Morbid Obesity Is A Health Threat That Many Do Not Wish To Cure

Dear Tazi:

I have an enormous appetite. I love food and can't get enough of it. Consequently, I am seriously overweight.  My doctor has told me that I am morbidly obese and need to lose 250 pounds. My problem is, I don't want to diet. I love food too much. I especially love sweets, so to give those up would be heartbreaking for me.

I know what I look like, and I know that the choices I am making will shorten my lifespan, but I would rather die younger and live a fulfilling life than eat like a bird and be miserable for the rest of my life, which would be much longer because eating healthy is said to prolong your lifespan. No thank you!

My doctor has told me that he cannot help me if I won't help myself. I asked him what he meant by this and he told me he would drop me as a patient! Can he do this? Is this even ethical? I am sure I could find a new doctor, in time; one that I like and who accepts my insurance, but in the meantime who would prescribe my medications? I am on insulin for diabetes and I take several other medications for my heart and blood pressure. My doc says he is trying to keep me from an early grave, and then he tries to push me into one!

Signed,
Overeating And Loving It

Dear Overeating And Loving It:

If you are certain - and I mean absolutely positive that you are not using your love of food to compensate for something that is missing in your life - you need to make this clear to your doctor. We all have the free will to live our lives as we see fit, and if your choice is to wreck your health through a poor diet that is your decision. Some people choose to smoke in spite of the overwhelming amount of medical evidence that argues against it; some participate in extreme sports that result in multiple broken bones and arthritis; you are choosing your poison.

Your doctor also has free will, and if it is his choice not to continue seeing you as a patient he has every right to dismiss you for not following his medical advice. Why would you want to continue to see this doctor when you disagree with his plan for treating you? Just as personal relationships break off, so do professional ones; it sounds like the time has come for you and this doctor to part ways, with no hard feelings.

Whether it is ethical of your doctor to dismiss you as a patient is a judgement call, but I will say it would be unethical of him to dismiss you without plenty of notice and a list of referrals for other doctors who would be willing to treat you and prescribe your medications. Until then, he should remain your primary care physician, regardless of his desires. I suggest you bring up this idea to him, and ask for a list of referrals to other doctors who could meet your needs.

Snuggles,
Tazi

Ask Tazi! is ghostwritten by a human with a Bachelors of Arts in Communications. Tazi-Kat is not really a talking feline.

Morbidly Obese Child Needs Acceptance, Love,...and A Healthier Direction

Dear Tazi:

My son’s mother and I are divorced and we share custody. “Justin” is eight years old and of average height, but he weights almost 120 pounds. The boy is morbidly obese, and I am deeply concerned about his health. With regard to his upbringing, this is the one issue over which his mother and I disagree; unfortunately, that disagreement spills over into several areas.

When Justin is at my house, I make sure he eats healthy foods; plenty of fresh fruits and vegetables, lean meats, and low-fat foods. Justin is not happy with this arrangement, but he has learned the hard way that if he does not eat the food he is given less nutritional alternatives will not be offered. When Justin is with his Mom, the opposite is true. She has given in to Justin’s desires for poor dietary choices like macaroni and cheese, Raman noodles, hot dogs, and sugary foods.

We have only been divorced for two years, and Justin’s weight has more than doubled during that time. His pediatrician has ruled out any glandular problems, and agrees with me that Justin’s weight problem is related to diet; my ex-wife insists that it is “just baby-fat” and that he will lose it as he ages. I am afraid that my son will not be aging well and will die young if his diet is not overhauled now. He gets absolutely no exercise at his Mom’s house, since she allows him to sit around and play video games whenever he is with her. I try to make Justin exercise, but the effort it takes him just to ride his bike up and down the street is heartbreaking, and he is soon sweating, out of breath, and begging for a Gatorade.

My ex-wife could easily afford to buy healthy food for Justin – I have offered to purchase it for her myself, but she refused, telling me that money is not the problem; the problem is that at the end of the day she lacks the energy to argue with Justin over what he will and will not eat. She thinks it abusive to allow him to refuse a meal until he realizes that healthy food in a reasonable portion size is all he is going to get. (Portion size is something else his mother refuses to control; last Halloween she allowed him to eat an entire pound of chocolate in one night to make up for the fact that he did not have the energy to go trick or treating.).

I am considering suing for full custody of my son, a commitment I am willing to undertake to save his physical health, but I do not wish to take him away from his mother. I just want his mother to be a more responsible caregiver. Can you think of any other way to motivate her, short of taking our son away from her?

Signed,

Fit And Frustrated

Dear Fit And Frustrated:

Your letter leaves me feeling a deep concern for your son. It is obvious from his choice of food that he is being malnourished while at the same time being fed to death! From the sound of his diet he is not receiving the nutrients he needs to fortify his growing body, and at the same time is receiving too much of nutrients meant to be taken in sparingly. A single serving of Raman noodles in sauce has over 1,200 mg of sodium; if Justin is eating the entire block of noodles, that is two servings – and more than a full day’s worth of sodium and carbohydrates, with little to no other vitamins or protein.

From what you say, your son will eat nutritious food in proper portions, he just prefers junk food. Since your ex-wife is worn-out at the end of the day and caves to Justin’s preferences, a plan that works for her will be the plan that is most successful. Her comment that Justin’s extra pounds are “just baby fat” is obviously a denial of the reality that is before her eyes. Rather than sue for full custody – a serious and dramatic step – try other options first.

Together – as a family – the three of you should see a Nutritionalist. Showing Justin a united front on this issue may be what he needs to realize the severity of his problem, and will also show that he can no longer pit one parent against the other. A Nutritionalist will teach you – as parents – proper meal planning and foods appropriate for a growing boy who needs to lose weight. S/he will teach Justin the definition of portion size and tasty substitutes for his favorite foods. For example, turkey hot dogs are fat free and make a delicious substitute for beef or pork frankfurters; fresh fruit can be sweeter than candy.

Justin also needs to start exercising. Nobody likes to exercise alone, so as his parents you need to make it a point to exercise with him. Since Justin likes video games, the Wii Fit or other game system that requires physical movement to play would be an excellent investment made on his behalf. Justin did not double his weight overnight, and it will take a while for him to lose it.

Making diet and exercise a punishment will only discourage him from following such a regimen, so I do not suggest that you withhold food from him. Rather, try to find compromise. Both you and Justin’s mother should try meal planning, and include Justin in the process; if he feels involved in deciding what’s for dinner every night there will be no battles to fight with him at the end of the day. In the end, you need to make Justin’s journey a journey towards better health and more energy, not about making him feel badly about himself.

Snuggles,

Tazi


Ask Tazi! is ghostwritten by a human with a Bachelors of Arts in Communications. Tazi-Kat is not really a talking feline.

Permanent Weight Loss Requires Discipline, Commitment, and Exercise

Dear Tazi,

I am extremely obese and am not happy with the way that I look. I am barely five feet tall and weigh over 330 pounds. My weight is causing me medical problems such as asthma and diabetes. I tried taking up smoking because I have been told it speeds up your metabolism, but all it did was aggravate my asthma. I want to change but do not know how.

Every year around this time People magazine prints an issue about people who have lost half of their body weight and now look like beauty queens. My goal is to one day be featured in that annual article. I just don't know where to start. I have considered getting gastric bypass surgery, but I do not want to have to give up food completely. I tried the OptiFast diet and it did not work for that reason. I also hate exercise. It bores me, and the thought of going to a gym is upsetting; I am afraid that all the other people will stare at me because I am so huge.

Do you know of any way that I could lose weight without all of the discipline required to do so? I know this sounds lazy, but I am not. I am just scared of being judged and getting easily discouraged because I am not progressing as quickly as I would like.

Signed,

Big Bertha

Dear Big Bertha:

If you bother to read the articles in People magazine that you reference, you will notice that a proper diet and regular exercise are a large part of how those profiled lost the weight and kept it off for good. I doubt that you reached your current weight overnight, and it is going to take several months to lose it. This is just the cold reality of the matter. You will have to be disciplined enough to stick with a long-term diet and exercise regimen if you are serious about reaching a healthy weight.

Your first step should be in the direction of your primary care physician's office. He or she will be able to direct you to a qualified nutritionist who will teach you how to eat healthy, control your diabetes, and still lose weight at the same time. S/he should also order blood work to make sure your weight gain is not thyroid related. As for joining a gym, I suggest that you research local fitness clubs in your area. Many of them may offer programs tailored to the extremely obese and could be exactly what you are seeking. Furthermore, professional trainers specialize in working with people who need to lose 50% or more of their total body weight. Your local YMCA or Jewish Community Center is a great place to start your search.

If you are completely against joining a gym at this point, your home and neighborhood provide opportunities to exercise. The stairs in your house make for a great manual StairMaster and neighborhood parks make for excellent places to go walking. In time, you will find you enjoy the way exercise makes you feel and will become less self-conscious as the extra pounds start to fall off of your body.

In order to be featured in People magazine, you will have to keep the weight off for a minimum of one full year, so you will have to remain committed to your new disciplined lifestyle if you wish to see your dream realized. I wish you all the luck in the world! Please keep me updated as to your progress.

Snuggles,

Tazi

Ask Tazi! is ghostwritten by a human with a Bachelors of Arts in Communications. Tazi-Kat is not really a talking feline.