Blog by Phillip Chang, MD: Board Certified Plastic Surgeon with Offices in Loudoun, Winchester, and Fairfax Virginia
You might be thinking, “What does a plastic surgeon know about solving the health care crisis?’”. Well, I happen to think I am well situated to have all ( ok… many) of the answers. It may come as no surprise that a good percentage of my patients are overweight. In discussing their lifestyles, I have given a lot of advice through the years on how to how to treat my patients surgically as well as on how to maintain their improved image after their procedures. Often, this conversation begins with what are you doing for exercise, what kind of diet do you eat, and how much weight have you lost? Believe it or not, I have a stake in having my patients maintain their appearances after a tummy tuck or liposuction procedure, or part of a Mommy Makeover. I have found that most of my patients do what I call- Binging on Lifestyle Changes. That is, they start an intense work-out regimen that is not sustainable ( for the average person )… or start a diet that is impracticable or unproven ( for almost anyone ). They do this without the basic understanding that they would be better off by simply making minor lifestyle changes.
I recently posted a link to a Time Magazine article entitled “Why Exercise Won’t Make You Thin“. ( http://www.time.com/time/health/article/0,8599,1914857,00.html ). The article had the premise that exercise in and of itself is not the solution to weight loss. 50% of Americans are technically “obese”. This article lead me to think about all the patients in my office who struggle with weight loss. Contrary to popular belief, most women ( and men ) who come to my office don’t come in trying to use plastic surgery as a quick fix to weight loss. My patients often struggle for years before they have the courage to step through my doors. More often than not, they have joined gyms, hired physical trainers, bought treadmills, exercise bikes and/or boxing gloves. All to no avail. At the same time, these patients, are also afflicted with busy lives which predispose to unhealthy lifestyles. Many are stay-at-home moms who find it hard to lead active lives while they struggle with taking care of their families. Others have stressful metropolitan jobs that don’t allow them to be active and encourage poor dietary habits.
I believe many of the suggestions of this article are true. Namely, I believe that rebound eating is a norm after “exercising”. I see too many people trying to take an hour out of their busy days to exercise while the rest of their day remains sedentary. I see even more people eat poorly throughout their days using the fact that they exercised as an excuse. I have seen people diet only to fail in their diets because dieting ( which should not be confused with eating healthy in moderation ) is an unnatural behavior. Researchers have pointed out that there is NOT A SINGLE DIET that has ever consistently lead to weight loss over an extended period of time.
The Time Magazine article suggests that Exercise in and of itself is not the solution. There is the implication that increasing your normal daily activity as part of a lifestyle change is the solution. Take walks, join a sport, ride a bike to work, take the stairs, etc. Whether because exercise makes us hungry or because we want to reward ourselves, many people eat more — and eat more junk food, like doughnuts — after going to the gym. And don’t start the new fad diet. Eat healthy, including proteins ( which decrease your appetite over time ) and decrease carbohydrates and oily foods. But eat normal portions to prevent binge eating.
Reading this article and trying to relate it to my patients, I have developed some solutions to the health care crises. These beliefs are based on the following facts:
1. Americans live very unhealthy lifestyles compared to the rest of the world
2. Americans are addicted to fast food and unhealthy processed foods ( watch the movie Super size Me- its a classic )
3. Americans live sedentary lives compared to the rest of the world
4. Obesity predisposes to diabetes, hypertension, and further decreases in activity
5. The problems with dieting and exercise are that they represent short lasting, self limiting activities that are often difficult to sustain. For example, how often have you are people you know started on a diet or exercise regimen only to fail the first time the routine is interrupted )
Based on these principles, I believe that trillions of dollars could be saved if people simply walked to work and took the stairs, stopped smoking, stopped drinking, and ate healthy meals in moderate portions ( not dieting ). I believe that millions if not billions of medical health care dollars should be redirected toward a national campaign to encourage healthy lifestyles; trillions of dollars could be saved. Note that 75 percent of all health care dollars are now spent on treating hypertension, diabetes, cardiovascular disease, and lung diseases associated with obesity and smoking. You might think that the national government would further encourage the cessation of smoking, and encourage lifestyle changes amenable to weight loss. The present health care debate is misplaced and misdirected. The answer is not in nationalizing the health care system. Government run systems in general waste our tax base. We already have two examples of nationalized health care in the United States; that is the Veterans Administration and the Military Health System. Anyone who has used either system knows that both are inefficient bureaucratic behemoths. We should be encouraging healthy lifestyles instead. That is my two cents…. don’t even get me started on Tort Reform!
Very well written and thought-out, Phil. I don’t agree with your conclusion re whether to nationalize or not, but as you say, I don’t think that should be the focus. You are dead on with your suggestions for helping the health of our country from both a physical and a fiscal standpoint!
Several years ago my brother moved to the Netherlands. I was on the phone with him and he mentioned he had lost almost 20lbs. He wasn’t really heavy to start with so I asked – have you been trying to lose weight? “Shaya, ” he said, “I haven’t been in a car in 4 months. We walk or bike everywhere – to work, to the kids schools, to the market.”
When we went to visit him, it was true – there was never really a reason to get in the car. At most we would bike to the train station and then take our bikes with us to whatever town we are going to, or rent them there.
I didn’t have a weight issue while I was living in Switzerland for the first 30 years of my life. I used my car maybe once or twice a month. I would walk to most places and if it was further, take the bike and/or train. Ever since I moved here I struggle to stay healthy. It is hard to adapt and exchange the daily active lifestyle that came naturally there with conscientious workout and eating habits here. It’s a different lifestyle and culture and I need to adjust… which means I’m gonna head to the gym now by car
Amen!