I think people understand alcoholism and have some sympathy for the alcoholic.  I think it is understood that it is a chemical addiction and a powerful draw to the recovering alcoholic.  The same goes for drug addiction.  We may not exactly sympathize in many cases but we do understand the chemical dependency and the hold that the drugs have over the addict.

Certainly if a medication were introduced that would aid the alcoholic by reducing the urge to drink or aid the drug addict to avoid the pull of the drugs, most would consider it a societal gain.

The simple fact of the matter is you don’t become an alcoholic with your first drink, nor, as I understand it, a drug addict with your first snort of cocaine.  Both addictions are avoidable by never taking a drink or doing a drug.  The alcoholic can avoid situations where alcohol is consumed or served.  The drug addict can avoid situations where drug use is in play.

We have to eat.

Obesity is proving to be as much a chemical dependency as are drug addiction and alcoholism.  Chemical changes in the body drive our hunger response.  There is evidence from medical studies that the obese have high levels of a combination of hormones that trigger the feelings of hunger and low levels of the hormones that signal satiety.  This stays true even after the weight is lost.  There is further evidence that these skewed hormonal levels exist to some degree from early on, before an individual reaches clinical obesity.

So why do we have so little understanding and so little compassion for the obese?  Because, we believe as a society, overcoming obesity is simply a matter of willpower, desire, and good habits, that’s why.

We look at fat people and see them as failures.  People so out of control of their own behaviors that they don’t even know when they are full, when simply to push away from the table.  I have heard more than one person ask rhetorically “don’t they ever look in a mirror?”  Trust me, we do.

I read some comments on a blog last night that triggered in me this bit of thought and introspection.  The blog post was reasonable: What do you think about the newly approved diet drug and the fact that it received approval even though there is significant health risk involved.  The responses saddened me.

Both responses prior to mine were along the “magic pill, don’t have to diet and exercise, take responsibility” line.

I don’t think it is that at all.  I am not looking for a magic pill and the people I have spoken with that have had bariatric surgery all wanted to avoid surgery and pills but after years of the weight loss rollercoaster pills and surgery became the last best option for saving their lives.

The amount of willpower, dedication and effort required to lose 100, 200 pounds, is incredible.  Even the 30+ pounds I have lost has been a fight; a daily struggle against urges, desires, and hunger.  Certainly many people do overcome obesity with hard work and developing good habits.  That is the path I am taking and I am working hard to make it happen.

The sad and simple fact is the people able to maintain weight loss are in the minority.  The majority, more that 95%, will see significant weight gain within two years of reaching their maximum weight loss.

Why is this?  You simply cannot write it off as a lack of willpower, bad habits, bad choice…  There must be more at play, just as there is for the drug addict and the alcoholic.

Obesity is a national plague.  Certainly bad habits are a large part of the problem.  The average American Diet is a recipe for obesity.  Our approach to food in this country is abysmal.  That said, once the slide towards obesity begins, the body chemistry takes control.  It compels us to eat ever-increasing amounts of food.

How is this much different from the path of alcoholism?  Our approach to alcohol in this country is abysmal.. Are we not taught from an early age that good times include large quantities of alcohol?  Just as we did not get obese from our first slice of pizza with double meat and extra cheese, we did not become an alcoholic from our first night of binge drinking in college.

Those that have not walked this path cannot possibly truly understand it.  It is not an easy path and trip hazards abound.  We cannot wall ourselves off from the world.  We cannot avoid parties forever, nor can we never walk in to a restaurant.  Families will hold holiday dinners; boxes of doughnuts will be brought to work…

There are no easy answers and I doubt that this is what the truly obese are looking for.  They are asking for help after years and years of frustration and failure.