Wednesday, August 02, 2006

How Did You Get SO FAT?

How did you get so fat?

When people see people who tend to the bigger side of fat this question is often asked, but almost certainly more often pondered silently then asked. So, it’s pretty apparent that there isn’t any single answer. But are there some basic categories of ways in which people become exceptionally fat, or is there a separate story for each very fat person? The simple answer, I don’t know. But, that’s never stopped me before from exercising conjecture and massaging the little grey cells in an effort to tease some answer out.

The obvious answer is.. you eat a lot and you get fat. You eat more than just a lot and you get really really fat. Those who are strict mathematicians say that every pound of fat is 3500 calories and if you eat 3500 calories more than you burn you will have gained one pound. Of course this is total balderash as there is no such direct relationship between consumption and weight gain.

Why? Several reasons. First, when we eat the traditional way.. that is through the mouth, the food is processed by our bodies starting in the mouth with chewing and saliva until the food wends its way through the long tube continuing through our stomach, small intestines and large intestines and out the distaff end. As we’re all aware that our bodies don’t use all of the things that go into our mouth… ergo the reason that we sit and ponder the mysteries of the universe and read magazines and books in private rooms, some of the things we eat aren’t absorbed by our bodies and pass right through us. One example that most of us are aware of us is cellulose(plant fiber) which our bodies can’t digest because we don’t have 3 or 4 stomachs like cows. However, there are many things which our bodies can’t absorb so well because they are lipophilic and hydrophobic(fat loving and water hating), which means that they will dissolve in fat, but not in water, and our human guts are a water based system. Our bodies have gall bladders which generate bile which tends to emulsify these lipophilic materials and bind it to water based chemicals in our bodies so that some of it can be absorbed across the intestinal walls, but we tend not to absorb very much of these materials. In fact, many nutritional supplements which are not well absorbed are so poorly absorbed (Coenzyme Q10 is one), that unless they are manufactured or treated in a way to enhance absorption they are porcelain bullets. This lovely expression is a term for something that is ingested through the mouth and speeds through the body only to exit into the porcelain bowl essentially unchanged and unabsorbed.

So, there are many things which we eat which have calories, but aren’t really absorbed very well, so those calories, or many of them never cross the barrier between the insides of the intestines and insides of our body through the blood vessels and will never turn up on our hips, bellies, butts or thighs.

Well, this is an interesting thing.. we eat something and it doesn’t stick. One of the reasons that many people eat fiber(which is not digestible) is as a human Roto Rooter, cleansing the insides of our intestines like a pipe brush.

But, there are additional factors.. all of us folks are not the same inside, just as we all look differently on the outside. Some people’s innards are more efficient at extracting more of what we eat and pumping that into our blood streams and cells. These folks, who were selected by natural selection when frequent famines and uneven food supplies were the norm, have more efficient bodies for extracting nutrients from the food they eat. In our current world where there is plenty of food if you have the money to buy it, these people are predisposed to being fat.

On the other hand, we all know people who eat incredibly huge amounts of food all the time and weigh almost nothing. Human garbage disposals with their internal engines set to high who burn or excrete most of what they eat. Five meals a day, nothing but sweets and carbs, but they can’t add even 5 pounds. I had a grandfather like this who ate a 5 pound bag of sugar every week of his life(lived to 95) and never weighed more than 135 pounds. In times of famine folks like these would die off. But in times of plenty they can eat and never get fat.

So, different people start with different systems. Some people can eat what are normal meals and gain weight. Others can eat enormous amounts and keep their weight constant or lose weight. Not fair, but that’s a fact. While there’s no evidence I know of on this point it wouldn’t surprise me if the efficiency of the digestive systems of people are distributed along a normal curve just like all the other physical and mental characteristics of people. Again, for a review of those who haven’t taken statistics(a/k/a sadistics for those of us forced to take this at a highly mathematical level in college), the bell shaped curve that you’ve seen many times in connection with IQ, height, weight, grading systems and the like has most of the people in the center, around the mean or median or mode(the highest point of the curve) and fewer people as you get further from the middle(more standard deviations outwardly). So, you’ll have most of the people with similar efficiencies of digestion with some variation, but some people at either extreme who are either incredibly inefficient or incredibly efficient in their digestive systems and extracting calories from food eaten.

Okay.. so this is something we can understand, knowing that a certain percentage of people will be somewhat fatter than average(with a similar number slightly skinnier than average), and a smaller number extremely fatter than average(with a similar number extremely skinnier than average).

But this doesn’t begin to explain what we see.. with so many people relatively speaking much fatter than average and.. a growing number of us.

So, is it the theory which is bad? Or maybe the math?

I don’t think so.. I think the problem is that our system is too simple.. fatness is not a factor of only one thing because the simple, eat more than one burns up, theory isn’t robust enough. So, what else.

Well, our bodies are not simple systems without controls, but tightly regulated feedback control systems. If we do something that throws our bodies out of whack, the body fights back to get back to a comfort zone.

An easy example… you study for a big exam and pull an all nighter. You rob your body of a night’s sleep to cram, you make your body fight through the exhaustion, take your test and go out to celebrate… so what happens? Well, your body doesn’t just take it.. it does everything in its power to get you to recapture that sleep you sacrificed. How does it do that… it dozes off if you sit down, determinedly tries to sleep more when you try to get it up with that irritating alarm(ten snooze hits till you finally turn the sucker off and sleep for a few more hours). It may not get all the sleep you deprived it of, but your body will not let you off the hook without trying its darnedest to get its sleep requirements met.

Our bodies do something similar when it comes to eating, and dieting is a part of this. Using the basic rule.. eat less than you burn and you’ll lose weight. Well, this often works initially, often for a few weeks or even months, as you rob your body of the nutrition it expects and needs. But does it just take this? No way. It slows your metabolism. It can’t possibly believe you would be so stupid as to intentionally starve yourself so it assumes that there must another of those irritating famines underway. So, to save itself and survive until the food arrives again, it slows the motor down, slowing your metabolism so that you burn fewer calories and thus are able to survive on less. To keep losing weight you have to rob your body of even more nutrients. But, your body knows this is not a good thing, so, as soon as it senses that there’s more food available (a/k/a going off the diet), it stores the nutrients away like a squirrel with acorns, in the form of fat. This way, the next time there’s a famine(or you diet), it has built a storehouse of nutrients to help you through the tough times. Also, it generally doesn’t speed up the metabolism so quickly or to its original pace, and if you eat the same as you did before the diet, your body will tend to gain weight because you’re eating the same amount and your body is burning less.

So, is that it?

Nope, there are other factors. One, is setpoint. Like a well regulated cruise control on a car, most bodies seem to be set for a particular weight. If there is a hill, the system works harder to keep up the weight, if there is a downhill, the system works harder to shed the weight to get back to the setpoint. Most people who don’t diet and haven’t ever done that have pretty good setpoints. Whatever they do within reason will result in their bodies staying around their setpoint. Of course, a major problem is that we’re not necessarily happy with the setpoint that our body has. It’s not something we have any say in and just because society values a particular size doesn’t mean we can dial our setpoints to the sweet spot we want. If our setpoint is 155 and we want to weigh 125 we have to work increasingly harder to keep our bodies well below our setpoint. But, unlike the cruise control system, our bodies are not so permanently regulated. If we play with our weights by dieting and then regaining the weight(the usual arrangement over more than a few month period), our bodies tend to regain more than they lost, overshooting the original setpoint and resetting it at a higher weight.

Interestingly, most people who are fat(and many who aren’t) have dieted. And, it is a very rare person who has only dieted once. We’re a society of serial dieters. What’s the effect? Yoyo dieting in which we lose 25 pounds and regain 35. Then we lose 20 more and regain 30. This tends to reset the set point higher and higher and the bigger the swings in weight loss and regain the more our setpoints tend to get out of control. For many serial dieters they actually diet themselves to a point that their bodies have lost the ability to have a setpoint and just continue to gain weight because the bodies continue to act like they’re in a severe famine (diet) even if they aren’t, and the weight just pours on.

Well, that’s not a good thing. And, it makes figuring out or controlling what we weigh more difficult. Also, as the body goes into a setpoint free mode, the advice we’re used to about eating less just doesn’t work anymore. I know a significant number of women (they seem to diet more than men), who really don’t eat that much at all, but can’t lose weight from the 400 or 500 pound range, no matter how much they exercise and how little they eat.

Really a very frustrating situation, how will we ever answer the question, how do people get fat?

Getting back to the traditional theories for a second there are a few ways in which people can gain weight. Overeating is one. We can all agree on that, right?

Gee, what does overeating mean? You’re eating more than what? Is there some fixed amount that is correct eating for everyone? No. So, if the amount that is correct for you to eat is more than what others eat, are you overeating? Depends, doesn’t it on definitions. If you’re eating more than average, or average for your weight is that overeating? Not so easy, is it. About all we can say is that if you eat more than your body needs to maintain its current weight and you’re overeating. But that’s a pretty useless statement because its divorced from eating to maintain good health which would seem to be much more important.

But wait, you say, I’ve seen that fat guy eating plate after plate of food at the King Buffet. That’s why he’s fat. To that I say maybe. Or, perhaps, probably, but not definitely. There are people who starve themselves for periods of time who go off on binges. Perhaps the fat guy has been dieting for several months, lost 100 pounds and just went out of control once. So, that isn’t what made him fat and it won’t be what keeps him fat if he gets back on the wagon, perhaps.

But then you see a woman ambling slowly through Walmart or riding a scooter, who is well over 500 pounds, and you’re convinced that she must eat like a horse or a pig(gee, why do we always associate negative behavior with animals). But you don’t know and I don’t know what she eats or why she’s so fat. As I say, I know a fair number of folks who weigh over 400 or 500 pounds and while some of them do have prodigious appetites, its actually only a small fraction of the people that fat.

Wait, you say… I know there are feedees out there who eat to gain weight and they grow to such incredible weights that its mind bending. Yes, I suppose that’s true, and I’ve chatted with folks who have weighed upwards of 1000 pounds and they’re usually gluttons or food addicts on a grand scale. But, there are many others who have tales of woe that have led to them weighing 350, 450, 550 or more pounds without intending to gain weight and without eating significantly more than their much thinner friends.

So, how did they get there. Well, there seem to be a variety of stories, but many seem to fall into a small number of general categories.

1. The slow metabolism folks. Their bodies are incredibly efficient and whatever they eat turns to fat. In most cases these folks if they haven’t been serial dieters were active fat folks until their weights reached a point or their health had a bump in the road where they couldn’t keep up their active physical conditioning and the usual eating combined with the reduced burning caused them to gain weight which repeated the cycle by lowering the activity level they maintained which caused them to gain more weight, etc.

2. The dieting to gain folks. Their setpoints have been screwed up royally by their dieting and regaining so that each time they’ve gone on a diet they end up at the end of the cycle being fatter than when they started, and their setpoint resets upward. Most of the over 500 pound folks have gone through series of diets, usually starting when they were young kids, many with drugs prescribed by their friendly pediatrician and given to them by loving parents.

3. The sexually or parentally abused folks. It never ceases to amaze me how many children have been abused by their parents, relatives, and “friends” in a way which scars these fragile young children. Many respond by turning to food as a way to insulate themselves from the abuse. Eating to take away the pain. Eating to find a safe place. Eating to make themselves unattractive to the adults sexually abusing them. While some find their way to mental, emotional, sexual health, many are unable to shed the pounds that were added in this way.

4. The feedees who eat because they love to eat to gain or those who eat because they get intense pleasure from eating and those who eat until they achieve the pain of being too full because that is their desired pleasure. I’m sure that all of these three groups exist and I’ve chatted with members of each, and with many more who have some tinge of one or more of these approaches. However, I suspect that these three groups together are by far the smallest(numerically) of the four groups I’ve identified.

I think this entry has grown beyond the point where folks will want to read more for now, so I’ll end it by asking those of you who read this and are fat to try and describe as best you can why you believe that you are as fat as you are.

I suppose I’ll go first.

For me it started with a healthy appetite (gee, why does that sound so good, but in actuality be something that society considers bad), caring parents who turned me on to Weight Watchers…. Twice, … the first time at age 12. And being a success both times, lost and then eventually regained the weight I’d lost. Then I lost weight as my schooling ended by increasing my activity level, which then came back with additional friends as my career started and I became necessarily more sedentary. Finally, when I grew to a certain size my sleep apnea became more severe and that resulted in me eating much more in an effort to keep awake. When the sleep apnea was diagnosed and treated, my eating habits improved and being awake enough to exercise more, my weight went down significantly. Over time my exercising became less intense and the eating more intense and the weight peaked at about 400 pounds. And then I was diagnosed with diabetes and began to focus more on what I was eating. Not on dieting in a traditional sense, but more in a what types of things I eat and at what times during the day(not so much late at night, and no snacks on the way home to dinner). Combined with an enhanced exercise program(back to what I’d been doing), my weight has come back down below 350 where I feel much more active and vigorous. Where I go from here… I don’t know, but that’s my story.


Anonymous Anonymous said...

How did I get so fat? Hmm...I can honestly say that it's not just one thing. I thought long and hard about this when I read your post, Huge, and I've used a good part of the day trying to compose a coherent response. Here goes:

I was a normal sized baby, 7lbs 5oz, normal length 21.5". I look at pictures, and I see that starting at age 3, I was chubby. I was NEVER one of those skinny kids. I never had knobby knees, I never saw a ribcage or back bone poking out of my t-shirts. I was always active, playing out until the streetlights went out and riding my bike as fast as I could home to not get into trouble. I grew up in the Midwest, where you cleaned your plate, ate what was put in front of you, and it was all cooked in the bacon grease that was kept in a ceramic cup on the edge of the stove.

Getting older, parents splitting up started the fairly sedentary life. Oh.. was ALWAYS the biggest kid in any class I was in. I remember being asked, in 5th grade how much I weighed, and I vividly remember saying "115". It was the only number I could think of that was large enough, but I thought, not too much larger than anyone else, surely? I think now, I was much over that, probably 150-200lbs, if I had to guestimate. Middle school was such a transition period, with my mom, brother and I seperating from my dad by more than divorce decree, but distance, too. New school, town, friends, let the poundage begin!

The diets began hardcore when I started high school. My mom was a large woman, not always so, because she had used the Tomato Juice diet, the Correctol Laxitive diet, grapefruit diet, etc. I've seen pictures of her scarily thin...but in the 60's, thin was in...Anyway, she was now round and staying that way. My father, who'd been a substantial man, would soon develope high BP, and have cardiac problems himself, so mortality hit and he dieted himself down and stopped smoking/drinking. Now? He's still got high BP, suger is a little up, and STILL has to lose 20lbs. It's a never ending battle for him, as he LOVES food as much as I do. Everything I learned about making most foods, I learned from him. The apples don't fall far from the trees, do they?

Anyway, we started TOPS (Taking Off Pounds Sensibly), paying minimal "dues" every week, and it worked for a while, and I recall weighing in one week, finally coming into the 250lb range, and the woman says to me "Ohh..the 50s were good years!. That was the first time I had actually realized what I weighed. The weight came back on, and then in late HS, Weight Watchers had me losing almost 70lbs, and even though still a big girl, I had no double chin! I'd always been blessed with fairly thin face, so with the weight loss, it was very apparent. The weight that was lost was quickly found, and then some, and college was filled with indulging in drink and smoke and all sorts of fun stuff and the diets were just not a part of the plan.

Disaster struck with my mother suddenly dying and my world crushed. After a year of working literally morning, noon and night, I took the steps to do something for ME. I became a nanny and moved to CT. The first family I worked for had dysfunction of their own, but they were nice, and introduced me to the East Coast. The pay sucked and they wanted me 24/7, so I ate a LOT in my room/suite. 2 years of hidden/closet eating, and I ballooned. Still not weighing in, I had no idea how big I was. I ended with this family and moved to work for another who were absolutely fantastic, but who placed activity and healthy eating very high on thier list. I did that, and was highly active, eating better and so much happier. I don't think that I lost any weight, but my fitness level was very high and was in great shape for a fat girl. I soon met the man who would become my husband, who is an FA, and I finally found out how much I weighed. 405lbs. Wow....I knew I was up there, but wow..., comfort and a whole new world of FA's added 25lbs and I was the highest I've ever been. I had a surgical procedure, pannus removed and was down to 375, felt great, but again, love and comfort allowed a gain up to current 450lbs. So, what made me this way?

I'd say genetics played a big part as both parents were of size. I would have to say that lifestyle/environment had a big part, too. I grew up eating what I wanted and no care to limiting fat intake. No one in the family did, and that was ok. NO stresses to stay thin, as there are today. And finally, the things that I CHOOSE to eat are probably not the best. Not that I eat a LOT, because I probably eat less than most "normal" people, but when I do eat, it's what I choose to eat that is full of crap and additives. Yummy, cheap and easy. God Bless America!

wow...that was long winded, but I think you get my point. It's a lot of factors that contribute to size, and it's never the same for anyone. All these studies that finger point to one thing are bullshit, and I'm a 35 year old, 450lb living work of art to prove it.

Ok..Huge, that's my story, and I'm sticking to

3/8/06 8:49 PM  
Blogger Charlotte said...

I suppose in specific it might not seem fair, but it works out on the average. More people die on this Earth every year from famine than they do from obesity. A few maladjusted Westerners have clouded even your own judgement towards 'fair', haven't they?

Hold on, we associate good behaviour/traits with animals too. Healthy as a horse, foxy babes, strong as an ox. Considering how important pigs and cows are to the course of human civilization, I'm not sure people are aware that being compared to them would be viewed as a good thing by just about any anthropologist. Pigs is smarter than dogs, I'd rather be a pig than a dog ;-)

*My Story*
It's a long one, it's a complicated one, and it's a fun one. First, I'm one of the few people who have experienced life both underweight and overweight. I know the difference. Each has its own set of advantages, disadvantages and general experiences. In many ways, its tough for an open minded individual to say which is better. You might as well be comparing Michelangelo with Picasso. People will have their favourites, but you cannot be taken seriously to claim one is superior.

A fair world would be one in which people would have the opportunity to explore life at a variety of sizes. Indeed, one big regret is that I've been thin, I've been fat, but I've never been muscular. Maybe that's the best of all, but I doubt I'll ever know. Any opinion I have on a muscular physique is tainted by sour grapes.

Back to my gain: I was always thin. In high school, I only hung out with thin people, and any fatsos who dared cross into my life were subject of my wrath, for no greater crime than being an easy target. I'm not proud of that, yet any experience in my life that brings me to the present day is a piece of the puzzle. Maybe without seeing how evil I could be, I couldn't appreciate the full spectrum of life. (In other words: I'm sorry!)

Through a series of life altering events one of my friends gained weight (which reminds me: 1b) pregnancy changes your metabolism too. You don't have to be subject to capricious social factors to screw with your metabolism.) I felt so sorry for her, she was just disgustingly fat, and eating like a... tough to use a simile without using an animal. No one eats like a Redwood, do they? But the funny thing was, she was HAPPY. Life had given her a big sack of lemons and she didn't just make lemonade, she had seconds of lemon meringue pie.

It blew my mind. One day I woke up, and I got it. I mean, I understood what had happened to her. She'd done more than grow out, she'd grown up. I was still in my feeble adolescent world view that being skinny was the best thing you could do, be worth any sacrifice. Then, it wasn't.

Well, like your classic #2, I went off my life long diet (never to lose weight, just never to gain) and binged, and I loved it.

Further, I discovered #5: food isn't fuel. Food is an experience, food is to be enjoyed, food stimulates all the senses, food is art! Again, this revelation blew my mind. I was an art historian, I was a painter, I'd dabbled in sculpture, poetry, interior design, fashion, anything that was 'art', but somehow had simply never considered food to be art. But once I realised that I could take raw ingredients into the kitchen, and come out with a masterpiece on par with anything from the Italian Renaissance, I was hooked.

I'd have cooked like crazy even if meant staying skinny. I'd have eaten like crazy even if it meant bland food. You mix those together and, well, you get fat. Very fat.

Opening my mind, finding other like minded people, I did fall nicely into #4. I liked to gain for the sake of gaining, and it charged my life like never before, adding in food that charged my life like never before, and you have a classic feedee.

4/8/06 7:48 AM  
Blogger emily pound said...

Eating like a maniac when I'm not hungry. That's how I got so fat. It's really that simple, folks.
:-) Not simple to stop, though.

17/8/06 5:01 PM  

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