YOUR HEALTH

Human beings need food to live, and, for this purpose, they need a supply of various nutrients. Severe restrictions or the exclusion of certain classes of food are not sustainable over time. They are mostly associated to abstract choices rather than to medical and nutritional reality.

Obesity experts will tell you that fad diets often backfire on their original purpose. Instead of overcoming overweight or obesity, compulsive fasting disrupts the metabolic regulatory mechanisms of taste and satiety. They thus lose all food control and succumb to the Sirens of bulimia, regaining the lost weight with, as a bonus, a discouraging feeling of failure.

There are, however, basic principles recognized by modern science and validated by the experience of billions of human beings, from antiquity to now:

• Cook at home, healthy food that you love
• Prioritize food quality over quantity
• Avoid industrial dishes and fast food as much as possible
• Follow Canada’s Food Guide recommendations. This guide offers all the tools necessary to meet nutritional needs, reduce the risk of obesity and better resist diseases associated with overweight and malnutrition.
• Be wary of fads and media hype. Publications based on serious scientific sources are more likely to contain genuinely useful and beneficial information. For example:

 Freely translated: 

“A good diet does not normalize eating. Each individual is different. (…) We must also give back the control of food to the individual and make him responsible for the solutions. There are many avenues: improve your knowledge of food and how to prepare it, learn to perceive and respect your body’s internal signals (hunger, satiety, taste), stop feeling like a victim deprived of everything that is good. Sometimes all it takes is small changes. The important thing is to arrive at a solution that is acceptable to the individual. “

— Réjeanne Gougeon 

Here again, the popular (and even scientific) literature is sometimes quite confusing. The conditions surrounding meals vary from one country, one type of environment, one family, and even one individual to another, so much so, that it is difficult to correlate them very precisely with the risks of overweight, and obesity. Each case remains specific, but some principles seem to be well established:

It is better to eat according to the effort to be provided, before rather than after. In theory, you should therefore take 4 to 5 “meals” per day: 

• a good breakfast (20 to 25% of daily energy intake), 
• a hearty lunch at noon (30 to 35%), 
• one or two snacks in the morning and/or afternoon (±15% each) 
• and a light diner at the end of the day, at least two hours before going to bed. It is clear that this is not really the norm in Quebec, and this explains, in large part, the increased prevalence of overweight and obesity that has been observed there over the past 40 years.  

However, it is possible to improve your habits:

• Snacks and other industrial delicacies with a high sugar or salt content that are eaten at any time are to be avoided. 
• Fruit or carbonated beverages, including those marketed as “diet,” are to overweight people what tobacco is to asthmatics—poison. 
• Taking care of your daily nutrition is good but accompanied by a regular exercise regimen is better. Without forgetting to sleep well because sleep disorders are also often associated with eating disorders. 

As we have seen above, there is no miracle solution, but nutrition is one of the keys to limiting overweight and overcoming obesity. In order to avoid pitfalls and abuses, it may be useful to consult a professional specializing in these issues. Regarding the bariatric course of patients with severe or massive obesity, it is even an essential resource, both before and after the operation.

Essentially, a nutritionist will collaborate with their patients to set realistic goals to improve their quality of life. He will teach them to listen to the signals of hunger and satiety sent by the body and help them rediscover the pleasure of eating.

He will also give them lots of advice on the choice and preparation of food. In short, he will put the science of nutrition at their service in a human and personalized way, both theoretical and practical.

Physical inactivity is the main cause of overweight and many diseases in our society. Health authorities therefore agree to recommend a minimum of 30 minutes of moderate to intense exercise per day, throughout life.

In a medical paper published in 2008, the Kino-Québec organization highlighted a dozen statements resulting from rigorous scientific analysis. Here are a few:

• Increasing physical activity is the only way to increase energy expenditure over which we can exercise voluntary control
• Increasing physical activity while reducing caloric intake is the best strategy for losing weight 
• Maintaining a high caloric expenditure is the key to stabilizing weight after weight loss 
• High aerobic capacity reduces the risk of developing type 2 diabetes 
• Physical activity lowers blood pressure in people with hypertension
• Physical activity improves the lipid profile of people who lose weight. 

Knowing all this, we must recognize that there are plenty of bad excuses for putting off until tomorrow the exercise that we should do today: “Too much work… I’m late… The weather is bad… I’m not equipped…” the exercise seems as complicated as eating well, when in fact it is just as simple – just a question of motivation and organization.

When you decide to make it a life goal, in fact, you realize that exercise can bring real pleasure and that it does not cost more than you want to invest in it. From there, all you have to do is let yourself go and count the disappearing calories.

Calorie outlay by physical activity and by weight: 

While it is true that regular physical exercise can stabilize weight, make you healthier and reduce the risk of disease, it presents quite a challenge for obese people. Intense training could expose them to the risk of injury and joint or cardiovascular complications. As for moderate exercise, you might as well have realistic expectations. It would take 63 hours of brisk walking to burn a single kilo of fat!

It is therefore advisable to start gently, to listen to your body and not to impose more on it than it can endure. Three daily episodes of about ten minutes are sufficient, initially, to get moving. After a few weeks, it will be easier to extend the duration, even if it means practicing “interval training” by alternating 5 minutes of more intense effort and one minute of moderate effort. It is over time that this physical hygiene will bring all its benefits, toning the body, reviving inner strength, self-esteem, and the determination to take charge.

People who are overweight or obese, regularly experience embarrassing situations that affect their self-esteem. A fitting of clothes that are too tight in a store, a cruel passenger in the metro, embarrassed or even mean looks at the grocery checkout… all of this can hurt them and affect their morale.

What about the fate of a person suffering from morbid obesity? To tie their shoes is an ordeal to them. They can’t exercise for more than five minutes a day without their heart racing. For them, travel by bus or plane is uncomfortable, overpriced, and complicated. When they shows up at the restaurant, everyone looks at them with calorie calculators in their eyes. As for the love life, it is an inaccessible dream.

It is difficult to realize how society has enormous prejudices against excess weight. Yet these are expressed everywhere – in the street, at school, at work and even in the family. In the long run, it doesn’t take much – a breakup, professional stress, more discrimination – to trigger a complex pathology leading in particular to the loss of food control and withdrawal.

The psychological evolution of an obese person is a vicious circle. The gaze of others affects their self-esteem. Rightly or wrongly, they feel it as a condemnation. They then compensate for the shame and guilt by developing an addiction to food, increased isolation, and a sedentary lifestyle. As a result, they gain even more weight. The gaze of others is even more difficult to bear, especially since they have even more reason to feel guilty. And it goes on like this until they find the strength and support to take charge of themselves.

It is difficult to realize how society has enormous prejudices against excess weight. Yet these are expressed everywhere – in the street, at school, at work and even in the family. In the long run, it doesn’t take much – a breakup, professional stress, more discrimination – to trigger a complex pathology leading in particular to the loss of food control and withdrawal.

The psychological evolution of an obese person is a vicious circle. The gaze of others affects their self-esteem. Rightly or wrongly, they feel it as a condemnation. They then compensate for the shame and guilt by developing an addiction to food, increased isolation, and a sedentary lifestyle. As a result, they gain even more weight. The gaze of others is even more difficult to bear, especially since they have even more reason to feel guilty. And it goes on like this until they find the strength and support to take charge of themselves.

Like all addictions, these behaviors are not voluntary. They are forced, irrepressible, imperious. It takes an iron will to get rid of it, but fortunately, there are solutions. Self-help groups, which promote socialization and externalization of the problem, can support individual willpower. It is also possible, today, to prescribe medication to control bulimic episodes and reduce emotional shocks.

Psychological help is undoubtedly the safest way. It can take the form of occasional support or more systematic cognitive and behavioral therapy, or even psychotherapy. The main thing is that it is adapted to patients so that it is experienced as a positive exploration giving them the strength and confidence necessary to overcome their difficulties.