Fat In The Era of Thin

By Carol Boyce

A different kind of epidemic

As homeopaths of the 21st century we find ourselves in an interesting era of epidemics – epidemics of autism, of ADHD, of juvenile diabetes, of asthma, of any number of other chronic diseases and, in recent decades, the most widespread and potentially damaging epidemic of all; obesity.

We have children under five whose joints cannot support their weight, adults who can no longer walk, unprecedented rates of bariatric surgery and a multi-billion dollar diet industry that may be compounding the very issue it is, according to the advertising, designed to resolve.

As the developing world adopts the Standard American Diet (SAD) we are witness to other populations sacrificing their health, as they trade one form of malnutrition for another. 

The stats

The rate of obesity in the (so-called) developed world stands at record highs.  According to the Center for Disease Control, the rate of adult obesity in the US is currently 35.7%, with the rates in some ethnic groups even higher. The rate for African-Americans is 49.5% and for Mexican Americans 40%, with the rates now increasing across both genders and all income and education levels. 

The list of associated chronic diseases is well established and includes the leading causes of preventable death: heart disease, stroke, type 2 diabetes and some cancers, to say nothing of the ongoing suffering caused by joint problems, breathing difficulties, gastric symptoms and so on. In 2008 the annual medical cost of obesity in the US was $147 billion while the actual ongoing cost to government departments, health services, the workforce, the economy and to individuals and their families is incalculable. 

Are we homeopaths or are we health practitioners?

Increasingly patients are showing up at our clinics with primary presenting symptoms related to obesity. It’s an interesting dilemma – we live in a culture where this has become, if not exactly the ‘norm’, at least not surprising. Our patients visit primary care medical practices where people on staff are morbidly obese.  In a culture where the “ideal body” moves ever closer to a pre-pubescent waif, and nine year old girls are already dieting, discussion of weight has become a sensitive area. The medical profession seems reluctant to grasp the nettle in any meaningful way and their patients are referred to weight loss programs that are built on the same flawed principles as the diet industry itself.

As homeopaths we find ourselves in an interesting position - on the front line while often being the last resort. When our homeopathic philosophy dictates that we work with susceptibility and maintaining causes, we surely must directly address this fundamental issue. Hahnemann (Aphorisms 77 and 94) seemed pretty clear that removing possible obstacles to cure was an essential part of our remit!  

But should we give nutritional advice if we are not nutritionists?  If we were to recommend an eating program, what would it look like? In all good conscience can we reassure ourselves that if we give the right remedy then the food addiction will subside, the underlying emotional triggers will be resolved and the patient will naturally wean his or herself off junk food? 

Big Food, politics and ‘science’

The world of weight loss is a minefield of get-thin-quick schemes, while the media bombards the public with unrealistic images of what the ‘ideal’ body should look like. Even otherwise intelligent, well-informed people are tempted to give them a try and the average woman will spend six months of every year, most years of her adult life, lurching from one fad diet to the next.

The most popular run the gamut from the no-carb to the no-fat diets, from the six meals a day to the fasting diets, from the blood-type diet to the metabolic diet, and to those based on specific celebrity promoted products like raspberry ketones, green coffee extract and Sensa. They all promise rapid (and alarming) weight loss - with many promising results without any change of food or exercise! 

Incredibly it’s a multi-billion dollar industry fraught with assumptions, prejudice, outdated science and a fundamental conflict of interest.  For decades, together with Big Food, the weight loss industry has been built on a false premise that is finally being publicly dismantled. It’s a myth built into the fabric of not just the diet industry, but also the medical industry – that fat makes us fat and that if we cut out fat and eat only low-fat foods we will lose weight, lower our cholesterol and protect ourselves from heart disease.

As we know too well, much of what now passes for science is actually at the mercy of politics and the food and diet industries are no different. We can trace a good deal of this flawed premise back forty years to President Nixon’s need to provide the population with inexpensive food and secure himself another term in the White House. Enter the industrial production of the sweeter, but much less expensive, High Fructose Corn Syrup (HFCS) and the sugar lobbyists. Draw a straight line between fat consumption and heart disease and “voila”, the lucrative low-fat food industry was born. 

Over the same four decades Western populations, and in particular the US, have become increasingly addicted to sweet foods.  Delivered in thousands of processed foods, from fruit yogurts to ketchup and pizza, HFCS is now the main source of calories for most of the US population.  Artificial sweeteners like aspartame promise (but fail) to feed our addiction without fear of calories and weight gain and bring their own negative impact on our biochemistry. 

The cholesterol lowering drug Lipitor is one of the best selling drugs of all time, despite the fact that we know cholesterol is vital for the metabolism of every hormone, that we need fat for our brains and for the integrity of every cell wall. In drawing that straight line between fat and heart disease, they threw the baby out – bathwater, baby and all.

By trading fat, including healthy fats, for a sugar addiction we have become obese.  Something has gone very, very wrong.

Diets don’t work. Period.

One of the main criticisms leveled at overweight people is that they have no willpower. If only they would stop eating; if only they would pull themselves together. As practitioners we know that many overweight people have emotionally driven eating patterns, but emotional triggers aside, it’s just not possible to exert the kind of willpower needed to resist what is essentially a formidable addiction. Hormones implicated in our very survival dictate how, when, and largely what we eat. Our metabolism moderates our intake - when our metabolism, and therefore our hormones, are unbalanced, we find ourselves struggling against our most powerful, primeval mechanism – that of survival itself. We can’t fight that – we’re not supposed to fight that! Millions of years of evolution have got us here and those same mechanisms are still active, even if in some circumstances they are actively working against us.

It’s your hormones, baby 

We humans, like most other animals, evolved in a feast and famine cycle – our body knows that in a period of easy access to food it needs to store the excess as fat, so that if we experience a period of famine we can survive. However, as soon as the famine is over, the body will revert back to feast mode and store every excess calorie, as an insurance policy against a future famine. It’s a beautifully balanced mechanism that has ensured our survival for millennia.

These evolutionary safeguards are immensely powerful within the individual. Studies show that if a woman is severely undernourished in the womb or during the first two years of life, the methylation of certain genes are compromised, her metabolism will be ‘permanently’ changed, so that every spare calorie will be stored as fat. If, later in life, the woman has access to a nutritionally poor diet, but with a higher calorific content, she will become obese, while her children will suffer from the nutritional deficiencies of the poor diet and be stunted in their growth. If however she is pregnant during the famine, the methylation of several genes in the child will be compromised, impacting growth during gestation and insulin metabolism later. 

As populations or individual families shift from poverty to better income, with the move from starvation rations to a calorie rich, but nutrient deficient diet, this situation becomes increasingly common. (The methylation of genes described as a ‘permanent’ change does not of course allow for the possibility of homeopathic intervention, the relationship between epigenetics and Hahnemann’s miasmatic prescribing, and a nutrient dense diet for both mother and child.)

Unfortunately, our bodies can’t tell the difference between a famine and a deliberate crash diet. It’s designed to ensure our survival, so it slows down our metabolism and conserves what it can, and as soon as the diet is over it goes back into feast mode, building up our fat reserves. Within six months to a year, we have regained all the weight we lost plus an additional 5-10lbs “just in case”. The more often we ‘crash diet’ the more additional “just in case” weight we will gain. Over the years this can be significant. We continue to eat more and our body is perfectly equipped to make us do it!

The ‘hunger’ hormones, leptin (from leptos, the Greek for thin) and ghrelin, regulate our appetite. Leptin, which suppresses our appetite and ghrelin, which increases our appetite, need to be delicately balanced in order to send signals to our brain indicating satiety or hunger. Unfortunately, a typical SAD diet and poorly controlled blood sugar leads to leptin resistance and a disconnection with the signals from ghrelin. We don’t know when we’ve eaten enough and we always feel hungry. 

We feel weak-willed and wracked with guilt because our willpower seems to have let us down, it compounds our emotional frustration, undermines our self-esteem and perpetuates the cycle of crash dieting and binging. We are involved in a long-cycle eating disorder at the mercy of our biochemistry. 

Artificial sweeteners like Aspartame spike our blood sugar, just like sugar. Our pancreas pumps out insulin to deal with the expected glucose, but no glucose arrives and we go into a hypoglycemic crash, feel weak and shaky and need to eat, we grab a low-fat, high-carb snack and our blood sugar spikes again. Jack up on caffeine because now we’re feeling tired. Eat a high-carb, low-fat lunch and never feel satisfied. Eat more snacks and feel bad about ourselves and then indulge in some emotional comfort food and feel even worse… and so the cycle continues.

It’s important for patients to know that it’s not about willpower – we are literally at the mercy of a complex biochemical feedback loop. Unless we take the steps necessary to rebalance our metabolism, so that our body works with us instead of against us, we can’t escape this vicious cycle, and despite immense effort on our part, achieving our healthy weight will be all but a pipedream. 

And by the way a calorie is not a calorie

As hard as it is to believe, the idea that a calorie is a calorie and that all calories are created equal is still promoted in the food, diet AND medical industries, along with the notion that as long as we use more calories than we consume, we will not have a problem with weight gain.

In terms of metabolic disruption, HFCS is one of the most disruptive substances that we can eat – it interferes with the production of leptin, and produces insulin resistance, and therefore problems with the stabilization of blood sugar as well as increased levels of tri-glycerides. It has now been directly implicated in obesity and the rapid rise of non-alcoholic fatty liver disease and increased fibrosis. 

The concept that we build our bodies from the foods that we eat seems to have escaped common sense. 

 We have created a population severely deficient in essential fatty acids and addicted to sweet foods. Add in the reports of Genetically Modified Foods complicating the human digestive process, possibly for generations to come, and we have a population that is overfed and undernourished – our food is literally killing us.

The remedy is not everything 

When Linda Shannon and I were working in the slums of Kolkata in 1985, we quickly realized that the correct remedy can only do so much if the patient is malnourished – whether that’s calorie deficient, nutrient deficient or both.

Health is a pro-active process.

As homeopaths of course we know that an essential aspect of creating health is the ability to change the habits that helped create the ill-health in the first place. Our patients also need to be clear about what’s involved in their healing.  If we have an unhealthy emotional relationship with food, simply rebalancing our biochemistry may not be enough to prevent a return to our unhealthy patterns. We need to take a look at our emotional triggers and do some work – we need to be pro-active in our own recovery.

Having our patients think about their health differently is a fundamental goal of every practitioner. Understanding the mind-body connection, the issue of prevention and what that really means, the role that susceptibility plays in sustaining our recovery, is all part of a patient’s essential education.

Never diet again. Ever.

At Vitality TV we had just finished producing our What is Health series which looks at susceptibility, what prevention really is, the mind-body connection and other issues familiar to CAM practitioners in general and to homeopaths in particular, and were taking a break. We found ourselves discussing the increasing obesity epidemic and thought why not explore the issue further from a holistic “homeopathic perspective” and create an individualized program dedicated to creating lasting health and by default solving the issue of weight gain. Eighteen months later The Vitality Programme (TVP) was launched!

TVP is built on the premise that creating health is a fundamental aspect of weight loss and that once we are living a healthy lifestyle and our biochemistry is back in balance, our weight will take care of itself, forever.  

TVP is an empowering, all-encompassing twelve-week health creation program. It enables the patient to become conscious of their patterns; to learn how their body works so that they can make healthy choices for themselves; to take specific steps to reset their metabolism so that it works with them, and to build a new and healthy body from the nutrition they get from the real food they eat. It encourages them to let go of impossible ideals of body image that only serve to undermine their self-esteem, to take a look at emotional triggers that may have trapped them in their patterns and to work steadily towards their own, individualized, healthy weight.

In the process of working with TVP, patients become actively engaged in their own healing – they learn how to take care of themselves – emotionally and physically. When they go off track they know they are off track but more importantly, they know exactly what they need to do to get themselves back on. 

Science backed program

The entire TVP is individualized and encourages the patient to work at their own pace – with online support – to consciously construct a healthy lifestyle that will support them for the rest of their lives. It’s specially structured for real people who also have a life. It’s beneficial for practitioners because patients learn about how their body works, what health really means and the part that susceptibility plays in their future health – patient education is built directly into the program itself.

Results from our testers have been exceptional – they have all reported weight loss, for some of them significant weight loss (28 lbs and still losing). Maybe more importantly in terms of the long term benefits, they have reported an increased sense of self-awareness, a relief from the guilt associated with overeating, more energy, better sleep and improved health measures such as lowered LDL cholesterol and lowered tri-glycerides.

At Vitality TV one of our core beliefs is that if you provide the necessary information, people will be empowered to make healthy choices for themselves, now and into their future.  

We like to think that Hahnemann would have approved.