Alexa Fleckenstein M.D.

At a dinner, I came to sit beside a beautiful French lady of a certain age, elegant and sophisticated. Always looking for good stories and good advice, I asked her what she did to keep her weight. She gave me that long look, shrugged her shoulder and said: “One takes care of oneself.” I have often thought of the French lady’s remark. It sounds so easy – “One takes care of oneself.” But it involves a lot. It obviously is easy in these times and age to gain a lot of pounds as we are getting older. Some folks even seem to think that aging itself puts pounds on the scale, so “normal” is it to gain weight with every additional birthday. Similar to what we physicians thought about blood pressure: It was “normal” to have higher blood pressure with higher age. So normal actually that physicians had a formula for it: 100+age, the systolic blood pressure was to be. It turned out it was only “normal” in a statistical sense: Most older people had indeed higher blood pressure. But not “normal” in a healthy sense: Healthy people should stay around 120 over 80 – no gain with age. High blood pressure hurts the heart and the arteries, the brain and the kidneys – nothing “normal” in it. The same goes with weight. In some Asian cultures, the grandparents helped with raising the children, but they tried not to be a burden on the families. They voluntarily ate less. Because the thinking was older people need less food. I am not sure they need less food if they are still active. But in those Asian cultures it was “normal” that older folks got skinny. Presently, we hear much about self-reliance and self-care. It doesn’t come out of the blue. It comes from bad economic times and the realization that overweight, obese people not only eat more than they need, they also gobble up a bigger share of health care costs. Taking care of oneself should not take the form of starving oneself – which is never healthy. But to make oneself knowledgeable about which foods pack on the pounds and leave us with a ravenous appetite right after we have eaten might be a way to go. It is easy to blame advertisements, the food industry, indulgent parents, or what not. But in the end it comes down to ourselves who make the decisions. One doesn’t wake up one morning, and all of a sudden, with no forewarning, one has gained fifty or more pounds. It is a daily process, and we should look at our face in the bathroom mirror and should take a long look at what the bathroom scale shows. We harvest what we sow. The natural laws apply to all of us – no one is exempt. That’s what the French lady wanted to say, I guess. Society has ways of dealing with people who can’t care for themselves: We are caring for the very young and for the very old, and usually that caring is fairly benign. We also put people in mental institutions and, in extreme cases, in jail if they can’t care for themselves. When States want to make laws restricting sugary drinks or forbidding smoking in public places, there usually is an outcry that rights are taken away. To me, who always was deathly afraid that somebody might take over my life and make decisions for me, it only seems consequent that laws have to take over personal responsibility in certain situations. One doesn’t let oneself go. One shouldn’t be the problem but the solution to the problem. One takes care of oneself. Read More