Fact vs. Fiction – Here’s The Skinny

I’m a woman, so, of course, I think about my weight every single day.

Thus, I found the Casazza, et al., article Myths, Presumptions, and Facts about Obesity interesting.  I will readily admit I was surprised by how many of my beliefs were myths?! Such as: (1) without a realistic weight loss goal you will likely fail; (2) initial rapid weight loss doesn’t support long-term success; and (3) diet readiness is necessary for success.  Who knew?  (Isn’t education awesome?!)

It is completely relevant to put the following into some sort of measurable model of health.  That said, my favorite is the biopsychosocial model.  This model is a healthy, well-rounded or balanced complete picture of “you.”  It is appreciation for “Wellness” – a state that is not only disease free but is also actively striving to achieve or maintain overall health!

 

 

So, on to the “myth-busting!”

A few initial thoughts… Implications for models (a way to measure or support a theory) is important.  A healthy model (to support a theory) can’t be thin – the meta-analysis must be consistently extensive.  Such as, it is widely understood that long-term, healthy practices will achieve long-term positive health results.  Who knew – Mom was right… good character isn’t only moral but contributes to good biopsychosocial health as well (Friedman Lecture 11/10/16)?!

#1 – Without a realistic weight-loss goal you are likely to fail.

                FALSE!

Wow?!  I can’t express how often I’ve heard that this was a key ingredient to my weight loss success yet empirical experiments prove “unrealistic goals resulted in more realistic outcomes ….” (Casazza, pg 448).

Health-Related Quality of Life (HRQL) takes in to account our well-being in the physical, mental, and social aspects of our lives.  This article reflects “going for the gold” or setting lofty weight loss goals does not set you up for failure; in fact, it could lead to more pounds lost.  Someone may need an extreme weight loss goal to fulfill their mental motivation to lose weight.  Understanding that there are different paths and identifying the most useful path supports the HRQL.

#2 – Initial rapid rate of weight loss eventually leads to poorer long-term weight loss.

FALSE!

                                “Greater (rapid) weight loss has been associated with lower body weight and the end of long-term follow-up” (Casazza, pg 448).

Let’s be optimistic!  Optimism would reflect a personality that had low neuroticism and some extroverted tendencies.  Of course, losing weight and then keeping it off long-term would be ideal.  Optimism can help achieve that outcome.  Optimists like to be constructive and problem-solve.  They set achievable goals, and are effectively realistic.

#3 – Diet readiness is irrelevant.   

                TRUE!

                                Great news!  You don’t have to prepare or be ready – if you choose to begin a diet right now you are already winning and will likely succeed at some level!  Readiness is trumped by the fact that we voluntarily choose to participate in a diet – thus, we are already engaged/committed at some minimal level.

Overall, I support a self-healing personality.  In my effort to lose weight, remaining energetic and enthusiastic is key.  Maintaining homeostasis is key to reaching long-term weight loss goals and promoting overall great health!

After digesting all the above, what is the take home message?

Research is useful!  Busting the above myths was constructive.

For those that are overweight, there is no more worthy a task than losing weight to achieve a normal body mass index (BMI).  Live long and prosper!

Simply put, both your mental and physical states will immediately and infinitely improve.

That said, how exciting that you can shoot for the moon and set an ambitious weight loss goal – GO FOR IT!!!

If you are heavy, you will likely lose many pounds quickly – Great – it in no way indicates that you won’t be successful in the long run.

Finally, ready or not, your willingness to attempt dieting today is already moving you forward… BRAVO!

My personal battle has been a weight loss of 29 pounds in four months… the struggle continues.

Here are two websites that might help you acquire useful weight loss tools.  May we all achieve biopsychosocial health!

https://www.weightwatchers.com/us/

http://www.prevention.com/fitness/how-to-start-walking-for-weight-loss

 

 

 

“Go Ask Alice” and the Biopsychosocial Model

A few weeks ago, I ran across John Korty’s 1973 Go Ask Alice film and was reminded of my very vivid twelve-year-old memory.  My girlfriends and I would pass the anonymously written book Go Ask Alice (1967) to each other, under desks, due to its scandalous content.  Our parents would never have let us see the movie.

 

 

 

 

 

 

 

 

 

 

The book is allegedly the diary of Alice: a fifteen-year-old, coming-of-age girl who has an unhappy ending.  Her agonizing life experiences were tangibly excruciating to read.  I was curious if the movie would be as graphic as I had remembered the book.  Additionally, I wanted to see if the written behaviors supported the biopsychosocial model.  This model reflects that complete physical, mental and social well-being are required to maintain health.

Alice, the main character, considers her diary to be the only one she can “talk” to.  The biopsychosocial model contains emotional, societal, and cultural contexts.  Societal norms define someone who thinks there is no other living soul they can confide in as ostracized.  In turn, feeling ostracized would negatively impact behavior and health.  Indeed, in Alice’s case, it does.

Loneliness and social isolation are now proven to cause greater psychological stress and poor health.  Specifically, “… it has much more to do with how much control you have over life circumstances and the degree to which you’re able to participate fully in society …” (Marmot 2002).  Alice worried about her weight, finding friends, the relationship with her boyfriend, and fitting in at a new school.

Alice has upsetting experiences, as she experiences a new high-school and summer with the grandparents, but the game of “Button Button” was particularly damaging.  During the rare social experience of being invited to a party, Alice “luckily” and unknowingly receives the button.  It was a Coca-Cola laced with LSD.

Her trip irrevocably changed her life.  The drug hid her inhibitions and she was being accepted by a social clique (peer-student drug-users).  Initially, she vowed never to knowingly do drugs again but the drugs won her over.  She quickly became thin, was popular, had a boyfriend, and life seemed awesome.  This clearly speaks to the behavioral context mentioned earlier within the biopsychosocial model.  The lack of social and mental well-being led to her change in behavior and eventual addiction to drugs.  In response her parents were in denial despite her change in verbiage, clothing, and behavior.  This also reflects the impact of the social-cultural norm of the late 1960s.

Before vs. After

 

Neuroticism is one of five main personality types.  This personality tends to remain in distress and unstable.  Alice’s personality mirrored neuroticism.  Unless she was high on drugs, she was constantly in distress which led to the unhealthy behavior of drug-use.   Her temporarily groovy world looked like this:

 

Aspects of Alice’s personality resulted from her negative drug therapy.  Her disease of addiction continued to cause further negative change.  Additionally, Alice’s behavior reflects tropism.  Certain personalities, like Alice’s, are pulled towards the crutch of mind-altering drugs.

Her neuroticism and her social-cultural environment led her to embrace drugs.  The drugs negatively impacted her mental and physical health.  The constant instability in her biopsychosocial make-up influenced her negative spiral.  Her need for drugs led to her sexual assault, physically harming herself, and ultimate death.

The movie included a factoid that was not in the book.  There were over 5,000 deaths the year Alice’s parents found her dead upon returning home one evening.  Alice had been sober for months and had stopped using her diary.  Thus, no one would ever know what happened.  That said, the biopsychosocial model reflects Alice’s failure to simultaneously maintain mental, social, and physical well-being clearly led to her eventual death.

Overall, the movie covered all the important points.  Albeit it was much more G-Rated than the diary’s deceased author’s completed entries.

If drug or alcohol addiction should ever happen to you or a loved one, I would highly recommend researching the following websites.  Both are renowned for their long-term success rate with drug and alcohol addiction.

http://www.chapmanrehab.com/

https://www.hoagaddictiontreatment.com/hoag-addiction-treatment-rehabilitation/#~D1h4f3

Best wishes to you and yours…

The Sympathetic Nervous System is anything but “sympathetic!”

Many moons ago, while stationed aboard the USS Mount Baker (AE 34) as a Navy Chief, I was struck by a military van and knocked off the road while running the physical fitness test on a Navy base.

It resulted in multiple fractures of my right hand’s metacarpal bones and the development of a rarely heard of disease called Reflex Sympathetic Dystrophy (RSD now called Complex Regional Pain Syndrome).

Before I explain what RSD is, I would like to frame it with the fact that there is no cure.  At most, one may only wish (or pray) for long periods of remission…

In layman’s terms, RSD causes the Sympathetic Nervous System (SNS) to go into overdrive.  The SNS is the nervous system mechanism that stimulates our body’s fight-or-flight response when you are injured.  Among other things, these nerves raise your heart rate and provide excruciating pain to ensure that you are aware of the interruption to your homeostasis. You might wonder what the SNS might feel like with the addition of RSD?

First, long after your injury is healed, imagine that RSD will continuously transmit a “current injury” message to your SNS because RSD truly believes 24/7 you were just now hurt.  This means that your past injury feels as if it has just now been insufferably injured − EVERY SINGLE DAY FOR WEEKS, MONTHS, AND YEARS.

Your previously-injured appendage will continue to weaken, minimal blood flow will cause the entire area to turn blue, hair will cease to grow, and the skin will become shiny in an unhealthy way.  RSD is unrelenting and the chronic pain it creates is powerful enough to make you certifiably insane.  This kind of insanity convinces you that walking out in to traffic would be better than enduring yet another day of pain over an appendage that has been healed for more than a decade.

This happened to me.

Simply put there was, is, nor will be anything “sympathetic” about my Sympathetic Nervous System.

Fortunately, the US Navy was apparently on the cutting edge way back when.  They invested a great deal of time, expense, and effort to afford me a very broad (and therefore uniquely effective) biopsychosocial approach to recovery.

Initially, I was just given a heavy dose of morphine (in full transparency, I took morphine daily for over a decade).  However, it became apparent that my health issue was far more complicated than a simple broken hand.  My orthopedic doctor added mental health, occupational therapy, biofeedback therapy, coping skills counseling, and family counseling to provide me with the most optimal path to recovery.  I was sent to Navy hospitals in several different states, as well as, civilian specialty clinics.  It made all the difference in the world.

I experienced the Kubler Ross five stages of grief over the loss of using my right hand, the incessant pain, and likely loss of my career.  In response, my doctors were ensuring that I had a toolbox of skills to cope with all of the above.  It was sort of like that Mastercard commercial… the biopsychosocial approach was “priceless.”

Why was it priceless?!  Because RSD is always there.  Remember the “fight or flight” response?  Whether it be yesterday, today, or tomorrow − any time I am scared, sleep deprived, taken by surprise, exceptionally stressed over an exam, or God forbid another injury to that area… the RSD will flare again.  My arm will instantaneously feel on fire and begin to swell, as if I was just struck by the van all over again.  It is overwhelming and maddening − it takes my breath away and significantly impacts my behavior, while outwardly others have zero indication of my physical distress.

In hindsight, I’ve decided that my nervous system isn’t very sympathetic.  Although my “recovery” was arduous and took forever, I am eternally grateful for the coping skills the Navy’s healthcare system afforded me.

Go Navy!

If this should ever happen to you I would highly recommend researching the following websites and making yourself aware of more constructive treatments than just the crutch of opioids.

http://www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/detail_reflex_sympathetic_dystrophy.htm

http://rsds.org/how-to-obtain-the-best-medical-care-for-crps/

 

 

 

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