again. Of course, that prompts the question, “why are there things you should not eat ... in your refrigerator?” (And why does his wife not have some kind of gainful employment?)

Deuel said humor is his best coping device.

“It’s either curl up in the corner and cry or keep it light and try to get through it,” he said. “I could be pretty upset pretty easily, but why should I be?”

Yes, the classic laughing, smoking, fat guy. You know them, and I know them.

Um... maybe he should be upset – because he’s morbidly obese and unemployed, maybe? Maybe some distress would make him realize what’s going on and that he really is in control – but again, it’s not “how much” he eats. It’s “what” he eats.

Do I seem hostile? I don’t mean to be. I’m actually sympathetic for the guy, assuming that he doesn’t have the information he needs to make a positive change. I’m just frustrated that no doctor has the sense to tell him, “Dude. You’re an addict! And just like any other addiction, the more you use, the more you crave! You have to abstain, if you want to live!”

I’m sick of reading people talking smack against controlled carb as a way of life that will normalize your weight. I’m sick of hearing how it’s bad for you, not nutritionally balanced, is no different than counting calories, blah, blah blah!

The magic of controlling carbs is two-fold:

• Your appetite for carbs will go down. It’s not willpower — it’s appetite that causes your problems.
  
  
• Burning fat is less efficient than burning blood sugar. Why does this help? Because the theory that “a calorie is a calorie” is a crock. Fat-burning is meant for survival. Presumably that’s the reason that when fat is broken down for energy, a lot of that energy is converted into waste products – “ketones” – which are flushed out by your kidneys and down the drain. Gone. Not used. Before you ask, “oh but what about the poor guy’s kidneys?!” remember – duh – that’s the same thing that happens after the bypass. Duh! DUH!!!
  

How hard is it? (Remember, I speak from experience.)

As Alex Trebek would say, “the answer there is...” It’s not hard. You just have to have the right information. Once you have the information, you have to believe it. Once you believe it, you can hardly control your desire to put it in to practice.

— 2008-08-31 10:45: minor content tweaks for clarity.