Fat Tuesday

One of the main medical problems plaguing our country is obesity. The fast-food nation in which we live has given rise to not only unhealthy adults, but also to an entire generation of children raised on Happy Meals, processed meats, and Cheese Whiz. There's an old adage that goes something like, "give a man a fish and you'll feed him for a day. Teach a man to fish, and you'll feed him for a lifetime." I think a more updated version should be, "give a man a fish and CHOMP CHOMP CHOMP I want McDonald's now." As a physician practicing in a very unhealthy state, I have seen my share of obese people - adults and children alike. Today, however, I saw one that took the proverbial cake, not in the actual poundage this lady was packing, but in the utter ignorance of the dangers her weight carried.

It was a busy morning at Disability. Everyone, for once, was showing up, and for the most part, people were demonstrating some physical impairment. Towards the middle of the morning, a claimant entered through the door, and stated that she was here "to get a second opinion about her heart." After informing her that there would be no second opinion today, my secretary proceeded to get her social security number, her height (5'1"), and then asked her to step on the electric scale to be weighed. The scale went through its calibration, blinked a few times, then read ----. The scale had worked just fine earlier in the day, and after the claimant stepped off the scale, it proceeded to work fine again. The claimant again stepped on the scale, and the scale numbers turned to ----. With a shrug, the claimant stated that she usually weighed around 400 lbs, and then proceeded to walk into my exam room.

After a brief history, it turned out the claimant had "very bad heart failure," and that her ejection fraction (a measure of pump capacity of the heart), was around 13% (normal is above 60%). She admitted to smoking a 1/2 pack of cigarettes a day, and stated that her back always hurt, and she just didn't know why. The remainder of the history was fairly typical for a heart failure patient, and her physical exam revealed typical signs associated with decreased cardiac pump capacity. As the exam was ending, she looked at me and asked, "I'm on Lasix (a typical medicine for heart failure), but it just doesn't seem to work. Is there anything else I can do?" Normally I don't give out medical information in this setting, but this lady seemed so uneducated about her condition that I felt compelled to speak. "The best thing you can do for your heart is lose weight and stop smoking." She looked very puzzled at this. "But it hurts too much to exercise," she said, "how am I supposed to lose weight?" "Diet. It sucks, and it takes a long time, but if you want to really lose weight, you're going to have to change your lifestyle, and the foods you normally eat." She started to cry a little at this point, and said, "well, I guess I'll find some other way to lose weight, then, because dieting just won't work for me."

We are all responsible for our own health. I can't make you eat carrots and tofu every meal, nor would I want to. There's too much good stuff to eat out there. However, it's our responsibility to take care of our own bodies, as well as set an example for future generations to cherish the bodies we've been given. No pill will reverse a lifetime of poor choices.

And now, the quote of the day from disability physicals:

"My kids got taken away from me because I bit them too hard, and this really depressed me."

Cherish your body,

DD