I mentioned (at the very least) last time that new research indicates that there are biochemical changes in the way the brain functions in obese people. I’ve been trying to find the original article, because I saw it a while ago and meant to write about it, but hadn’t figured out what to say, so now, of course, I can’t find it. The first thing I found was a terribly depressing article about the relationship between obesity in men and severity and outcome in prostate cancer. So that was a bummer. Everything else that came up on Google was about triglycerides and obesity, osteoarthritis and obesity (I’d never seen the word mechanobiology before, but I kind of like it), biochemical outcomes of bariatric surgery (which introduced me to the phrase acceptable morbidity rates, which I am less charmed by, though I understand it intellectually. It still sounds like a military-strategic planning term, though), and a whole host of other grumble-producing medical articles, all of which used BMI at some point, as though it were a valid research tool (it’s not) or marker (it’s not). And the stuff on bariatric surgery all confined itself to outcomes 24 months out. Like that’s a decent time for real data collection to occur. Like I said, bummer.
The article (it fluttered by on FB, and I have yet to learn how to find stuff I read and remember from weeks, let alone months ago on FB. Is there a way? And I think it was an NPR report.) seemed to suggest that the bio-neuro-chemical differences between fat people and thin people both excused (they really cannot help it) and damned (they really cannot fix it) the obese. So it was almost comforting and kind of terrifying.
In any event, my capacity to talk about biochemistry and neurology is pretty limited. And mostly, the article made me want to hop on one of my pet hobby horses about why no one works at studying very slow weight loss and why it might work better than all the prevailing hyper-fast solutions. I am not a scientist, so there’s no reason any scientist should listen to me–besides I’m fat, and you now we’re all a little dumb… But, more seriously, I realize that I am asking the medical/scientific profession to engage in research that would take a very long time, involve giving the subjects a lot of control as well as a lot of support, and would not be sexy. Bariatric surgery and The Biggest Loser are, for different reasons, sexy. And the first is a function of an approach to medicine that is based, with pretty good reason, on the model of seeking fast changes/ solutions/cures. The only branch that I know of that preaches patience is neurology when dealing with nerve and brain injuries, which it is fairly well known can be VERY slow healing.
If obesity changes the brain, then logic (my untrained logic, at least) would suggest that the solution is patience and slow , incremental progress rather than speedy cure/salvation/alteration, yes?
I don’t know. I do know that I have been losing steadily, though very slowly, since I added Victoza to my T2DM meds without making any tectonic shifts in my life. My A1C is perfect and my sugars are happy. My endocrinologist got pretty excited and suggested moving the dose up, which I agreed to, in the interest of “science.” The digestive and dermatological consequences were not tolerable, so I’ve moved back down to the dose that was working (though I am pretty sure it’s also making my hair fall out and my nails peel, but those seem worth the lovely A1C, and the stupid thyroid numbers remain stubbornly in the normal range, which everyone seems to think means I should stop fussing about it, even though that test is notoriously fallible…I’ll keep pushing, but in the meantime am taking hair/skin/nails vitamins to see if they help. Victoza’s hormone based and I have always been terribly sensitive to hormones, so it could be that my particular thyroid needs more help than the “norm”–my particular biochemistry–or that the Victoza is mucking about with other hormones that are causing the crappy nails and disappearing hair. This is where a combined degree in endocrinology and biochemistry might have come in handy). So, my theory is that if I lose ca. 10 lbs a year, my body will have a chance to get its shit back together and accept the new version. Now, I’m sure there’s some doctor out there who’d be more than happy to remind me that being 90 lbs. overweight may mean that I don’t have 9 years to conduct my personal experiment. Fortunately, that particular medical schmuck is not on my regular team. And, should I run into him or her anytime along the way, I’ll be happy to discuss the schmuck-itude with him or her. Perhaps emphatically.
So that’s the hobby horse. I’d rather call it a theory, but I don’t know that you’re allowed to call it a theory when there’s only one subject in your experiment though heaven knows whole diet-guru-fortunes have been built on what-worked-for-me programs… And I’m sure I’ll continue to have periods of obsessive contemplation of the surgery. It is so seductive, and would certainly make getting long-term-care insurance a lot easier. So far, I’m sticking with no–partially because I’ve read too many really scary articles about it and the regain-rates, and partially because the system that’s set up around it sounds like a bunch of folks fussing at me a lot and questioning every decision I make or don’t make for about a year, and I might not handle that level of slightly invasive now-now-dear attention very well.
What I’d really like is to be able to quit eating altogether. That seems somehow really peaceful. I don’t mean self-starvation. I mean that I’d like to be the human equivalent of an air-plant. Which covers the fantasy portion of today’s discussion.
Anyway, I rather thought I owed y’all a more focused discussion after Saturday’s rambling descent into Lent-and-disappearing-mother-induced depression. It was useful to me, anyway–I hadn’t realized how far into my lap the Black Dog had crawled. A couple of you have been lovely enough to say it was of some (perhaps tangential) use to you, for which, my thanks. Keep flapping those wings, my dears.