Thursday, January 04, 2007
Veterans Fight Fat
As you probably know, I am on a kick about obesity in this country. One of the reasons I entered television journalism was that I thought it was too easy to sit on the sideline and complain. It was too easy to resign myself to watching a nation that used to be one of the most fit, robust and vibrant in the world gradually become one of the most obese. I wanted to do more than simply talk: I wanted to try and educate as many people as I could. Truth be told, I am optimistic that we can reverse this trend.

So, here's another good opportunity to raise awareness, and possibly your ire, about something related to obesity. Get this: If you are a U.S. military vet, you've got a better chance of being diabetic than just about any other part of the population. The reason is that most veterans are overweight. In fact, almost 75 percent of male veterans are considered overweight or obese. That percentage is higher than among the general public. In fact, when I searched a little harder, I discovered that it is higher than overweight and obese rates in Native Americans (73.9 percent), Hispanics (72.7 percent) and whites (72.5 percent). It appears, according to a study of nearly 2 million patients who were treated at 136 Veteran Affairs medical centers, our U.S. veterans are the most overweight and obese of any group in the country. Our veterans.

I was surprised by that. I always imagined that a rigorous military training and associated boot camps would create lifelong habits that would fend off obesity and the countless chronic diseases associated with it. It appears that is not the case. It is true that the VA hospitals are trying to do their part. Any overweight veteran who visits a VA doctor gets referred to MOVE. It is a program to get veterans to start eating healthier, become more physically active and start focusing on those behaviors that led them to obesity in the first place.

It is hard to say whether it will be enough. As much money as we spend on body armor, gas masks and firepower, the biggest enemy of all may have been the fatty food we have served our military men and women and the sedentary lifestyle they live once they retire. So, if we are optimistic we can reverse this trend. What would you recommend to better care for our veterans? And, whose responsibility is it?
As a former military dietitian, I think we should also look at the effects of yo-yo dieting on metabolism. Soldiers must "make weight" twice a year, and extreme dieting is common. The military works hard to educate on health and nutrition as well as encourage physical fitness on a regular basis. However, one cannot force someone to make healthy choices on a daily basis. Many soldiers begin to struggle with weight as a result of poor diet habits combined with some sort of physical injury that limits activity--they then turn to fad diets to make weight, but never truly change their eating habits.
These cycles tend to lower metabolic rate. Also, once a soldier retires, weight gain accelerates because dieting attempts and exercise decrease.
Interesting study. Probably what's happened is, after a regimen of exercise on a daily basis while serving in the military. People after being discharged, and living the civilian life tend to take things easier. Not all, but some. Sad, but true.
Don't blame the VA for obese veterans. The VA is doing its best to manage ALL of the chronic health conditions that beset veterans, and they do an excellent job.

However, if there's anything that's nearly impossible, it's telling a veteran what to do or how to live his or her life. Has it occurred to you that many of these veterans narrowly escaped death and figure that every day since that event is a bonus? Has it occurred to you that many of these veterans may have become fed up with the extreme controls on every aspect of life while in military service and are now doing exactly as they d--n well please?

Obese or not, veterans spent a portion of their lives obeying every order and suggestion. They gave up every freedom they had to protect yours. If they don't want to deal with being overweight or the consequences of it, they earned that right.
I'm curious about these so called statistics anyway. Who measures them? Anti obese advocates? Much of it is either bias or pumped. Who does independent studies on lifestyle and health? No one, yet legislation passes on from bias stats. Besides, if society is shocked by fat people, who asked them anyway? Who gave society or lawmakers the choice to chose for others when their corruption, immorality, and shortcomings need to be addressed more than the citizens lifestyles? My new years pledge is to keep my health problems between my doctor and I, and to openly question the immorality of the lifestyle radicle activists who are getting rich off of fat people, smokers, and other self appointed health pundits with no proven credibility. Thanks.
More veterans are diabetic because the military has admitted that agent orange is a causative factor.
Veterans' ages matter. Things contributing to obesity in a young person are going to be entirely different from what causes obesity in an older vet. I have a feeling this study has a lot more Vietnam vets (older men) than vets of the Gulf or Middle East.
I didn't know male veterans we're at higher risk for obesity. I always thought it was women who had a higher chance of obesity.

And hasn't it been proven that people can have digestive tracts that absorb more calories and nutrients than others? I know America is now the fattest nation in the world and it is probably because of what we feed our people and our sometimes lazy lifestyles, but there are other factors that come into play.

Example 1:
Poverty is a big factor. Tell me why it's so cheap to buy almost anything that has an extreme amount of fat and calories and healthy foods that are on most weight loss programs cost a small fortune. An example would be fresh fruit and meats which is good for you and on the South Beach and Atkins diet, is fairly high in most grocery stores (such as grapes are $3.50 to $4.00 dollars, and fresh cooking meat cost anywhere from $5.00 to $15.00 to cook you a meal) compared that to the cheese burgers at McDonalds and Wendy's you can get for a dollar. Most poor people will take the cheese burger for a dollar. I really don't think McDonalds and Wendy's is an obese person's enemy though. These restaurants seem to be trying to help people know what the food content is. They give you food content charts if you just ask for them. The food they serve can be calculated into any weight loss program. Weight Watchers has put places on the web that show people how many points is in the food products they serve.
Weight Watchers is one of the best, most health, and easiest programs out there. I tried it for a long time before I had my babies and it worked for me.
Also McDonalds serves healthier choices now. It may cost more, but for about 5 bucks you can get a salad and they serve fresh fruits and nuts with yogurt for about 2 dollars. Which is totally delish.

But if you're like me and you get fat beyond belief, which is what I did when I was pregnant with my twins, (I had Preeclampsia Toxemia and put on bed rest for 5-6months) You might consider surgery, especially if you have been fighting the battle of the bulge all your life and you're losing. I don't think surgery is the best way to go though. I think people should try to lose weight in anyway possible before trying surgery, but I had gastric bypass surgery and it really really really helped me. It's so nice to be able to fit into normal size clothes and not have to worry as much about getting diabetes and how high my blood pressure is going up or if I will be able to fit in a sit on a airplane. I still have to diet, but it's not as hard to keep the weight off as it was before. My doctor told me that he was removing part of my smaller intestine and that would make it to where my body would not be able to absorb the same amount of calories as it did before, and I'm not hungry all the time, like I used to be when I had to diet all the time. I went hungry a lot of the time when I was on Weight Watchers, Jenny Craig, and other diets like Atkins and thoughs diets cost alot of money. Even though I had this surgery, I still have to diet or I'll gain weight, but I don't have the cramping and stomach pains you feel when you are on a low 1500 calorie diet and feel like your starving. I was told that the most sensitive part of a human's stomach is located at the top or the upper tapered portion of the stomach which extends a short distance from the opening of the esophagus. This is the main area that causes hunger pains. When your stomach is cut down to the size of an egg, it's easy to fill and you just don't eat like you used to. Instead of eating full meals, I have to eat small portions all day long. It's more like eating 8 to 14 small portions a day. It forces me to have a different eating habit.

Also from the female patients I have seen who have had the bypass surgery; the surgery seems to be less successful for long term results on women who get pregnant after by pass. They seem to lose the weight after surgery and once they get pregnant gain most of the weight back. I think it remains a better idea for women who want bypass to wait until after they have had they're children, because pregnancy seems to have negative long term results of gaining the majority of the weight back again. Bypass also makes pregnancy more complicated. My conclusion is pregnancy and bypass shouldn't mix if it's possible to avoid, unless the women is so obese that it makes it more complicated to have a child. I really do think that young girls should be more restrictive to getting this surgery, and try to lose weight with other methods; at least until they're child baring years have passed.

I got to stop writing because this is too much, sorry I could write novels, cause it's something I�m passionate about.

Happy New Year Dr. Gupta and CNN staff

Your fan
Its interesting that while the VA is offering nutritional and weight-loss support to our diabetic veterans, military spouses with diabetes are given no such support options.
As someone who works with men and women with eating disorders (on all ends of the weight spectrum), I think it is naive to solely consider nutrition and exercise among this population of vets without also exploring the "emotional" component to eating. Is it possible that some of these vets may be experiencing depression or PTSD or other emotional issues that cause them to over-eat for comfort or solace? I wonder if vets, who are taught to "stuff their feelings" so that they do not appear weak or vulnerable are using food to serve that function. Could part of the problem be the lack of skills for coping with the full range of human emotions?
You might look to problems with the hips, knees and backs. I know several overweight vets and they all have those problems. It's really difficult to exercise when you can't walk very well without pain.
Dr. Gupta,
The problem of obesity is that people cannot see the actual physiological damage that is being done on the inside. People often think of obesity as an asthetic problem and/or only a problem of a subset of overly obese group. The fact is that obesity or even mild elevation of triglycerides and food intake incrases the risk factors for a variety of diseases. The best way to treat disease is to prevent it in the first place and that is the message that you and others in the medical community are doing a good job on stressing. People always ask me why are their supercentanarians who live long healthy lives, one of their secrets according to the New England Centenarian study at Boston University with Dr. Thomas Perls shows that people who eat less live longer. Keep up the fight to get the word out, there are alot of diseases that we can prevent by simply cubing excess food intake.
I'd like to see a study showing the number of people getting paid via US tax dollars and obesity. If we are paying these people, and their health insurance, they should not be obese, or smoke or whatever. This goes for all employees, from cops, to city clerks, to Dick Cheney. How much has the American public spent on him? Ironic. He's obscenely rich, yet me, a guy who can't afford to get my cavity filled, is paying his health insurance.
When I retired I gained weight, I did not change my eating habits at all. I think what made the difference is the change in physical activity levels. When you go from 10-14 hours a day, to the relative sedintary civilian life of 8 (or less), that is a distinct diffenence in how your metabolism reacts to your food intake.
I was in the USNavy for 4 years, and I learned that no matter how much you motivate or teach someone about diet and active living, lazy people just don't care. Everyone is responsible for the welfare of their own physique...
It's a veteran's responsibility to take care of him or herself, same as it is for someone who hasn't served in the military. It simply isn't practical to make it the job of the U.S. Government or the Armed Services to police the health of every veteran - yes, we should care for our veterans, especially when they're injured in the line of duty, but how can we justify putting more time and effort into making sure a veteran is in the peak of condition than anyone else?
Dr. Gupta, it's because we in the military go from being very active (pt every day and more) to sedentary civilian jobs when we retire and don't change our eating habits in the military to match the less active civilian lifestyle (and we often stop working out for awhile). I know, I became a type 2 diabetic for this very reason and I am now in the fight of my life to lose weight. regards -Clay D military vet
Cancer has been no stranger to me from the time I was 12 and my father passed away just after turning 39. Memebers of my family followed with lung, breast, and skin cancer. I have always felt that cancer gets the short end of the stick in funding, and think that it is appauling, especially lung cancer (which can strike non-smokers too). Its too bad that some felt the tens of billions of dollars were better spent in Iraq than on programs like cancer research. After seeing what people go through first hand, there are not many other ways to leave this earth worse than what the desease does to you.
i am a severly obese vet. I weigh 380 lbs. I was 185lbs at the time i was injured in Iraq February 18,2004. I gained weight for the next 4 months due to the fact that i fractured my right acetabulum (or hip socket in case you didnt know) and crushed two vertabrae in my lower back after falling a distance of 45 feet from the top of a building landing on my battering ram which was layed across my lower back. i went from 185lbs to 365lbs. It was difficult to say the least. Especially since i was so used to running and excercising every single day. We are trained, we are pushed, when we feel we cant do any more, we get pushed even harder. Now that i am out of the push but with that, i was never given physical therapy. I was never offered an alternative solution for excersise. We dont get the guidance and support that people think as vets. We are the last thought on peoples minds and many of us suffer. Unfortunately do to my injuries, even to this day i am scared of working out in the happenstance that i re-injure myself.
When you talk about obese vets, you have to understand, we deal with lack of money, lack of housing lack of food, lack of work options. I am 70% disabled and still I have to work to survive. Vets have to fight PTSD, we fight that every single day. We have to deal with the fact that..while we were injured we left our buddies in battle. THat adds depression. Trust me when i say that these many things build. You lose your interest or CARE for focus more on survival at this stage. Like me, I would give anything to lose weight. I just found out i am believed to have Cushings Disease...and I have to use Kaiser Permanente because in order to see a specialist at the VA...i have to wait 6 months. I dont get the care i need at a VA hospital. I feel the VA treats their patents with a biased opinion. I dont feel that at my doctor.
Being severely obese and an injured combat vet makes life hard. You think one way but your body looks another. Trust me, i dont accept being obese, i just am scared to death of rehurting myself, or causing more problems...i guess i just live with it. SHoot im getting married next year. i would give everything to lose 100lbs by then hahaha. THanks for your moment.
your injured combat vet Aco 5/20BN 3rd Brigade Stryker Team 2nd Infantry Division
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