The Obesity Epidemic Poses a Threat to Wellness in Recovery

As you are probably aware, our nation—and indeed the world—suffer from a growing epidemic of obesity. A recent Los Angeles Times piece really drove home to me how serious the problem has become (Healy, 2016).

Over the past decade leading medical experts have pointed to data from the Center for Disease Control and Prevention (CDC) that indicate that obesity is running neck and neck with smoking as our nation’s leading preventable cause of death (Flurry, 2009). Ludwig is disturbed by the uptick in deaths from heart disease, stroke, diabetes, and chronic liver disease over the past year, underscored by a 19 percent rise in deaths from Alzheimer’s (Healy, 2016). Each of these causes of death has been linked to midlife obesity, which now impacts 35 percent of our adult population.  Indeed, over two-thirds of adult Americans are either clinically overweight or obese.

Equally frightening is a recent report by the World Health Organization (WHO) stating that worldwide cases of diabetes have increased nearly fourfold over the past twenty-five years, driven by excessive weight, obesity, aging, and population growth (Keaten, 2016). Worldwide, WHO claims that diabetes and prediabetic high blood sugar levels together accounted for close to four million deaths in 2012. Undoubtedly the majority of these deaths are attributable to Type 2 diabetes—formerly called adult-onset diabetes—in which the main culprits are obesity and sedentary lifestyles.

Let’s take a moment to explore why recovering alcoholics and addicts are at elevated risk in regard to obesity and its untoward consequences.

For one thing, many if not most people working in the field would probably agree that aside from genetic predisposition, a leading causative factor underlying addiction is a misguided effort to fill a perceived spiritual or existential void in addicts’ lives. Once they have weaned themselves from their primary drugs of choice, it is not particularly surprising that many of these people turn to food in an effort to fill the void. Indeed, eating disorders and food addiction emerge as fairly common substitute addictions among many people in recovery.

In my book The Wellness-Recovery Connection (2004) I discuss in detail the propensity of many recovering alcoholics to gravitate toward high sugar foods. Unfortunately very few cells in the body are able to effectively utilize sugar. When we eat a lot of sugar, most of the glucose or fructose gets metabolized by the liver, where it is turned into fat which is secreted into the blood (Gunnars, 2013). In addition to the detrimental effects of sugar, many sugary foods such as ice cream and pastries contain substantial amounts of saturated fat. 

If this wasn’t bad enough, many recovering alcoholics and addicts carry their addiction to nicotine over into their recovery, which dramatically increases their likelihood of succumbing to declining health and premature death. Indeed, millions of people in recovery are unwittingly stacking the deck against themselves by subjecting themselves to the hazards associated with both food addiction and smoking.  

I encourage you to conduct a brief self-assessment of your own risk level in regard to obesity and its potentially devastating consequences. Obvious “first cuts” include looking in the mirror, stepping on the scale, and trying on a pair of jeans or dress you bought several years ago.  

In the fields of medicine, nutritional counseling and fitness training the gold standard for evaluating one’s current standing in regard to body weight is the body mass index (BMI). In a nutshell, BMI represents a ratio between a person’s weight and height, calculated by dividing one’s weight in kilograms by the square of one’s height in meters (CDC, 2015). Google either “body mass index” or “BMI” and you’ll come up with a wealth of information and a plethora of sites where you can easily calculate your BMI. Commonly accepted BMI ranges for adults aged twenty and older are 

• Underweight: under 18.5
• Normal weight: 18.5 to 25
• Overweight: 25 to 30 
• Obese: over 30 

The obese category is in turn divided into three subcategories: 

• Moderately obese: 30 to 35
• Severely obese: 35 to 40
• Very severely obese: over 40

In interpreting ramifications concerning your own BMI, keep in mind that the BMI for a large-boned or very muscular person may be somewhat inflated in regard to actual health risk factors. With that caveat in mind, if your BMI falls within the middle to upper range of the overweight category or within the obese category, you are at substantially elevated risk of succumbing to heart disease or stroke, diabetes, liver disease, cancer, and/or a number of other potentially life-threatening diseases. I would urge that you consult with a health professional—ideally a physician in combination with a skilled nutritionist—concerning steps you should take to reduce your risk factor profile. This is especially true if you fall within either the severely obese or very seriously obese categories.

Generally speaking your best line of attack is to begin a medically supervised program of diet enhancement, weight reduction, and regular vigorous exercise, and stay with that program. Unless you have undergone a recent physical exam, schedule a thorough medical evaluation including a comprehensive blood panel. It is critically important that you bring your diet into balance concerning a more optimal mix in your nutritional intake. I personally favor the Mediterranean diet, sans the meat and wine, which I’m been practicing over the past several decades. You can find the Mediterranean diet pyramid in my book or download a copy online (“Mediterranean,” 2015). 

If you fall within the BMI categories for overweight or moderate obesity, joining a group weight-loss program such as Weight Watchers, combined with consulting with a skilled nutritionist, should get you headed in the right direction. It’s important that you stick with your diet optimization and exercise program to fully integrate these healthy behaviors into your life.

If you fall within the severely or very severely obese categories you may want to discuss this with your doctor, together with the pros and cons of bariatric surgery. Bariatric surgical procedures cause weight loss by restricting the amount of food the stomach can hold and/or restricting the absorption of nutrients (ASMBS, 2016). While bariatric surgery is a life-saving procedure for many people that can dramatically improve their quality of life, the risks associated with this major surgery must be carefully considered. If your doctor believes you might benefit from this procedure, obtain a referral and schedule a consultation with a qualified bariatric surgeon. You may also want to seek out a second and even a third opinion to help you decide whether you want to undertake this major surgical procedure and, if so, which type of procedure appears best for you. Subsequent to the procedure you will need to follow a lifelong regimen of vitamins and minerals, together with a periodic battery of lab tests. It is also highly recommended that you bring your diet into balance and adopt a medically supervised exercise program.

The best way to protect yourself from unwittingly participating in our worldwide obesity epidemic is to fully integrate a wellness lifestyle into your recovery program. As the saying goes, an ounce of prevention is worth a pound of cure.  

I hope this column may inspire you to initiate proactive action in your own life as well as with your clients to safeguard against unhealthy lifestyles that set the stage for obesity. As always, feel free to share this column with your clients and others who may benefit from the message.

Until next time—to your health!

American Society for Metabolic and Bariatric Surgery (ASMBS). (2016). Bariatric surgery procedures. Retrieved from http://asmbs.org/patients/bariatric-surgery-procedures

Centers for Disease Control and Prevention (CDC). (2015). Body mass index (BMI). Retrieved from http://www.cdc.gov/healthyweight/assessing/bmi/

Flurry, S. (2009). The most affordable health care there is. The Philadelphia Trumpet, 20(5). Retrieved from https://www.thetrumpet.com/article/6074.24

Gunnars, K. (2013). Four ways sugar makes you fat. Retrieved from https://authoritynutrition.com/4-ways-sugar-makes-you-fat/

Healy, M. (2016). Will obesity reverse the life span gains made over decades of health triumphs? Los Angeles Times. Retrieved from http://www.latimes.com/science/sciencenow/la-sci-sn-obesity-will-reverse-lifespan-20160403-story.html

Keaten, J. (2016). The World Health Organization says excessive weight, obesity, aging, and population growth were top factors behind a nearly four-fold increase in worldwide cases of diabetes over the last quarter-century, affecting some 422 million people in 2014. Retrieved from http://www.usnews.com/news/world/articles/2016-04-06/who-diabetes-rises-fourfold-over-last-quarter-century

“Mediterranean diet pyramid.” (2015). Retrieved from http://oldwayspt.org/resources/heritage-pyramids/mediterranean-pyramid/overview

Newport, J. (2004). The wellness-recovery connection: Charting your pathway to optimal health while recovering from alcoholism and drug addiction. Deerfield Beach, FL: Health Communications.