Like most Americans, I'm fat and trying not to be

·19 min read

On today's episode of the 5 Things podcast:

The obesity epidemic has been around for about four decades. What have we learned in that time that can help those struggling with weight loss today? USA TODAY health reporter Karen Weintraub asked just that. She wrote a six part series for USA TODAY called 'Rethinking Obesity."

She sat down with the team at 5 Things to share some of what she learned, including the fact that it's not your fault you are fat. What sleeping more can do for your weight loss, the real benefit of exercise and so much more.

To follow James Brown on Twitter, click here.

To leave a voicemail for James Brown with story idea or feedback, call (585) 484-0339

To follow Karen Weintraub on Twitter, click here.

To read Weintraub's six part series:

Episode 1

Episode 2

Episode 3

Episode 4

Episode 5

Episode 6

For more from Weintraub on obesity, click here and here.

Podcasts: True crime, in-depth interviews and more USA TODAY podcasts right here.

Hit play on the player above to hear the podcast and follow along with the transcript below. This transcript was automatically generated, and then edited for clarity in its current form. There may be some differences between the audio and the text.

James Brown: Hello, and welcome to Five Things. I'm James Brown. It's Sunday, August 14th, 2022. Every week, we take a question, an idea, a concept, and go deep. If there's something you'd like us to look into, you could always email me at jabrown@usatoday.com or leave me a voicemail at 585-484-0339. Or you can find me anywhere on social media @JamesBrownTV. We might have you on the show or at least use your idea. This week is personal for me, like many Americans, roughly 40% of us I've learned, I'm fat, or I was fat. I'm less fat now. At my heaviest, I was 370 pounds.

There's a picture of me conducting an interview outside of school that I can barely look at. I was uncomfortable a lot. I remember being out of breath, walking upstairs and not even a lot of stairs. And at my old job, they had to bring in a new chair for me. When I was hired, it was very embarrassing. This morning, A few years later, I weigh about 266 pounds or the size of a heavyweight UFC fighter, but I'm not done. I want to lose at least another 20 pounds. With the help of doctors, a nutritionist, friends and family, and a much healthier routine. I'll get there eventually. As USA Today's health reporter, Karen Weintraub found out there is no silver bullet for this process. Just hard work, dedication, and motivation. Karen Weintraub, welcome to five things.

Karen Weintraub: Thanks so much for having me.

James Brown: You spilled a lot of ink on this project so far and I-

Karen Weintraub: Yes.

James Brown: So did it find you, this idea, or did you find it?

Karen Weintraub: Can I blame my editor? It's a topic that is of interest to a lot of people. 70% of Americans are considered to have excess weight. And as you said, more than 40% meet the category for obesity. So it's the vast majority of us have an issue with this.

James Brown: And what, if anything, surprised you about your journey through this concept? Did you already know the basic facts or were there things that jumped out at you?

Karen Weintraub: So one of the biggest challenges with this series was I feel like health reporters have been writing the same story again and again, really for 40 years, since the epidemic was declared around 1980. And so it is an old problem. It is not a new problem, but it keeps getting worse and worse. And there are now I think 200 health conditions that are tied to obesity. Obesity itself, as an advocate made clear to me is not a disease itself, but it increases your risk for many, including diabetes and liver disease, kidney disease, lot, lots of problems.

So I started out trying to say, okay, what's new with obesity? I don't want to write the same story. And what really struck me the most was the fact that doctors are now saying it's not people's fault for being fat. It's not that you were lazy or weak or whatever that you ended up overweight, that so many of us end up overweight, that we live in an obesogenic culture and society. And that once we gain weight, it's really, really challenging to lose it. The body's biology fights efforts to lose weight. I don't know if you tried to lose weight before in your life, but many people try, they lose some pounds and then it comes back again, which is even more frustrating. So there's a lot of those issues that people face as well.

James Brown: If it's not our choices, what is it?

Karen Weintraub: So it's a combination of factors. Some of which, as I mentioned, are biological. So once the body gains weight, it's programmed to hang onto that weight. We're evolutionarily programmed. People would've died, cavemen and women would've died if they had not been able to hold on to extra calories. So the people who could hold those extra calories were more likely to survive, and we are the descendants of those people. So again, it becomes very hard to lose weight. In terms of gaining, it's very easy in our society to gain weight. Just where I am. I could walk within 10 minutes to a couple of grocery stores, two 7/11, a beer pub. There's a lot of stuff within a short walk of me, an Indian restaurant. And so we have such easy access today to food and to so much of it. Portion sizes have increased dramatically, particularly between 1980 and 2000.

Then there are some people who are not as lucky as I am to live with so many food options. There are some people, one gentleman I talked to for the story, the closest food option to him is a Dollar General and they don't carry fruit. All he can get there is essentially ultra processed shelf stable food, which is another factor that people are finding is a contributor to the obesity epidemic, that the food itself might be making us heavier, where this ultra processed food, the way our body digests it, that we pack it on as fat immediately, and don't have access to the nutritional value. So we gain weight, but we need to eat more in order to get the same energy from our food. So it really is a vicious cycle that is very hard to escape.

James Brown: So food deserts play a large role in all this?

Karen Weintraub: Absolutely food deserts are an issue, and the price of food. Ultra processed food, you walk into a big grocery store and the first thing you see are bags of snack food, junk food and soda, which are relatively cheap. On sale, you can buy a two liter bottle of soda for under $2, $3. So per calorie junk food is a lot cheaper than healthy food.

James Brown: There are six parts to Karen's series and it was the last one that really connected with me the most.

Karen Weintraub: Thank you for reading.

James Brown: Yeah. I love your work. Tell me about Betty McNair.

Karen Weintraub: The last one focuses on pediatric obesity, and basically we can't solve this problem as a nation unless we address pediatric obesity, unless we help kids avoid gaining weight in the first place. Betty McNair was this wonderful woman I met who runs a daycare center outside of Cleveland. And she makes it her business to help her kids learn how to eat healthy and what they should eat and to be active. So she was telling me things like even with the two and three year olds, they're growing plants in Dixie cups, so they understand where food comes from. They learn their colors by blueberries and spinach and raspberries, and she provides water for them to drink. She doesn't provide things like chocolate milk or soda. So she really emphasizes from their very earliest days, how to eat properly. They get a lot of exercise, a lot of activity in her daycare. And she also works on the parents. So if she thinks that the parents aren't giving the kids good nutrition at home, she will provide friendly lectures for them, give them some information so that they do offer their children healthier options.

James Brown: The other piece of that piece that stuck out at me a lot was you were talking about what parents can do. And you mentioned sugary drinks. Just speaking for myself, I grew up with a lot of sugary drinks. It was a regular regimen. Can you tell us a bit more about that?

Karen Weintraub: Yeah, sure. Nutritionists consider it sort of the lowest hanging fruit. The thing that should be the easiest to get rid of from our diets, it's fine to have soda as a treat once a month at a family picnic or whatever. That's not a problem, but some people are consuming lots of soda on a daily basis, and those are essentially empty calories. We're getting the sugar, what's turning to fat and it's not providing us any nutritional value.

The gentleman I spoke with who's lost 40 pounds so far said he used to drink a two or even a three liter bottle of soda every day, and now he's cut way back on that. Another researcher who I interviewed, she's an emeritus professor at NYU, Marion Nestle. And she wrote a book a number of years ago called Soda Politics, which talks a lot about why we drink so much soda, why we're so ingrained in our society now. And she said, after she wrote the book, she got emails from people who said, "All I did was cut out soda and I lost 20, 30, 40 pounds just from soda alone." I wish it were that easy for all of us to lose that much weight, it's not, but certainly soda is a relatively easy thing to give up. Drinks should not be sweet. Water is the best drink.

James Brown: Did you notice any other low hanging fruit for lack of a better term? I mean-

Karen Weintraub: [inaudible 00:09:14].

James Brown: Yes. When it comes to this subject? Simple things we can-

Karen Weintraub: Fruit is good. Fruit and vegetables, a plant based diet. Obviously we're all going to eat other things besides plants, but basing your diet around that is the healthiest. The other thing that really struck me again is sleep. People who sleep six and a half, routinely sleep six and a half hours or less of sleep a night eat, I think the last study I saw was 270 calories more a day for people who slept six, six and a half hours or less. That's a lot of calories added up over time and a lot of weight. So if you're not sleeping seven to eight hours a night and you can add that, you can improve your sleep, it's a really good idea. And there are ways to do that. The expert I talked to instead in particular turning off social media 90 minutes or so before bedtime is what she recommends, not watching movies in bed, that sort of thing. That we really do have more time to sleep in our day than we think we do, and we need to take advantage of that.

James Brown: I definitely am a victim of the adequate sleep. I'm a terrible sleeper.

Karen Weintraub: I'm sorry.

James Brown: So it's one of those things I'm working on myself. What else can we do to work our ways through this process?

Karen Weintraub: So exercise is important. You're not going to work yourself into being thin. There was a study out of if people have watched, and I should give a little personal admission here. I hate this show, The Biggest Loser, the TV show that ran for many years. In part, because I think it mocks people. It does not treat people with respect, I will say. And a study of people who were participants in that showed that almost all of them regained the weight that they had lost on the show and the ones who didn't regain all of it or go even further were the ones who kept exercising afterwards.

So exercise may not help you get thin, but it will help you stay once you've lost weight. And also, even if you're never going to be a size two, you can still exercise. You can become much fitter if you exercise. It can be difficult if you weigh a lot, if you're not physically comfortable in your body, if you're out of breath, walking out a couple of flights, a couple of stairs, not flights of stairs, it can be difficult to exercise, but everything, every step you can take in that direction will help your heart, your brain, all of your organs and your general, hopefully your general sense of wellbeing.

I've seen people swimming can be a great way to ease into exercise. Just spending half hour in a pool, going back and forth. It doesn't have to be formal laps. It doesn't have to be perfect strokes. Just moving around in the water can be good for people, can be one way for people who have excess weight and aren't comfortable putting on jogging clothes or even a bathing suit. But it can be one way, if you have access to a pool, which obviously not everyone does.

James Brown: I understand you also would suggest medical help.

Karen Weintraub: Yeah.

James Brown: What do you mean by that?

Karen Weintraub: Sure. So for about 40 years, medicine has been trying to cure obesity unsuccessfully, but they have made in recent years, a lot of progress. And what they've finally figured out are a couple of drug treatments that seem to reduce appetite or improve the connection between the brain and the gut so that you don't keep overeating once you're full. And unfortunately those drugs are still hard to access and very expensive, but hopefully in a few years, that will change. So one of them is called semiglutide and it's available for diabetics, for people with diabetes. It's available as a drug called Ozempic and in higher doses, it's available as a drug called Wegovy for weight loss. That's W-E-G-O-V-Y, Wegovy.

Unfortunately though, there was so much demand for it when it came on the market last year that it's been in very short supply. Since the end of last year, they've asked doctors not to put new people on the prescription. So it's very hard to access to right now. Also it's anywhere from 1,300, 1,600 dollars a month. So you're not going to be able to afford that, most people are not going to be able to afford that without insurance, and most insurance companies will not cover weight loss medication. If you have diabetes, you might be able to get coverage, but not just for weight loss.

James Brown: Did they simply not make enough of the medicine?

Karen Weintraub: Yeah. So it's the supply chain issue that we're seeing in so many other aspects of our lives right now, and maybe they under anticipated the demand, but suddenly there was a huge amount of demand and they couldn't keep up. Sorry. The other drug is called trizapetide, sorry. And that one is on the market called Mounjaro, M-O-U-N-J-A-R-O, I think, Mounjaro, something like that. And that drug has been approved for diabetes is not yet approved for weight loss, but a study that came out earlier this summer showed that people could lose as much as a quarter of their excess weight on this drug, which is previous to these two drugs, about 5% of weight loss was typical for drugs.

So 15%, 20, 25% now is potentially possible with these drugs, if you can access them. And also if you want to be on these drugs for the rest of your life. At this point, all the studies indicate that if you stop taking the drug, the weight comes back. Most of the studies have been conducted by the drug companies, so maybe they have a self interest in showing that, but it's not clear yet whether you can give these drugs up.

James Brown: Exactly where my head was going. So both on the anticipating demand, that seems surprising, very surprising and seems like very poor planning on their part.

Karen Weintraub: I'll pass that on.

James Brown: We have a-

Karen Weintraub: To the company.

James Brown: Fair enough, but it there's a thriving diet marketplace.

Karen Weintraub: Huge.

James Brown: Of much less reputable things out there to think that, hey, something that might suppress appetite literally, and that's actually proven to do so would not be in high demand, seems very strange.

Karen Weintraub: Yeah. I think really it's just that the supply chain has been very challenging during the COVID pandemic and that they just haven't been able to get the ingredients that they needed. They promised that problem will be solved sometime in the second half of this year, we are in the second half of this year, I haven't seen it yet. So hopefully soon though.

James Brown: And the second element of that's really interesting is getting off of it and the weight coming back. So I don't know if you would know this, but I'll ask anyway, is it the appetite coming back or simply the weight coming back?

Karen Weintraub: Yeah. So I don't totally understand it, but what has been shown is that when you lose weight, your body has a set point. So if you were 370 pounds, that was your set point and your body is going to be inclined to go back to that weight, almost no matter what you do. And that's why continuing to exercise after you lose weight is so important because it helps fight that natural inclination, the body's desire to hold onto those extra calories. So I think what happens with these medications, once you stop, your set point hasn't changed and your body just programs itself to gain that weight back.

James Brown: So day by day, I'm in a fight with my body.

Karen Weintraub: Exactly.

James Brown: It sounds about right.

Karen Weintraub: Yeah. And unfortunately, it's kind of an unending fight. I mean, I would like to say that a week from Tuesday, you can stop, but it doesn't stop.

James Brown: As I'd like to say, brick by brick by brick, day by day, you can't stop.

Karen Weintraub: And that's why, frankly, it's so important to stop the weight gain before it gets out of control, because it's much easier to maintain a weight than it is to come down, because our bodies are just programmed to go back to that higher weight.

James Brown: Another point that I found just interesting is moving on from blame.

Karen Weintraub: Yeah.

James Brown: What do you mean by that?

Karen Weintraub: So there's a lot of blame among people who have extra weight. There's a lot of sense of if I hadn't done this, if I could only do that, what's wrong with me? Why don't I have self control? Other people reinforce that, even family members, even doctors, just stop eating so much, or just get off your butt and get some exercise and you won't be so fat. And that used to be the attitude of the medical community. And that has really changed in recent years, where science has shown again and again, literally for a century that self control does not lead to people being thin, and that it's not lazy or stupid people who are fat, that there's so much more going on. Biology is so much more complicated. But really it's tragic how much blame people have, self blame people have about being overweight. And it's not constructive. When you feel lousy about yourself, what do you do? You eat. So it fosters that negative cycle to feel badly about yourself, to feel like you're inadequate because you're overweight.

James Brown: Karen Weintraub, any famous last words?

Karen Weintraub: Food is something that we should be enjoying. We need it, but we also ... It gives great pleasure. And it's sad when fear about weight gain takes that away from us. And when society makes us feel badly for enjoying our food, but maybe don't waste those calories, don't drink the sugary sodas. Don't eat the bags of junk food. Spend those calories on food that brings a lot of pleasure and also is healthy.

James Brown: If you liked the show, write us a review on Apple Podcasts or wherever you're listening, and do me a favor, share it with a friend. What do you think of the show? If you have any ideas, comments, or questions, you can always email me at jabrown@usatoday.com or leave me a message at 585-484-0339, or send me a message on Twitter @JamesBrownTV. I love hearing from you. Thanks to Karen Weintraub for joining me. You can find links to her series in the description and on USAtoday.com. Thanks to Alexis Gustin for her production assistance. Taylor Wilson will be back tomorrow morning with five things you need to know for Monday. And from all of us at USA Today, thanks for listening. I'm James Brown, and as always, be well.

This article originally appeared on USA TODAY: Like most Americans, I'm fat and trying not to be: 5 Things Podcast