Avert the Winter Holiday Blues

Recent posts have a lot to say about the damage that can be done by mouths, both our own and other people’s. Some adults put intoxicants into their mouths, and unkind words come out. They have something to say about another person’s size, or their eating habits. Children, being such excellent mimics, can be just as rude without even taking a drink.

Often, hearers of those mocking and fat-shaming words become upset or “triggered,” and then proceed to shovel a large amount of food into their mouths, which ultimately makes the situation even worse. And of course, no parent wants to be ridiculed as an enabler who fattens children up as if to enter them in the State Fair’s giant pumpkin contest.

Why do they do it?

For an obese child, seeing relatives only once or twice a year can be a special kind of torment. It’s as if some people are robots, incapable of saying anything original. Their first remark is always size-related, and on a certain level, it really does not matter if the words are derogatory or complimentary. Without being able to sort out the thoughts and reactions they feel subconsciously, a child may still have an instinctive response along the lines of, “Who gave anyone the right to talk about my body?”

No one wants to feel like a piece of human merchandise up on the auction block, with their flaws and good points being discussed to influence the bidding. Even the least reflective child can detect the injustice. “Why is it any of her business what’s inside my clothes?” is one thought that comes to mind, or “We haven’t seen each other for a year, and that’s the conversation starter he has to lead with?”

To say, or not to say?

If each and every one of us could learn to bite our tongues and not repeat that fat joke at Cousin Lizzie’s expense, the world would be a better place, and even the impulse toward “positive” interference should be carefully considered. Whether the target is a child or adult, even the most kindly, well-meaning attempt at intervention will not be received with gratitude.

One year, the National Obesity Forum conducted a study to see how folks feel about telling others they are fat at Christmas. Here is an interesting detail:

Men find it hardest to tell their partners, while women were more worried about bringing up the issue with a friend.

Maybe, nobody should tell anybody anything. Maybe it’s simply not a discussion to have on this sort of occasion, especially when unasked for. On the other hand, Prof. David Haslam, the organization’s chairperson, says go ahead and be that dreaded bringer of bad news:

Suggesting to someone that they should consider losing a few pounds may not be a comfortable conversation to have. But if someone close to you has a large waistline then as long as you do it sensitively, discussing it with them now could help them avoid critical health risks later down the line and could even save their life.

Your responses and feedback are welcome!

Source: “’Tell loved ones they are overweight this Christmas’, BBC.com, 12/21/11
Image by FolsomNatural/CC BY 2.0 DEED

Abjure the Winter Holiday Blues

The types of social disorder mentioned in the last post prove that the mouth is the most dangerous part of the body. Our own mouths get us in trouble, and those of other people say things that cause us serious pain. In other instances, they don’t even need to use their voices. That sweater Aunt Georgie gave you, the Christmas when you were 10… Was its tiny size a pointed reminder of your extra pounds, or simply an “Oops!” from a nice lady with too much on her mind?

It comes as no surprise that adults are just as flummoxed as younger people are, by holiday family gatherings. Plenty of adults take on the role of director, deciding how everyone else ought to act and react during every moment. There is always one aged relative known as the most censorious and judgmental, and probably another famed as the eternal scamp who will never grow up.

Despite their seeming differences, it may be that neither one of them wants to continue as a caricature. Somehow they keep finding themselves inhabiting roles that nobody really wants — and meanwhile, their thoughts are identical: “Next year, how do I avoid this clown show?” Maybe they mean, “Could I simply neglect to show up, and get away with it?” Or perhaps they mean, “What must I do to become the person who can show up for this occasion, and handle it, next time?”

Other people’s mouths

For a child, the miseries of going out to somebody else’s house, or of being part of the host family, are probably about equal. Either way, the relative who loves to torment you will be there, pinching your cheeks and making snide remarks about dessert and portion sizes. Kids, you need to know that at this time of year, adults might do anything, especially at a large family gathering.

Some adults want to retain control by keeping the kids in sight at all times, as elaborate traditional role affirmations are played out. Or the grownups will go the other way and strive to keep the little kids in one space and the older ones in another, and all separated from the adults.

In fact, this is a great time to hit the parents up for some fancy delivered food, premium screen media content, or permission to use the car. As long as they are left alone to do their partying, they don’t care what the kids do, and children of all ages take advantage of this fact by extracting bribes. The corollary to that is, if overeating is their problem, young people who are vulnerable at any stage will certainly overeat during the holidays.

Your responses and feedback are welcome!

Image by JESHOOTS.COM on Unsplash

Beware the Winter Holiday Blues

The body part most closely associated with the winter holiday festivities is the mouth, and not only because of all the singing and eating. At any social gathering, there is generally quite a bit of loose talk, the kind that does damage. This is true of many different environments — work, school, and especially family gatherings. Is there anyone who has not been hurt or insulted by the words of some relative or family friend, at the exact time of year when everything is supposed to all be love and light?

Despite the common belief that nobody should be alone for the holidays, a lot of people would pretty much rather be on their own rather than put up with a lot of nonsense. They don’t want to hear about how overweight they look this year, compared to the same time last year. They probably don’t even want to commiserate with other parents about how difficult it is to keep the children from ballooning up.

A family get-together can turn toxic pretty fast. Children might face an excruciating dilemma, caught between two equally vital concepts. Your parents warn you there are certain kinds of kids you shouldn’t hang out with, because it can only lead to trouble. Then, you meet one or more kids that your personal spidey-sense tells you are bad news — except you have to hang out with them, because they are your cousins.

Enforced tribal cohesiveness

For many people of all ages, another unattractive aspect of a big family gathering is that you’re expected to stick with it for the duration. Some sensitive children get very unbalanced from being around too many people for too long. But to be separated from the grownups does not help, because some of the kids you get banished to the rec room with are obnoxious. At least an adult might go on a helpful or necessary errand, and make a temporary escape. A grownup can choose to drive away, or walk away, or find a place to be alone for a while.

A very clever grownup may engineer some quality time with a favorite relative while avoiding the less agreeable ones. It comes as no surprise that even super-sophisticated folk like psychologists, trained therapists, and clergy members can be thrown off their stride during the holidays.

The ordeal

Children are expected to be polite, good-natured, respectful, and most of all they are expected to cheerfully put up with personal remarks about their appearance. A lot of children and teens are defenseless against cruelty, especially from relatives. An overweight young person is aware that he or she will be critically scrutinized and discussed, and probably photographed for reasons other than a desire for fond memories.

What is worse — to endure this kind of discrimination alone, or as part of a group? There are family get-togethers where every adult considers it her or his sworn duty to issue an opinion about every single other person who is present — especially the kids. It’s as if critiquing each body, young or old, is their job, and they’re trying for a promotion. Somehow, you just know that Aunt Nell intends to go back home to her circle of evil witch friends and show everybody how much fatter her niece is today than a year ago.

Your responses and feedback are welcome!

Image by Ben Askins/CC BY-SA 2.0 DEED

Continuing Lifestyle Intervention, Part 9

This quotation, typical of many others, comes from Healthline:

Research has found that when people stop using semaglutide medications […] weight rebound occurs. Experts say this is because the drug is not a cure…

The author also adds, “and it does not prevent the metabolic adaptation that occurs during weight loss.” Just like in the aftermath of bariatric surgery, the patient will have to cope with the adjustments and compensations the body has made in an effort to get back to what it — rightly or wrongly — perceives as normal.

The term “the chronicity of obesity” has been brought up, and “chronic” is not a word we want to hear associated with any of our physical problems. It also is faintly reminiscent of a concept that Childhood Obesity News discussed at length — the Set Point.

It has been suggested that the Set Point is such a relentless foe, that it does not even stay faithful to its name, but sneakily persists in resetting itself, to an ever-higher figure of course. If the dreaded Set Point exists, then the subject of the present discussion, “continuing lifestyle intervention,” should necessarily be a part of just about everybody’s program, always. Anyone who finds the topic interesting can see more here, here, or here.

If there is such a thing as a set point, long-term maintenance would be impossible except for a small percentage of weight losers who are willing to devote to it a large percentage of their time and efforts.

The big question

One of the most important discussions to be had right now is, what to do about obese children and teens, and most of all, how to prevent them from getting that way in the first place. But, one thing at a time. For kids who are already over the line, they, their parents, and their medical advisors face a choice between surgery and meds. The trend toward favoring and recommending new weight-loss drugs seems so well-established as to be inevitable.

The biggest difference between them is that a whole lot is known about life after bariatric surgery, while not much at all is known about life after beginning one of the drugs. That lack of knowledge is true of patients who stay on the drug they are prescribed, and those who quit after a year or even a few months.

As for staying with a drug for several years or many years, a relatively minuscule amount of information has been collected. The only certainty is that everybody needs some help along the way, and most people succeed much better with continuing lifestyle intervention of some variety.

What has been the point of this series on continuing lifestyle intervention? To emphasize its importance of course, but more than that, to remind the Childhood Obesity News audience that there is an excellent tool for the purpose. We urge readers to check out BrainWeighve as a guide through the scary forest of continuing life.

It is for people who are actively working on breaking their addiction to overeating (and other things as well) and yes, even for people who don’t have an addiction-prone tendency and hope to avoid ever having one. It’s a flexible program, to participate in a little or a lot, as needed; both a tool for maintenance when things are going smoothly, and a staunch ally to do the heavy lifting when the train jumps the track and needs to be put back.

Your responses and feedback are welcome!

Source: “Ozempic Rebound: Why Most People Regain Weight After Stopping Semaglutide,” Healthline.com, 06/09/23
Image by Pam Lariviere/Public Domain

Continuing Lifestyle Intervention, Part 5

UCSF (University of California San Francisco) has words for the patient considering weight-loss surgery. Some of those words are, “Not a cure for obesity, but rather a tool…” In addition,

Long-term success depends on your ability to follow guidelines for diet, exercise and lifestyle changes… Now you must commit to a new way of life.

When the Bariatric Surgery Center talks about followup care and the future, it mentions “a support group, dietitian services and continuing education.” These would come under the heading of continuing lifestyle intervention in anybody’s book. Interestingly, part of the lifestyle is to avoid pregnancy — just like with the semaglutide drugs.

In the weight-loss realm, surgical and pharmaceutical patients both receive numerous tips about how and what to eat. The surgical patients are advised to burn calories and build muscle by working out. The users of the hot new drugs are given the same advice, especially since the drugs seem prone to melt away not just fat, but perfectly viable muscle tissue.

More great advice that applies equally to both types, is to maintain and cultivate social relationships, particularly the kind that fosters the goal. Like, join a weight-loss support group. And spend time doing things that are fun and meaningful, which ties in with the importance of positive displacement.

And furthermore

Other comparisons can be made. People who undergo bariatric surgery, or who have diabetes, are not expected to abandon their support systems partway through life. A person isn’t going to someday get their amputated stomach back, or suddenly receive a revelation about how to stay alive without insulin. The program of lifestyle intervention that comes along with the surgery or the shots is a “forever” kind of thing.

Why should people taking GLP-1 drugs be any different, whether they quit after a year, or continue forever? Either way, they need ongoing support and other elements of lifestyle intervention, on a continuing basis. Surgery is not a “set it and forget it” proposition, nor is embarking on a course of elective medication with no time limit in sight. Positive attention must still be paid to every aspect of life — and if we’re doing it right, attention quite often demands intervention.

“Lifestyle” is much more than a glossy magazine cover. There is nothing trivial about it. Life is a serious concept, comprising today and tomorrow and each succeeding day of our existence until it ends. And “style” being the individual choices and cumulative effect of the way we do every little thing, every single day, from now until infinity.

Your responses and feedback are welcome!

Source: “Life After Bariatric Surgery,” UCSFHealth.org, undated
Image by Alachua County/Public Domain

The Effects of Taking Weight-Loss Drugs

December started with breaking news in the realm of weight-loss drugs, making the case yet again that GLP-1 drugs can potentially cause significant adverse side effects and should be approached with caution and under medical supervision.

On December 1, 2023, pharma giant Pfizer announced that it decided to halt the development of the twice-daily version of its experimental weight loss pill due to serious side effects observed in a mid-stage clinical study. Obese patients experienced notable weight loss but struggled with tolerating the drug, primarily facing mild gastrointestinal issues.

Despite the setback, Pfizer still plans to release data on a once-a-day version of the drug in the first half of 2024, which will influence its decision on whether to proceed with a phase three study. The company had hoped to capture a share of the lucrative weight loss drug market, but this development puts it behind competitors such as Eli Lilly and Novo Nordisk, who are working on pill versions of their successful weight loss and diabetes injections.

Pfizer’s stock closed 5% lower after the announcement, impacting its aspirations to rebound from declining demand for its COVID products. CNBC Digital Reporter Annika Kim Constantino wrote that:

The new data is a blow to Pfizer and its hopes to win a $10 billion slice of the booming weight loss drug market, which CEO Albert Bourla previously said could eventually grow to $90 billion.

The side effects spread to stopping taking the drugs, too

As we’ve mentioned in our previous post, not just taking but stopping the meds can have serious negative consequences, too. This has been backed up by both research and observing the patients who have experienced them. The list is rather long and includes weight gain, blood sugar increase, an increase in blood pressure, mood changes, a negative change in cholesterol levels, and so on.

Health.com writer Michelle Pugle wrote about Ozempic in particular:

Experts emphasize that Ozempic is intended for long-term use and should always be used under the supervision of a healthcare professional. Experts recommend people who are going off the drug should enroll in a nutrition program before going off the medication, so they’re better equipped to make healthy choices that support their health needs post-Ozempic.

And yet, the weight-loss drug market is thriving

An investigative report by Chad Terhule and Robin Respaut that was published on the same day of Pfizer’s announcement by Reuters said that the Danish drugmaker Novo Nordisk paid U.S. medical professionals at least $25.8 million over a decade in fees and expenses related to its weight-loss drugs. It concentrated that money on an elite group of obesity specialists who advocate giving its powerful and expensive drugs to tens of millions of Americans.

One such doctor is Dr. Lee Kaplan, the chief of obesity medicine at Dartmouth College’s medical school, and a leading U.S. obesity specialist. Terhule and Respaut quoted him in their piece:

Obesity, he said, should be treated as aggressively as other chronic diseases such as high blood pressure or diabetes — with lifelong prescriptions. “We are going to have to use these medications,” he said at the June gathering, “for as long as the body wants to have obesity.”

Novo’s most lucrative market is, you guessed it, the USA. The authors explain why:

[…] because more than two-thirds of adults are overweight or have obesity and drugs frequently command the highest prices worldwide. Novo charges U.S. customers $1,300 a month for the weekly injection.

The Reuters report also quotes Dr. Arthur Kellermann, a health administrator and former dean of the Uniformed Services University of Health Sciences, the U.S. military’s medical school, who reviewed Reuters’ findings on Novo’s spending.

The company’s large-scale payments to doctors, he said, illustrate a longstanding problem in the drug industry “The pharmaceutical industry still sees value in paying medical thought leaders to promote their products, and too many of them are happy to sign up for a six- or seven-figure check,” he said, calling such lavish payments “morally and ethically way over the line.”

Your responses and feedback are welcome!

Source: “Pfizer to discontinue twice-daily weight loss pill due to high rates of adverse side effects,” CNBC.com, 12/1/23
Source: “Maker of Wegovy, Ozempic showers money on U.S. obesity doctors,” Reuters.com, 12/1/23
Source: “What Happens to Your Body When You Stop Taking Ozempic?,” Health.com, 11/30/23
Image by Diana Polekhina on Unsplash