Fool’s Paradise

Back when my classmates were playing with blocks, I was stacking cartons. The glove compartment, as far as I know, might as well have been called the smokes compartment, because that’s all we kept in ours. I can visualize the plastic sealed, blanched white bodies, stacked in rows; I can still smell the unmistakeable insult of the ash that used to cling, like velcro on the lace of my shoes. He was going through two, three packs a day, habitually pounding cigarette after cigarette as if each puff was giving him life… when in fact, it was doing the opposite.

So, I’d draw family caricatures and bold, arching, colorful print that read something along the lines of “Please Stop Smoking DAD” and variations of. I’d sneak letters into his travel bag, and on the occasion I’d get to see him, I would beg him to quit. For us. For a healthier life. For, at only six years old, I was already afraid that the next time I’d see a plastic sealed, blanched white body, it’d be his.

What I had yet to learn was that the success of behavior change is determined by adherence, which can only be cultivated intrinsically. My father continued to smoke for many, many years, and despite positive behavior changes that renovated different aspects of his life, he could never fulfill the intricate web of physical, emotional, spiritual, intellectual, environmental, and social health. Because wellness is a cumulative interaction between these six dimensions of health, behavior change that hinders the maintenance of this balance may –in consequence– be fleeting, inefficient, and even detrimental.

The film, “Fat Chance,” portrays the journey of behavior change intended for weight loss that is later redirected to self acceptance. Rick Zakowich is first introduced, thirty pounds lighter but not much happier since the start of his plan to lose weight. Feeling pressured by cultural standards of beauty and acceptance, he uses appearance-based motivation to take on behavior change involving diet and exercise. It is no surprise, considering how heavily our society weighs the significance of body image, to hear a even medical professional deviate from motivational interviewing. The physician advises, “Best way to make yourself feel better about yourself… is to lose weight so that your blood pressure improves, so that you look better.” Inherent in modern American thinking is that looking better equates to happiness.

As Rick finds support from those who are content with their obesity, he adapts to a new perspective that directly antagonizes fat shaming culture; he ends the documentary by saying, “The way you are is fine. Walk through this world in that way.” On a superficial perspective, one could argue that Rick achieves a step towards wellness by coming to self acceptance, increasing his self confidence, and joining an empowered community. However, despite it being a step in the right direction, Rick fails to recognize the danger of extremes. By orienting behavior change strictly towards emotional and social health, he completely neglects the other essential components, such as physical health. There is no doubt that self love, in the right context, is deserving of praise, but the fact that he is happier does not eliminate the risks of being overweight. By the summer of 2008, my father ended up in the ICU. If he, then, had settled on self acceptance and placed another cigarette between his lips, would you have applauded him, too?

Fat shaming and fat acceptance fall on opposite ends of the spectrum, and through understanding the crucial interplay of the six components of wellness, we unveil the importance of moderation. Had the medical professional taken a different approach, like educating the benefits of exercise, rather than implying blame or demonizing Rick’s body image, perhaps Rick would not have fallen victim to an illusory state of happiness that is likely evanescent. Increasing studies now indicate that cardiorespiratory fitness and physical activity can improve multiple aspects of wellness and reduce the comorbidities tied to obesity, with or without weight loss (Dallow). This outlook on exercise may be a better approach towards positive behavior change, than one that is based on appearance. Furthermore, it would be of a greater benefit to implement behavior change that caters to both fitness, confidence, community, and other aspects of wellness. With Dr. Lerner’s medical knowledge and morale amongst Rick’s new connections, the support group could potentially be the perfect medium for a wellness program. With less emphasis on weight loss, they could tackle multiple obstacles at once and find a more permanent solution. In contrast of what they have been told by others –they can have their cake and eat it too.

To ensure safety, longevity, and efficacy of such program, professional advisement to promote adherence is crucial. Though the responsibility of wellness falls on the shoulders of each individual, it is equally important to have health care providers take the lead on public education. Patients are more likely to adhere to behavior change if they understand risk and the gravity of their conditions, so medical professionals can play a key role here (Stonerock). Proper motivational interviewing along with professional, objective, and evidence-based opinions is essential to assist others, particularly in the transition from earlier to later stages of the Transtheoretical Model. In “Fat Chance,” Dr. Moe Lerner highlights that obesity is caused by metabolism and dieting. Not once does he mention the importance of physical health. Despite his sensible attitude, his perspective holds a very narrow, almost defensive, focus to justify obesity. By relying on rationalizations and believing his physical state is not a problem, he, along with Rick and the others in the support group, regress and sink deeper into the precontemplative stage (Dallow).

In a society that strongly antagonizes fat and with a disproportionately increasing prevalence of obesity, there is a strong need for leadership towards fitness in all populations, especially obese individuals. The fact that Dr. Lerner’s personal stake in the issue does not take a backseat to his obligation to the public, and that another medical provider advises Rick “just do it” as a plan for losing weight reveal how the medical care system has ample room for improvement. Physical therapists, and all medical providers, can and should “provide key elements of effective behavioral change interventions” so that the general public can adhere to wholesome decisions about wellness (Rhodes). Even the most effective interventions whittle down to scraps, in the absence of patient adherence.

It is easy to believe a person is well when one aspect of wellness has been satisfied. One might say being fat and happy is better than being skinny and unhappy; one might argue the opposite. During an interview, supermodel Kate Moss was quoted saying, “Nothing tastes as good as skinny feels.” When we fall victim to such paradigms that cater to one aspect of wellness, such as emotional health, we neglect all else. The temporary contentment that follows blinds us from seeing the short-lived nature of it, and the resulting imbalance may put an us in a worse position than we started from. Fooling ourselves about our well-being is like sipping on a pina colada, floating comfortably above a circle of sharks. In shallow waters, it becomes more clear that a fool’s paradise –though paradise– thrives only in the minds of fools.

 

References

Bezner JR. Promoting health and wellness: implications for physical therapist practice. Phys Ther. 2015;95:1433-1444.

Dallow CB, Anderson J. Using self-efficacy and a transtheoretical model to develop a physical activity intervention for obese women. American Journal of Health Promotion, 2003;17(6):373-381.

Fat Chance. Dir. Jeff McKay. Perf. Rick Zakowich. YouTube. NFB, 17 May 2015. Web. 19 Apr. 2017.

Rhodes RE, Fiala B. Building motivation and sustainability into the prescription and recommendations for physical activity and exercise therapy: the evidence. Physiother Theory Pract. 2009;25:424- 441.

Stonerock GL., Blumenthal JA. Role of Counseling to Promote Adherence in Healthy Lifestyle Medicine: Strategies to Improve Exercise Adherence and Enhance Physical Activity. Prog Cardiovasc Dis (2016), http://dx.doi.org/10.1016/j.pcad.2016.09.003

How To Lose Fat By Being Fat

Recent studies reveal: fat cells burn fat. I read it on the internet, so it must be true, right?

Bear with me — I can explain.

In an Animal Histology course, one of the simplest tasks you are taught to tackle is in distinguishing between white and brown adipose tissue. In other words, you learn how to microscopically differentiate what society has trained us to dread: Fat. However, most of us concerned about the amount of pudge spilling over our waistbands don’t even realize that fat exist in different forms. Fat is not the enemy; ignorance is.

White fat cells — easily identified as large, circular blobs — accumulate under the skin and around organs as a predominant source of stored energy. Your muffin top? Blame it on white fat. On the other hand, brown fat cells look more dense under the microscope. They appear “brown” because they contain far more mitochondria; their main purpose is to produce heat. That’s right, you heard me. Brown fat burns calories.

One might ask, then how come fat people are… still fat?

Though brown fat initiates fat consumption, it does not exist in abundance within the adult human body. Most of our jiggle is from white fat; brown fat is found in odd areas like behind the neck. In fact, scientists were previously led to believe brown fat is only found in infants and animals who cannot shiver to produce adequate body heat. We now know it is present in the adult human anatomy, but the percentage of brown fat in relation to white fat is predominantly lower in obese individuals. Whereas “fat people” have plenty of fat, they don’t have the right kind.

Wouldn’t it be nice if we could convert our white fat to brown fat?

Well, we can.

Prolonged cold exposure causes notable changes in the body – specifically, in this case, activates brown fat, increases insulin sensitivity, and alters levels of metabolic hormones. In a controlled study led by Dr. Celi and Dr. Lee, five healthy 21 year old males were subjected to different environmental temperatures for three 1-month periods. When exposed to a colder setting for a minimum of 10 hours per night, the subjects revealed a “42% increase in brown fat volume and a 10% increase in fat metabolic activity” (Torgan, “Cool Temperature”).

It makes sense. If your body notices that it is cold, it will try to make up for the difference by burning stored energy (white fat) and producing it as heat! Since brown fat is efficient at this, the body accommodates by increasing its brown fat content. Researchers have discovered the presence of beige–or “brite” aka brown in white– fat cells that hold the same metabolic characteristics of brown fat (Torgan, “Insights”). One could potentially infer that the mixed appearance results from white converting to brown, one cell at a time.

Can it be as simple as sitting in a cold room for 10 hours to get the beach body we want? And is it worth it?

Typically, a cell converts chemical energy from fatty acids into a fuel called ATP. The process is called oxidative phosphorylation; a gradient of electric potential prompts a cascade of events which convert food into energy. Simply put, it’s how we survive. In brown fat, there are specific protein molecules called Uncoupling Protein 1 (UCP1) that are embedded along the surfaces of mitochondria. They “dissipate the mitochondrial electrical potential and drive the consumption of fat and its conversion to heat, not ATP” (Norris).

If you have no idea what I’m talking about, hang in there. I’ll explain in layman’s terms.

Think of mitochondria as machines that produce energy. Their job is to change food to ATP. These machines require an electric charge to do work. The proteins on the brown machines (UCP1) act like little hands that grab onto fatty acids, which transport positively charges (hydrogen ions) to the machine’s surface (membrane). When you have too many protons, it disrupts the normal charge across the membrane, so the machine can’t work properly. To return things back to normal,  the cell has to burn fat and produce heat!

The point is… An entirely different point.

The common consumer of knowledge will use this information and produce the take-home message along the lines of: cold temperatures will make me slimmer. Brown fat is the new brown rice. 

The take-home message is actually something drastically different: you, my dear, are too fucking gullible.

Blind acceptance of recruited knowledge leads to widespread ignorance.

 

There are things I didn’t tell you, things you assumed, and things you failed to challenge before drawing a conclusion. And this is why the internet has become a double edged sword.

Earlier I said, “in a controlled study led by Dr. Celi and Dr. Lee, five healthy 21 year old males were subjected to different environmental temperatures for three 1-month periods.” This study only considered five individuals. Of the five individuals, 100% of them were male and 21 years old. With a sample size this small and specific, we cannot conclude this applies to a 35 year old woman, a 21 year old male with diabetes, or even you and me.

What I didn’t mention is that when the five were placed in prolonged neutral temp environment, their fat levels returned to baseline levels of brown fat. And at warmer temperatures, there was a complete reversal effect (Torgan, “Cool Temperature”). As a diet fad only produces temporary results, prolonged cold exposure triggered brown fat activation but failed to keep the protein “on” for a lasting effect. Therefore, research is now devoted to bringing the actual science behind it closer to application; once we figure out how to manipulate the UCP1, it may be an invaluable weapon to combat adult obesity.

Also, if you haven’t read these particular studies yourself, chances are: you have no idea who Dr.Celi and Dr. Lee are. How can you assume credibility without having any reference as to who they are and what they study? They could be the names of a physical therapist and a psychiatrist. A prefix doesn’t imply accuracy. Had I quoted Dr. Pepper and Dr. Phil would you have even noticed?

What I presented isn’t bunk science –in fact, it’s potentially revolutionary– but it was skewed in the sense that a lot of information often gets left out while being transferred from person A to person B. There are so many unsupported articles that people post on Facebook… so many protein powders and waist trainers and juice cleanses that people promote on Instagram… And so many false claims floating around by word of mouth that we blindly accept.

My point is, WAKE UP.

Unless the source is presenting all sides relevant to the topic at hand, it falls victim to a bias. Truth and logic are at the convenience of the teller, so be aware. Question things. Research. Be an educated skeptic about everything you read and consider what you aren’t being given a chance to read.

Life is more variable than it seems on the Internet.

Do you believe me?

 

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Works Cited

Norris, Jeffrey. “Researchers Identify Lynchpin to Activating Brown Fat Cells.” UCSF. University of California San Francisco, 18 Oct. 2012. Web. 10 May 2016. <https://www.ucsf.edu/news/2012/10/12961/researchers-identify-lynchpin-activating-brown-fat-cells>.

Torgan, Carol. “Cool Temperature Alters Human Fat and Metabolism |National Institutes of Health (NIH).” NIH Research Matters. National Institutes of Health, 28 July 2014. Web. 27 Apr. 2016. <https://www.nih.gov/news-events/nih-research-matters/cool-temperature-alters-human-fat-metabolism>.

Torgan, Carol. “Insights into Energy-Burning Fat Cells |National Institutes of Health (NIH).” NIH Research Matters. National Institutes of Health, 15 April 2015. Web. 10 May 2016. <https://www.nih.gov/news-events/nih-research-matters/cool-temperature-alters-human-fat-metabolism>.

01/20/12 You are So Fat-tastic

Many people believe that fat cannot be beautiful.

These days people work out at home, just so they can look good enough to work out at the gym, just so they can look good enough to run in public, just so they can look good enough to… look good. What kind of twisted logic is that?

Our world places so much emphasis on size and shape, rather than quality and content. I guarantee that 99% of the time, we will immediately form a first impression of a person solely based on observing his or her appearance. You can’t deny it.

Usually it’s the bigger women that say “I’m big and beautiful and proud!” but you never see a skinny girl saying “I wish I could be big so I could be beautiful.” No matter what people say to feel better about themselves, we all have wished for another, better body, a better face, a better booty… We live in a corrupt society where success can often be measured by who you know and how you look, rather than what you do and how you are. It is not by coincidence that models have similar bodies; flip through any men’s or women’s magazine and most –if not all– of them are exceptionally good looking and fit. Now imagine that same magazine’s pages being replaced with models that are 300+ pounds. Would you still flip through it? Would you still want to buy the clothes and take their advice? Would you even bother to pick it up off the waiting room coffee table? I doubt it.

So I think it is safe to say that no one can deny that society’s desired beauty has been molded years ago, into a slim, cut figure. As we grow up, we become brainwashed with propaganda. The ideal “beautiful” men and women can step over others and skip their tight asses all the way to the top, to become rich and famous. We watch them on TV and advertisements, with a mixed concoction of jealousy and admiration. But you can’t blame us… our physical attraction is mental, and we’ve been programmed to be turned on by muscles and tight curves, rather than Ms. Jiggly Puff or Mr. Rolls Royce.

Although physical attraction is important, and necessary in a relationship, it can be changed. What once was ugly could be pretty, and what once was sexy could be disgusting. Our mentalities change, but only if we are willing to accept new things and let go of the old. If you are trying to find a nice man in your life –a keeper, that is– then you need to understand that your choices must revolve around sacrifice, compromise, and balance. Maybe it’s worth looking past his 4 chins if you really dig his sense of humor and kindness. Maybe it’s alright that he’s skinnier than you if you find yourself happily lost in conversation all the time. Maybe it’s cool that he’s got a little jiggle to his step, because hey, he treats you like a lady. Rihanna went for looks, and look where that got her. (oooh… too soon?)

I’m never here to shit on you guys. I’m at fault, too. I’m shallow, and I can’t help myself if I ogle at some beautiful man with pecs I can hang off of and abs I can do my laundry on. It’s in my nature. But I take a good look at myself and realize I’m no Jessica Alba, and sometimes we have to face reality. Bitch, wake up, you can’t be a 6/10, looking for a 10/10, complaining how men suck and break hearts…. when all you had to do was open your eyes and maybe give that 4/10 nice guy a chance.

Big boys, don’t be ashamed. I’m not saying you guys shouldn’t work out; God forbid, you should work out and try to be healthier for your own sake, BUT it’s not impossible to find a girl just because you look like Drew Carey’s left butt cheek. If your personality is bomb, it really can make appearance seem that less significant. You got it, dude. Just remember “30% of all women think their ass is too fat, 10% of all women think their ass is too skinny, and the remaining 60% say they don’t care… they love him, he’s a good man, and they wouldn’t trade him for the world!”