Monthly Archives: July 2013

Family-Style Fitness

Walking as an exercise option is appealing if you live in an attractive neighborhood with well-lit sidewalks (and shoveled sidewalks during the winter), a climate that doesn't roast you or freeze you depending on the season and is clean (doesn't choke you with bus fumes and/or trip you with litter). You may not want to take your young children with you on your power walk if they are too big for a stroller and too small for a jog. This means a nanny onsite, or waiting until an adult or older child is at home to baby sit, and for whom is that really feasible?

If we are really serious about doing (rather than talking about) something to reverse the unfitness of many Americans, we need to have places to exercise that are inexpensive or free, convenient and open when families have the time to use them.

Why not use schools? By 3 or 4 p.m., the playgrounds and gyms of elementary and high schools are empty or used only for team practice. This may not best use all of the available space. Schools with classrooms containing movable desks and chairs could be used for exercise classes like yoga or Zumba taught by volunteers or trained physical education instructors. An empty gym could be the site for games, gymnastics and balance-and-muscle strengthening. (A small fee to participate would be necessary to cover the cost of using the school, hiring instructors and covering liability.) Family members, young and old, could participate in age-appropriate workouts. The carpooling parent might be able to get some exercise while his or her offspring is running around a basketball court or doing sprints on the football field. Other siblings, perhaps not inspired by a competitive team sport, could also participate in activities compatible with their expertise and interests. Obviously, the moms and kids would be in separate areas.

Adding sports, exercise classes and even cardiovascular equipment to schools is costly. But wouldn't this front-end cost be balanced by the probable decrease in the medical costs of obesity and poor fitness? Although the YMCA is a relatively inexpensive place where families can exercise, there are fewer of them in neighborhoods than schools, and many of their programs for kids and teens fill up quickly. Schools could fill in this gap by providing an inexpensive place where the whole family could become more fit.

One complaint associated with late afternoon/early evening exercise is, “When can I make and serve dinner to my family?” What if these schools-turned-fitness centers also provided family-style dinners? Schools have cafeterias and lunchrooms, so the facilities are already available. Imagine dropping into the school/fitness center at 5 p.m., working out while your kids are also playing or participating in sports, and then sitting down for a healthful and delicious dinner at a minimal cost? Or if you get home late, meeting your kids at the school after their workouts and then having dinner. Additionally, making schools Wi-Fi accessible and having reliable babysitting and parking available at such centers may draw people who never considered the possibility of exercise. These school/community centers could be open during the weekends, and like community centers of yore, perhaps provide movies, bingo, arts-and-crafts workshops, cooking classes and demonstrations on gardening and DIY home repairs.

One argument, other than the cost, will be related to services that schools should or should not provide. But think of this. Schools are already providing services that were probably unheard of when public education became nationally available. Hot lunches and breakfasts are common, school nurses handle minor medical problems and school psychologists often work with parents as well as kids to solve learning and emotional issues. Indeed, during natural catastrophes, schools are often opened as shelters. Moreover, some schools function as day camps during the summer, especially if they feature well-equipped playing fields and playgrounds. So it is not entirely farfetched to expand the use of these buildings to provide fitness opportunities, not only the students, but also to their families, year round.

In this world of ever-expanding virtual activities, being able to go to a neighborhood center — where several generations can congregate, participate in exercise and other activities, share a meal and maybe even a movie — could have benefits that go far beyond a toned body and weight loss. You might make great new friends!

Is Food An Emotional Novacaine?

George Zimmerman is not on trial for weight gain, but his total change in body habits is a good case study on how stress can cause obesity. According to his defense attorney, Zimmerman was almost a recluse for this past year and avoided going out in public because of enormous negative publicity. The stress of the impending trial for murder, plus the psychological discomfort of being under constant scrutiny if he ventured away from his home, must have been almost unendurable. So he did what many of us do, under considerably lesser stress: he ate too much and moved very little.

Apparently this was sufficient to produce his substantial weight gain.

One does not have to be standing trial for murder to engage in stress-associated overeating. Although there are some who seem to shrink when stressed because their stomachs won't accept food, most people gain weight. And the current interventions, like putting calorie values on fast-food menus, or telling us we will have to jog up Mt. Everest to work off the calories in the sandwich we just ate, are not helpful. According to my weight-loss clients, the trigger to overeating is the feeling of helplessness. The problem may be a parent who needs 24-hour care, a long period of unemployment, or erratic, demanding supervisors who “forget” to mention deadlines or criticize the placement of a staple on a stack of papers. If living with the stressful situation is the only option, then many eat as a way of bearing the stress. As one of my clients told me when facing the terminal illness of a close relative,” Eating numbs the pain.”

The foods of choice are very high in fat. One client used to eat an entire jar of mayonnaise in one sitting while others consumed fried foods, butter, full-fat cheese, high-fat ice cream, bacon and fatty cold cuts. As with physical pain, the desired effect was to become numb. Think of it as getting food-based novocaine for an emotional toothache. They wanted to feel nothing. Unfortunately, like novocaine, the numbness wears off and the emotional pain returns. And then the eating resumes.

The numbness produced by binge-like consumption of high-fat foods does decrease emotional responsiveness, but it also dulls cognitive behavior. The client whose relative was so sick came to see me because she was facing many legal and logistical responsibilities. She described her high-fat diet as numbing her mental capacity. “I can't continue to feel like a zombie,” she told me. “How can I be calm and also cope with the stress?”

Substituting low-fat, high-carbohydrate snacks (like pretzels, popcorn and sweetened breakfast cereal) for the fat-rich snacks she was eating brought about the calmness she sought without numbing her cognitive capacity. By eating foods that allowed serotonin to be made, she benefited from the emotional well-being brought about by active neurotransmitter. But, of course, this came at a price. She emerged from her emotional coma once she stopped eating so much fat and had to face the very sorrowful outcome of her close relative. But we all have to face these pains and problems as we age.

George Zimmerman's weight gain is obvious to us because we knew what he looked like right after the shooting and how he appears now, as he stands trial. But we all know people whom we may not have seen for months or years who have also gained enormous amounts of weight. It is almost certain that stress precipitated the weight gain, rather than a sudden passion for doughnut, bacon and cheese sandwiches.

Can this weight gain be prevented? The American Medical Association recently designated obesity as a disease based on the pathology that accompanies excessive weight. A spokesperson for the organization made the analogy with lung cancer and smoking saying, in effect that although smoking may cause lung cancer, one cannot dismiss the cancer as a behavioral problem, i.e., the inability to stay away from cigarettes. Lung cancer is a disease. And although obesity is caused by the behavior of overeating and lack of exercise, the consequence is also a disease. But what about a person's inability to deal with unrelenting stress without eating excessively? Might that also be a behavior in need of therapeutic intervention?

Must the individual, unable to prevent excessive eating, wait until he or she is already suffering from the disease called obesity for help? To borrow from the AMA's example, one would not wait until someone has a diagnosis of lung cancer to help him stop smoking. Yet programs to identify and help people who are eating to numb their emotional pain by and large do not exist. Have you ever seen a message on TV offering to help such individuals?

What we need are fewer fad diets and more programs to help people deal with intense, chronic stress before they eat themselves into obesity.