Commentary -- Can we talk about your weight?

  • Published
  • By Col. (Dr.) David Williams
  • 18th Medical Operations Squadron commander
KADENA AIR BASE, Japan --  "Can we talk?"

I've probably said that 10,000 times over the course of my career as an Air Force physician.

It's usually a segue to a topic that's a bit sensitive or uncomfortable ... like talking to a patient about their weight. The question establishes my expectation that we will talk to each other, not just me doing a monologue about whatever the issue at hand is. So I'll ask you, my Air Force family - Can we talk about our weight?

You see, our weight is a little heavier than I'd like it to be. You probably know it already, but I'm not doing my job if I don't bring it out in the open. That look in your eye tells me you'd rather be somewhere else, but this won't take long.

Despite six years of enhanced fitness testing, squadron physical training, and healthier dining hall choices, we're heavier than ever. Over 50 percent of us are overweight (that's a body mass index above 25) and about 14 percent of us are obese (BMI over 30). If I count our family members (including our children), the numbers will be considerably worse.

This is not just an Air Force issue. For more than 30 years, health officials at the Centers for Disease Control have warned us of the growing epidemic of obese and overweight adults in the United States. In 1970, only 12 percent of U.S. adults were considered obese, but that number has steadily increased to an incredible 35 percent in 2010 - triple the number from just 40 years ago.

The good news is that our Air Force numbers aren't as bad as that, but they're still a problem. It's anecdotal, but I see a lot of young Airmen who are heavy and I know that it's not going to get easier to lose weight as they get older.

In fact, more than 20 percent of Americans eligible to join the military are too heavy to do so. Where we used to be able to choose among the best and brightest to join our service, now some candidates will never make the cut because they're overweight. The lost potential to our nation is tremendous.

How did we get here? Well, in simplest terms, Americans today eat an average of 30 percent more calories than we did in the 1950s and we get less exercise. Portion sizes are larger, we consume more processed and sugary foods and drinks, and we're less active at work and at home.

The science isn't complicated - eat one 50-calorie cookie more than you exercise off each day, and you gain five pounds of fat a year. The good news is that it works in reverse too, but that's not the situation we're in.

I'm duty-bound to discuss this with you but, to be frank, I don't really consider your weight to be a medical problem. It's a lifestyle problem with lots of medical consequences. There are a few Airmen with medical causes for their obesity, but please trust me that those are few and far between.

The problem is, the solution really isn't a medical one - it's a lifestyle one. I have no pill to make us stop eating fast food, cut down on sweets, or eat a piece of fruit for a snack instead of a piece of candy. I wish I did!

Every physician knows you have to offer some hope to a patient when giving them some tough news, so here it is: we can lose the weight. If that gives you images of starvation, dieting and endless hours at the gym, please lose them, because those things don't work. You can't exercise yourself thin. Really.

I love the sight of so many Airmen out doing unit PT around the base every morning, but it is not the answer to this problem. Exercise can help you lose weight, but you have to eat right also or you'll gain it all back the first time you're laid up with a sore knee or back.

Eating right has two goals - eating the right foods and eating the right portion sizes. The right foods include lean meats, fresh fruits and vegetables, and less starches, like pasta and potatoes.

The second goal is to right-size your portions. If you like going out to eat, start the meal with a plan to take half your meal home and stick with it. It stretches your dollars (or yen) further and gets you closer to what a normal portion size should be.

I don't have room for a full discussion of healthy foods and portion size, but the U.S. Department of Agriculture's website, MyPlate.gov, is a good starting point. Your healthcare provider and our Health and Wellness Center staff will also work with you to help you reach your goals.

Those last words are extremely important: your goals. If you start a trip without a destination, you're probably not going to get there.

The same goes for a commitment to a healthier lifestyle. Write down your goals and put them somewhere where you can be reminded of them every day. Maybe it's to lose 10 pounds or to fit into those old jeans again - writing them down and reminding yourself of them is key to making them happen.

Not sure where to start? We're here to help - this is a discussion your provider and our HAWC staff would love to have with you to help you get started. Let's reverse this trend and set course for a healthier, more active Air Force family. Thanks for listening.