Running around in circles to lose weight

Slimming down? It takes more than just giving your credit card a workout.

I AM very direct with patients lately. “What are you doing about your weight?” I ask.

I’ve received responses that vary from the defensive to the absurd. Probably the most frequent response is, “I’ve joined the gym.” Hardly anyone ever tells me, “I go to the gym.” Apparently, handing over one’s credit card is about as close to exercising as one can hope to come these days.

“At least I’m not depressed anymore,” one patient replied.

I think that implies that I should be thankful that one of her problems is under control.

Maybe there is a hint of a threat here too. If I pressure her any more about the obesity issue it might precipitate a relapse of mental illness. Hmm. There’s not much room for me to manoeuvre with this elephant in the room.

People also tell me of the diet plans and organisations they have enlisted. It seems the more they have had to pay, the happier they are with the advice.

I’ve found that some patients are unable to acknowledge that a problem exists.

I was dumbfounded by a woman who explained most unapologetically that she weighed no more now than she did during her last two pregnancies.

The fact that she was no longer carrying a fetus didn’t seem to matter. The fact that she’d had several decades to shed the baby fat was ignored as well.

While I was trying to think of a tactful follow-up to her comment, she continued:“I think pregnancy is designed to prepare you for later on in life when you are this size.”

Reading a popular science magazine recently, I came across another mind-blowing hypothesis about obesity, implicating the role of colonic bacteria.

Some research seems to suggest that the composition of gut flora can contribute to slimness or obesity.

Inoculation with faecal flora from thin mice to germ-free mice was associated with weight loss.

Inoculation with flora from obese mice resulted in weight gain.

Personally, I work at keeping a low BMI by walking an hour most days and eating with my health in mind. But now I’m just waiting for that not too distant day when a patient comes in requesting me to be a faecal donor.

Who knows, maybe I’m sitting on a gold mine.