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David L. Katz counsels overweight and obese people to be healthy by discussing “medical absolution”–you are partly responsible for your excess weight, but not to blame.

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David Katz:

David Katz MD, MPH, FACPM, FACP is an authority on nutrition, weight management, and the prevention of chronic disease, and a leader in integrative medicine and patient-centered care. He is a board certified specialist in both Internal Medicine, and Preventive Medicine/Public Health, and Associate Professor (adjunct) in Public Health Practice at the Yale University School of Medicine.

Katz is the Director and founder of Yale University's Prevention Research Center, Director and founder of the Integrative Medicine Center at Griffin Hospital in Derby, CT, and founder and president of the non-profit Turn the Tide Foundation. He was formerly the Director of Medical Studies in Public Health at the Yale School of Medicine for eight years.

Katz holds five U.S. patents and has published over 200 scientific papers, numerous textbook chapters, 15 books to date, and well over a thousand newspaper columns and blog posts.

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TRANSCRIPT:

Question: How do you motivate people to be healthy?

David Katz: The other thing many people require to avoid a feeling of futility and helplessness is what I refer to as medical absolution.

Somebody whose credentials they believe in telling them, “You are indeed partly responsible for your health and your future, but you are not to blame for the problems you’re having. You’re not to blame if you’re overweight. You’re not to blame that we have epidemic obesity. It’s not your fault.” And I find that with my patients, one of the critical elements in weight loss is setting down that weighty burden of failure and shame. People who struggle with their weight their entire life beat up on themselves. They feel like it’s their fault and honestly, it isn’t.

Tthat doesn’t mean that what they do with their feet and their forks is irrelevant. It’s absolutely relevant, but let’s face it, we have epidemic obesity. Nearly 80% of adults in the United States are currently overweight or obese and a recent publication suggests that should current trends persist by 2048, every adult in the United States will be overweight. Now, do we really believe that every adult in the United States in this generation has less willpower or self-control or is lazier than the previous generation? And do we believe that of our kids as well because they’re looking at similar trends? Are we actually producing kids with less willpower than the kids in previous generations? I don’t buy it and we don’t have a shred of scientific evidence to support it. What has changed is the world around us.

Human physiology and human psychology are pretty much the same as they ever were. The world around us, same as it never was before. Fast food, and crazy schedules, and no time for physical activity, and labor saving technology, and video games, and texting, and all the things that have changed the very nature of the way we get ourselves through our days. And perhaps the lives of kids have changed even more than those of their parents.

Well, you need to tell people it’s not your fault. The metaphor I routinely use for this is polar bears in the Sahara desert. And I point out that polar bears are marvels of survival but they’re adapted to the cold. They can’t do well just any old place. You take creatures adapted to the cold and put them in the heat, the very traits that allow them to survive in one environment will conspire against them in the other.

There is a unique homo sapien arrogance that allows us to talk about the world carved up into natural and manmade as if somehow we’re outside the box. We are not outside the box. We are creatures. We have a link with a native habitat just like every other species. Throughout most of human history, physical activity was unavoidable, calories were scarce and hard to get. In the modern era, calories are unavoidable, physical activity is scare and hard to get. The traits that allowed our ancestors to survive, and let’s face it, the survival of our ancestors is the reason that we’re here because the people who don’t survive and make very crummy ancestors, are our traits. But they’re very much at odds with the modern environment.

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