Everyday I see obese patients who want me to help them lose weight. Many of them have struggled with their weight most of their lives and tell me they have tried everything without much success, so now they are considering surgery. When I ask them “Why now?” the answer is often “Because my weight is effecting my health and I want to be around for my kids and grand kids.” A diagnosis of diabetes or high blood pressure may have frightened them into making the decision to do something they would otherwise consider as too drastic or too dangerous.
Last week I was a guest commentator on “Fox and Friends” discussing the subject of whether or not the state should pay for weight loss surgery. http://tinyurl.com/427btks My position was that while many people get great results from surgery, in large part their weight loss depends on their personal commitment to changing their behavior. You simply can’t keep doing what you’ve been doing or you’ll keep getting what you’ve been getting. Obesity is indeed the result of an addiction to unhealthy behaviors with respect to food. Addictions always are the result of a complex set of situations, including stress, fear, desire, guilt, trauma and other psychological factors. But one thing is consistent; the last one to recognize the true nature of the problem is typically the addict himself who remains in denial.
As I reflect on the diagnosis and treatment of obesity, I’m reminded of the debate going on in Washington over the debt limit and our nation’s spending habits. The fact is our government, on both sides of the aisle, is addicted to spending money they don’t have. For decades the Congress has appropriated funds for everything from building war ships to supporting research studying invertebrate behavior, based on a belief that as the most prosperous nation in history, we can afford it. We’ll just borrow the money and pay it back later. This sounds like the overweight guy who promises himself that he’ll workout tomorrow to make-up for that great tasting ice cream sundae he just devoured. Tomorrow brings still another excuse for not exercising, but there is no reason not to enjoy yet another bowl of ice cream.
Our nation’s economic health is very much like that of a 400 pound man with diabetes and high blood pressure. How best to treat it is at the core of the debate that rages on as we try to avert the looming disaster of default, the equivalent of a national heart attack. Unfortunately the solutions being offered have failed to address our underlying addiction. Despite the political rhetoric, our government continues to spend money we don’t have (deficit spending). But in large part the debt and deficit issues aren’t just about the guys in Washington. For decades we’ve elected lawmakers, and in far too many cases repeatedly reelected them, based on their willingness to appropriate money for programs that directly or indirectly benefit us, their constituents. Every two years they cobble together campaign platforms based on promises that “We the People” want to hear, and we keep sending them back to Washington to represent us. They are indeed our national addiction enablers.
Over the last century our elected representatives have passed numerous laws and initiated programs that we now feel we can’t do without. Our government has attempted to provide welfare for the poor, food stamps, unemployment benefits, free education, free healthcare, secure retirement, clean air, a strong defense, etc., etc. Only recently, has the general population become aware of the side effects of this “spendaholic” behavior. Some have started demanding that something be done, thus the rise of the TEA Party movement. But a large segment of the population has already become totally dependent on government spending and vigorously resists any change since they will feel the pain the most. For them the solution is higher taxes on those who are not government dependents. But once there are more people taking from the government than there are paying in, the system will very predictably collapse.
Obviously, the idea of a Balanced Budget Amendment as a mechanism of forcing us to live within our means sounds great, but like bariatric surgery it simply won’t work unless we make a commitment to making a fundamental change in our collective behavior. Perhaps since amending the Constitution requires a two-thirds vote of both houses of Congress and passage by three fourths of the State legislatures, successfully completing that process will demonstrate our national willingness to address our current spending addiction.
I often tell my patients that losing weight and keeping it off is perhaps the most difficult thing they will ever do, even with bariatric surgery, because it requires a fundamental change in behaviors that are deeply ingrained within them. But if they’ll stick with the program the results can be dramatic and very rewarding. I emphasize that there’s no such thing as a quick fix. The exact same thing can be said about reducing our national debt. My fear is our current “crisis management” approach is another quick fix effort and we’ll keep getting what we’re getting unless we stop doing what we’re doing. Spending money we don’t have, regardless of how worthy and honorable our intentions, will lead us to an early demise and therefore must be averted. Its time to schedule your weight loss surgery America, are you ready to make the changes necessary to succeed?
Twitter – @DrBob_Southlake