Preventive Medicine Column
Dr. David L. Katz
Collusion might reasonably be defined as meeting the enemy and discovering it is both them, and us. In the case of health- personal wellbeing and public health alike- exactly this sort of thing is going on. It is way past time to take the way past these toxic impasses.
The leading public health problems of our time are obesity and related chronic diseases. This is well studied and thoroughly established. As bad as the current situation is, with chronic diseases imposing an enormous burden in both human and economic terms, things are projected to get far worse. Chronic diseases are proliferating around the globe, affecting ever more people here in the U.S., and taking hold at ever younger ages. We are losing an enormous number of years from our lives, and an all but incalculable amount of life from our years. What makes this truly tragic is that it is almost entirely preventable.
What’s the collusion? We let their inventions become the mothers of our previously unrecognized necessities. Nobody needed soft drinks before they were invented; thirsty people did just fine with water. But we sure seem to need them now, downing sugar measured in tonnage, an astronomical number of calories, and spending fortunes for the privilege of propagating our collective risk for obesity and diabetes. Rakes once seemed to suffice, but now a wayward leaf clearly demands the revving engine of a power blower. To say nothing of the need to play soccer on a screen using only our thumbs, while an actual soccer ball sits unused in the yard. You get the idea. Nobody is making us stay on the couch or eat junk food- they are just selling stuff we keep buying.
Yes, it is true that junk food is willfully engineered to be addictive, but so are illicit drugs-and most of us choose not to use them in the first place. We have no fundamental obligation to call toaster pastries “breakfast,” French fries a snack, or to keep runnin’ on Dunkin. We do have choices.
As for personal health, the story is much the same. You, and I, have the means available to slash our personal risk of ALL major chronic disease- heart disease, cancer, stroke, diabetes, dementia- by fully 80%. If knowledge were power; if we used what we have long known- there are fully 8 chances in 10 that our loved ones who have been diagnosed with any of the above, would not be. This is not about some remote, anonymous public. This is up close, and very personal. It’s all about us, and the people we love.
What’s the collusion? We could, any time we like, concede that quick fix diets cannot be a solution to the lifelong challenge of weight control. We could acknowledge that going on diets that leave our children behind in an age of epidemic childhood obesity is not only fraught with the likelihood of failure, but is fundamentally irresponsible. Apparently, we are saying to our children: grow up and get fat, then you, too, can try to sort it out for yourselves. As long as we keep buying lotions, potions, and fad diets- the individuals and industries involved will all too happily keep selling them.
What, then, is the way past the impasse? Pretty straightforward, actually:
1) Apply common sense more commonly Reasonable, responsible people apply common sense to everything that matters- money and mortgages; education and careers; pet care and vacation planning. And yet, we turn it off and go into some kind of “trance of gullibility” when promises about weight loss and health promotion come along. We could stop, and apply common sense more commonly to health– which certainly belongs on the short list of priorities we all respect and take seriously.
2) Get empowered to be responsible The Spiderman movies famously served up the adage, “with great power, comes great responsibility.” That implies a corollary we all too often ignore: before we can take responsibility, we must be empowered. There is an empowering set of skills for getting to health in spite of it all that successful experts apply to themselves. Such skills can be acquired, and applied, by anyone willing to make the effort.
3) Take one step The journey of a thousand miles famously begins with one step. The journey to health in most cases is substantially shorter than that, but also begins with one step. Learn and apply a skill to sleep better, or manage stress, and you may find you have the energy to be more active, and so on.
It may seem as if what stops our progress to health is unfixable. Just the opposite is true. If we initiate the right process- take one step on the way past the impasses- then what would fix health could very well be- unstoppable. Shall we get started?
Dr. David L. Katz