Tuesday, December 10, 2013
By SUSAN FEKETY
FALMOUTH — This time of year, I become anxious and depressed at work.
Not because I don't think I'm going to get the right presents, or because my Christmas bonus isn't up to my Visa bill.
Nope – around now, I see my patients pumping themselves up for New Year's resolutions which typically will not stick much beyond maybe February.
It breaks my heart, because I know what's coming next.
I've been a health care provider for 25 years, working mostly with women.
When I ask about nutrition and activity, I often hear, ''Yup – right after the holidays. I need to lose about 20 pounds.''
This ''getting in shape in January'' thing is perennial and it comes with props: new calendars, lights twinkling like stars, January white sales.
It's my job to cultivate hope – but instead I feel sad.
Why? Because if the focus is on losing weight – rather than on getting healthy by being nice to your body – it will not stick, and it will make you sick.
Every year I watch folks apply force and determination to their bodies with mind-numbing low calorie diets and teeth-gritting exercise, thinking that if they're disciplined enough, or take The Magic Pill, they'll get Big Results Fast and be like the people in the magazines who are having so much fun.
I strive to lure people towards a better approach -- but I know that my spring schedule will be filled with people who landed back in their fat clothes, which are now tight. There are tears -- both of us, heartbroken.
This year, some of the approaches I'm hearing about are actually scary.
Amphetamine-like stimulants such as phentermine are taken for appetite suppression. Human chorionic gonadotropin (HCG) hormone shots are combined with super low-calorie diets.
Puh-leeze. That this is what modern medicine has to offer really breaks my heart.
Phentermine, like speed or crystal meth, trashes your appetite by scaring the bejeesus out of your body.
I can't believe that long-term health and happiness will come from subjecting yourself to chemical terrorism: Stress wears your body down like nothing else on the planet.
And while I am a big fan of working with the hormone system, the HCG approach is troubling.
Because it's a human hormone produced by the placenta (whose? collected how?) HCG is promoted as ''natural.''
As a women's health clinician, I think that taking shots of a hormone your body should not encounter unless you are pregnant is wicked nuts, even if it does let you feel OK on only 500 calories a day.
I hear that the HCG is given in a ''very tiny dose.'' Honey, all hormones are given in very tiny doses because they are incredibly powerful.
You'll drop your scale weight doing these things, but I'll wager you'll lose pounds of muscle -- not fat.
Stress bio-chemicals (which you make on a low calorie diet) trigger you to cannibalize your muscles for survival.
Muscle is your metabolically active tissue; the less you have, the slower your metabolic rate will ultimately be.
Lost muscle mass is the No. 1 biomarker of aging and illness, and it's what keeps the diet industry (and the pharmaceutical industry, for that matter) in business. This breaks my heart and it makes me mad.
So here's my dream for the holidays: to hear from my patients that for this New Year they're resolving to love, appreciate, and robustly care well for the precious bodies that have probably worked terribly, fiercely hard to serve them under adverse circumstances for many years.
That they're ready to use some evidence-based strategies designed to talk nice to the 4-million-year-old appetite-control hormone system they were born with.
That they choose to eat logical amounts of a variety of yummy whole foods that are full of vitamins and nutrients and which come from close to the soil instead of out of a box.
That they are going to see what they can do to move their bodies joyously and with fun and laughter so they can become powerful and energized, and that they will honor their needs for rest and sleep and love and companionship.
That if they have trouble doing this on their own, they will seek help to keep moving forward. Please hear me: These are the things that really generate health, and when they're in place your right weight will follow as sure as night follows day.
It's an inside job, and it feels really good.