Team S.J.G.R. REALNESS 101: The Sledgehammer.

"I want to be. . .  your sledgehammer."

~ Peter Gabriel

Oh just damn. I hate to come at you like a sledgehammer on this overcast Sunday, but that's how the realness usually comes, right? Hard like a sledgehammer and shattering everything to bits. And so. Here we go.

Feel free to stop here if you aren't ready for it.

So check it. There was this study that came out in the Annals of Internal Medicine (which is a super legit and high impact journal) very recently.  And sure, this is a study that, no, won't say anything that is rocket science to any of you, but that will nudge everyone a little further out of hypothetical la-la land when it comes to health and wellness.

At least it did for me.

Oh, my bad. You forgot about "hypothetical la-la land?" Okay. Well let me just remind you. And remember--any message for you is a message for me. Which means that you aren't the only one who needed this reminder. I do, too.

So hypothetical la-la land. That's the place where all of the things that happen from unhealthy practices and states of being somehow leapfrog us and land on someone else. Like Tony Soprano or some other person who isn't you or isn't connected to you. But see, since we are all members or at least peripheral members of Team S.J.G.R. we all know that at some point SHIT JUST GETS REAL. Hypothetical becomes a legit part of your world and not some far off thing that only happens to other people.

Or just "older people."

Yeah, I said it. So we will just go right ahead and put it out there that, for me, S.J.G.R. when my beautiful, talented, wonderful and hilarious sister Deanna Draper left this world as we know it on November 15, 2012 from a heart attack. Yes. A heart attack. The number one causer of death and disability in the U.S. that, somehow, I still sort of saw as something that was happening in hypothetical la-la land only.

Or mostly to "older people."

Yeah, I said it again. No, I never in seventy million years expected my sister who was only 20 MONTHS older than me to leave my house on a boring Wednesday night, text me with emoticons that she got home safe, and then never hear from her again. Because stuff like that happens in People Magazine or The Atlanta Journal Constitution or during the church announcements. Not in MY family. And certainly not in yours, I'm sure. I'm sure.

So when I read this study, it punched me in my mouth hard. It said, "Yeah, yeah, this is stuff you already know but like, for real, here it is with data in your FACE." Which is kind of different than thinking you know something. At least to me it is.

So here is basically the gist of the study:

There is no such thing as healthy obesity.

Sigh. Let me say that again--but in the way that less kind people and media are wording it:  You can't be "fat but fit." I mean, not really you can't.

And before I go into more of this study and unpack on all of it, let me be very, very clear.  I don't like the term "fat" used to describe people. I think it's hurtful and callous and mostly unhelpful. It's even more damaging when we use that word with reference to ourselves. Which happens far too much and is extraordinarily poisonous. And that? That could be it's own blog post. Hmmm. It probably already is somewhere but I just forgot about it.

Wait? Where was I? Oh, terminology. Yeah. So, instead I will use the term "obesity" or "overweight" to refer to being well over an ideal body mass index. Or over your ideal body weight. You with me? Good.

Okay, so check it. First a little background information: There've been some studies that have looked head to head at obese people who are "metabolically healthy" and also their "metabolically unhealthy" couch potato counterparts. Wait. That came out wrong. Okay, so those aren't necessarily their counterparts. They're just people. So yeah, researchers have compared these two groups in the past and found that -- duh -- it's better if you're overweight and metabolically healthy. There's also been a few small studies that looked at metabolically healthy obese people and metabolically unhealthy normal weight people,  too. That data mostly says that it's always better to be metabolically healthy no matter how much you weigh.

Now. Let's define "metabolically healthy."  Per most studies and my points today, that refers to people who don't have high blood pressure, issues with glucose control, and cholesterol -- or who have these things yet are consistently, irrefutably WELL CONTROLLED. And by "issues with glucose control" that's just a way to say that they didn't have diabetes or "pre-diabetes."

Here's what they weren't talking about. They weren't talking about how much the obese person is working out or how much weight they can bench press or squat. Although we do know that there are definite major health benefits and improvement to life expectancy for folks of any weight who do exercise regularly. So that doesn't mean that this isn't good. It just means that there has to be more.

Whew. I know. This is kind of confusing so far. But stay with me, y'all. I'm going somewhere.

Okay. So this study in the Annals of Internal Medicine -- a big meta-analysis of several studies -- broke down what I think a lot of us kind of know but have wanted to ignore.

But first the good-ish news:

• Being metabolically healthy and obese is better than being metabolically unhealthy and obese. 
• Even if you are of a normal weight, being metabolically unhealthy reduces life expectancy. Which means just being skinny can't be the endpoint either.

So it is critical to work hard to control blood pressure, blood glucose and cholesterol.

But here is the real talk part:

Even if you are metabolically healthy, if you are overweight or obese, you have a significantly higher chance of dying or having heart-related problems than if you are of metabolically healthy and of a normal weight.

Significantly, so.

So what does this even mean?  It means that SHIT JUST GOT REAL with our health and wellness goals, that's what it means.

Let's make this not hypothetical, shall we? Okay. I am the first to admit that this study would punch my mouth even harder if I'd struggled with my weight as much as some others in my family. I know I haven't so yeah, yeah it's easy for me to say this. But the thing is. . . .I am a member of a family where people started out slim and ended up not slim. And I'm also connected to and deeply love some people who are overweight that read this blog. So really, this message is for all of us. And, no, it's not just some slim internist wagging her smug skinny finger at everybody else.

You got that?

But even more real is this. I know for certain that my sister Deanna was not hypertensive and she didn't have diabetes. What I don't know is her cholesterol level. I had taken her blood pressure myself before and recall being surprised at how perfect it was. Now admittedly she wasn't in a doctor's care but the truth is that she very well could have been exactly what was described in this study: An obese person who was, by definition, metabolically healthy. Yep.

Perhaps that piqued my interest even more when I read this study because I felt myself saying, "Damn. That was my sister." And no, I don't know for sure if it was but the fact that it could have been or that it likely is for someone reading this, I knew we needed to unpack this and get the realness out of it.

So what is the realness out of it?

I'll tell you. Obese or overweight CANNOT be the endpoint. It can't. So even if you are 250 pounds  and have been "big boned-ed" or heavy for your ENTIRE LIFE, your endpoint cannot and should not be like, 180 or 175.  It shouldn't be if you want to increase your life expectancy and reduce the chances of heart-related problems.

Which I will KEEP saying is the NUMBER ONE CAUSE of death and DISABILITY in this country. And please--don't forget AND DISABILITY because while death royally sucks, severe disability can suck equally hard depending upon what that disability is and how it affects the quality of your life (or that of those who love you.)

So the realness is that we acknowledge that going from 250 down to 175 is awesome and a HUGE step in the right direction. But then we clean out the pantry and empty out the refrigerator and go harder. 175 can't be where the confetti settles. It can't.

I like to think of weight loss and fitness goals as having those people cheering for us at the "cheer stations" during running events. Think of hitting one milestone as the folks cheering at the mile five marker and later at the ten mile marker. It's way awesome and deserves some cowbell and major hand claps but it doesn't welcome you to leave the course. You feel me?

And what about when you run through the finish? What about when you reach a healthy weight and manage to do attain some metabolically healthy state to boot? Do you get to just sit on the curb and eat a banana? (Which is what I do after most races, ha.)

The answer? No. You do what any good runner does. You congratulate yourself and then sign up for another race. That's the only way to keep yourself training and running.

Yep.

Is this discouraging? I hope not. It shouldn't be. It should instead just be a jolt of realness. One that makes us look at the people and lives we love and vow to do what we can to remain a part of it. To put down excuses and fear and prove our little naysaying voices wrong, wrong, wrong.

Yeah. You hear them. Those little voices. They come in so many forms. Nice. Mean. Complacent. So stealthy, those little voices are. Recognize any of these?

"Girl, you just thick. You always gonna have junk in your trunk. It's good that you exercise though. Shoot! A lot of big people don't even do that. Don't worry about the weight!"

"Your man likes a woman with meat on her bones." 

"You work out WAY MORE than any of those skinny-minnies. You are healthy at this size! You ain't a couch potato like such-and-such is."

"You'll never be at a normal weight. Never have been, never will be."

"Everybody in your family is big. You will be, too. Deal with it."

"Your medical problems won't allow you to lose weight right now."

"You quit smoking that's why you gained weight."

"You just (fill in the blank) that's why you are this size." 

"People in my family live to be old. My grandmama-granddaddy-great uncle-great auntie was heavy set and lived to be ninety-nine and a half. Mmmm hmmmm."

"Man! You just ran a half marathon! You are healthy so don't worry about trying to look like something your body isn't. You just big-boned-ed, that's all!"

And you know what? That's all fine and good but is, unfortunately, bullshit. Bullshit if you want to reduce your risk of death or heart-related disease. And do what you can to be here with the people you love.

And I said "do what you can" because we certainly all know that sometimes the bell just effing tolls and it's nothing we can do about it. But you know? If right now somebody is telling you that there IS something that you could POTENTIALLY do, what the hell do you have to lose by trying?

Overweight CANNOT be the endpoint. It just can't. And, no, I'm not saying hate yourself. I'm saying be real with yourself, though. I sure am. I'm saying be real about how your weight directly affects your life expectancy and risk of cardiovascular disease.

So recall:  We LOSE WEIGHT by putting down the fork. That doesn't happen (really) from exercise. Does it help? Absolutely. And it especially improves the metabolic state to move you toward being "metabolically healthy." But as far as truly losing a sustainable amount of weight? That happens in the KITCHEN and at the dinner table with healthy choices.

Yep.

And that's doable. "NO" is sayable and doable. No starts at the grocery store and when perusing a menu. It doesn't have to be oppressive to all around you, either. It's passing on the egg nog because  it simply isn't 750 calories worth of delicious. It's a small glass of egg nog because you LOVE egg nog but no to the sweet potato pie because you can have a taste of one but not both. 

And NO you can't eat and drink both and then plan to "walk thirty extra minutes" on the treadmill. Because we LOSE WEIGHT by controlling what goes in our mouths. Period and END OF STORY. So disconnect the weight loss and constructive changes after naughty meals to exercise. Connect them to the next meal or the other things that are allowed during that same meal.

Whew.

I know some folks won't agree with that and say, "Of course you lose weight when you exercise." And to that I say yes, it does create a calorie deficit but not the kind of calorie deficit that putting down the fork or rather, choosing the right food and portions does. This is the reason why at every single race I've been in I am getting lapped and dusted by hard core distance runners who are still significantly overweight or obese. Which underscores my point: You CANNOT outrun, outjump or out-pilate a big ass until you fix your food intake.

This is suck a freakin' buzz kill at the holidays, right? I mean someone is just eating the last of the deliciously yummy latkes slathered in sour cream and apple sauce while someone else is perfecting their pecan pies and pound cakes for the next holiday party. But remember, what this calls for is AWARENESS not oppression. Have a latke. But have ONE. Put some greek yogurt on it instead or pass on the creamy topping. Enjoy your piece of pie. But modify the other food choices to counteract that calorie bolus.

Oh, and the same goes for alcohol which tends to come out even more during festive times. Because they have calories, too.

So the take home points are as follows:

1. When obese, we can't be our healthiest. 
2. Obese or overweight shouldn't be where the endpoint lies.
3. Exercise improves our cardiovascular health not matter what our size is.
4. We lose weight in the kitchen. 
5. We get fit in the gym.
6. This shit is not hypothetical.
7. Being awesome and loving your curves does not prevent heart disease.
8. You can do this.
9. We can do this.
10. Somebody is counting on us to at least try. Because your example can be a multigenerational catalyst and a message to your kids on "how to be."

Let's leave hypothetical la-la land for good. And recognize the realness for what it is. It's there whether you are celebrating with your family or not. And acknowledging the realness for what it is -- and not something hypothetical --  could quite possibly give us even more celebrations with our loved ones for years to come.

This message is as much for me as it is for you. So please--let me be your sledgehammer. Because I got love for you. . . and the realness? No matter what that little voice tells you -- it don't stop.  Plus I want YOU to be somebody's sledgehammer, too, through your strong example. And you can.

And you will. I just know it.

"Oh let me be -- your sledgehammer.

This will be my testimony."

~ Peter Gabriel

***
Happy Sunday. Say word!

Now playing on my mental iPod. . . . .a cool song (and one of the coolest videos ever) that probably was about the horizontal mumbo-jumbo more than it was Team S.J.G.R.  and cardiovascular health but lyrics are always open for our interpretation, right? Thanks, Mr. Peter Gabriel for this excellent soundtrack today. Rock out and enjoy.