January 1, 2010
By Jonathan Sackier
Overweight or obese—common words. For the sake of completeness, let’s clarify a few facts. First, your age (easy questions first), your sex (not too problematic, hopefully), your height in inches, and weight in pounds. These parameters allow calculation of your Body Mass Index (BMI) with a simple equation: BMI equals weight in pounds times 703, divided by height in inches, squared.
Alternatively, try one of the online BMI calculator tools such as the National Institutes of Health Web site (www.nhlbisupport.com/bmi). If the number you obtain is less than 18.5 you are underweight; if between 18.5 to 24.9, you are normal. Should BMI equate to 25 to 29.9 you are overweight; if greater than 30 you are obese; and one is considered “morbidly obese” if 100 pounds overweight or if the BMI is greater than 40. Just as we consider factors prior to flight, the same must be done in assessing weight—BMI is a tool, nothing more.
What are the implications of being overweight or obese? Given the price of avgas nowadays, you are throwing away good money to haul additional cargo and, no, those love handles cannot be considered useful load! I recently, perhaps indelicately, pointed out to an overweight friend that he does not need to bring a cushion along when he rents an aged Cessna 172 in the local fleet as he is already more than adequately cushioned.
Bone and cartilage fatigue are the human equivalent of metal fatigue, and obesity is tied to all sorts of joint issues from chronic back pain to arthritis, necessitating joint replacement surgery—just like an aircraft being stressed in turbulent weather.
Aircraft fuel pumps deliver avgas to the engine and prevent that most disturbing silence that might otherwise ensue. In humans, our fuel pump, the heart, can only deliver a certain amount of blood before it starts to feel the strain. Carrying extra weight can result in serious issues that could lead to a very worrying and maybe even permanent silence. Obesity is linked to problems in every organ, as well as increased incidence of cancer and other diseases.
Did you did make a New Year’s resolution to embark on a diet? Unfortunately, your likelihood of success is not high. Why? Most people are searching for a silver bullet and participate in what I call “the rhythm method of girth control,” short dieting bursts followed by frustration and binge eating.
When learning to fly, we progressively acquire knowledge and well-prescribed methodologies to address every conceivable situation and commit to practice, practice, practice.
If you are overweight—and want to do something about it (the most important step)—you must change your beliefs before considering changing behaviors. It is hard to lose weight because in our society many foods are peppered with salt, fat, and sugar, three stimuli we are conditioned to adore. Who can refuse a chocolate milkshake? Sugar, fat, and salt. Who can say no to a serving of French fries? Salt, fat, and sugar.
The wide range of diets are rather like the BMI—tools that can serve as a basis for a weight-loss regime. However, here are some very simple steps you can start taking today that are guaranteed to help.
First, eat breakfast in the morning. Many Americans grab a coffee and a high sugar/fat/salt snack they eat in the car. This is disastrous from a health perspective. Take the time to sit down at home and eat a high-fiber cereal or oatmeal with low-fat milk or soy milk, a glass of juice, and a hot drink—preferably a caffeine-free herbal tea without sugar. Within a short period of time after this meal, the gastrocolic reflex will kick in—basically the stomach will send a message to your colon stating that more food is on the way down so better dump the excess fuel.
Next, carry a bottle of water with you—simply from the faucet is fine. This will keep you well hydrated and limits “grazing” on tasty but unhealthy snacks.
Another simple belief change that leads to behavior change is to adjust how you view food. Our senses of smell and taste are primarily stimulated by food, yet do we really focus when we eat? Buy smaller plates for your home; do not eat and watch television simultaneously as such distractions limit your enjoyment and encourage overeating. Put down your utensils between bites and do not cut up the piece of meat at the beginning of the meal; rather, cut pieces as you eat. Mealtime conversation will also give your satiety sensors (the method your stomach uses to tell your body “I am full”) the chance to work. If you eat too quickly, you overeat. As with all changes in your health regime, discuss this with your personal physician.
Finally, it is important to have some perspective in all of this—enjoy that ice cream sundae by all means, but make it special, eat it slowly, and savor each bite.
Just as we load the aircraft with the terminology “weight and balance,” while managing your weight, keep balance in the equation.
Jonathan M. Sackier, MB, ChB, has practiced medicine in the U.S. for more than 20 years and is a longtime pilot. E-mail the author at firstname.lastname@example.org.
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