The Tribune

By DR KENNETH D KEMP

EVERY human being has at least one physical characteristic they’d like to change or, in the very least, enhance. That demand has fuelled a multi-billion-dollar global make-up and skin care industry. Weight loss products, hair dyes, weaves, spanx, press-on nails, contact lenses and all manner of plastic surgery comfortably and directly benefit from this thirst.

For the most part, I think it’s natural and healthy to want to be better and feel better about ourselves. But when the pendulum swings too far in the opposite direction, individuals can become aberrant and put their physical and mental health at risk. Earlier this week my brother and I were discussing how years ago in an effort to lose weight, women had their mouths sewn shut to prevent them from eating. It was something we had long since forgotten and demonstrated the extreme subversive measures some individuals employ in this pursuit.

In Part One of this series on our country’s obesity epidemic, I talked about my patient who died in her bathroom at the age of 48 weighing 400 pounds. Unfortunately, in my profession, stories like that are the norm and not the exception. In that regard, I have another patient, still alive, who in her early 50s stands at 5’3 and weighs 380 pounds. Her body mass index is approximately 67 (twice what it should be even at the borderline measure) and she has a past medical history significant for Diabetes. Her blood pressure is consistently elevated but against medical advice she doesn’t take any medication for this condition. That alone exponentially increases her risk of developing a stroke but she continues to ignore the pleas of her physicians.

She, like so many other patients, has a long family history of non-communicable diseases (NCDs) like Diabetes, high blood pressure and high cholesterol. The quality of this patient’s life is severely reduced because walking is a challenge as is breathing and standing on her feet for a prolonged period of time. So, performing rudimentary tasks like simply cooking causes her physical pain in her back, knee, feet and ankles - long before the meal she has prepared for her family is complete.

Research now shows obesity may substantially increase the risk of developing over ten different types of cancer, a finding that can help to explain why the level of cancer within our country is so breathtakingly high.

The case of this patient will hopefully have a happier ending as she is slowly beginning to realise the risks she’s taking with her health and is now seeking ways to curb this dissent.

Leading Bahamian nutritionist, Dr Patti Symonette explains that the pathogenesis of the obesity epidemic can in part be blamed on a learned behaviour for many individuals. This behaviour is then recycled from generation to generation since bad eating habits are taught at home and reinforced within the school cafeteria.

But for every story of despair, there is a story of hope and I had initially planned this week to talk about one of my patients who underwent a dramatic weight loss via an intense diet and exercise regimen. After talking to her last week, however, she admitted she regained almost all of her weight within the past two years. Every other patient I knew who had lost weight in the past sheepishly admitted the same thing. The weight was back to their dismay. One patient blamed it on the devil. The rest blamed it on the COVID-19 pandemic.

Clinical psychiatrists define obesity as a behavioural problem with a high rate of relapse. They further espouse that its effective management must employ behavioural interventions given the increased risk of depression and decreased quality of life. But you can’t heal what you don’t speak so the need for more Bahamians to not only seek but embrace getting professional mental health is a burgeoning dilemma.

During our interview, Jimmy Mackey, the founder and president of MacFit360 fitness facilities, echoed this sentiment. He added many people start and stop their weight loss and fitness journey, oscillating from one trendy Hollywood diet to the next, but the ones who endure and enjoy the most success are those who embrace it as a lifestyle. He refers to it as breaking a mental barrier on weight loss and fitness. We also both reflected on the financial constraints associated with being healthy and deduced that the system is severely broken when a hamburger, fries and soda are less expensive than a fruit smoothie with a tuna-spinach wrap.

His first tip is for clients to consult with a physician to determine where they are in terms of starting their health journey. This is essential because every client is different and understanding their health can help better facilitate an effective diet and exercise regimen. Once that’s completed, he suggests clients simply get started. Whether at a gym, with a professional certified trainer or simply engaging in an activity that brings them joy (and doesn’t necessarily feel like exercise) like swimming, jogging, tennis or dance. From there you can slowly work your way up to something more challenging.

Regarding nutrition he recommends following the 90-10 rule where 90 percent of the time you eat clean (i.e., fruits, vegetables, lots of water etc) and 10 percent of the time you indulge in your favourite foods. Most importantly Mr Mackey believes in getting sufficient sleep, mindset training and surrounding yourself with like-minded individuals who share a commonality of interests. Being around people who are more motivated than you and are conducive to your new lifestyle reinforces good habits and the second you change your behavioir; the universe naturally and simultaneously changes in tandem.

I’ll be following-up with my patient over the next few months to see if she’s finally able to overcome a half a century of bad eating habits and self-doubt. I reminded her that (legendary professional basketball player) Kobe Bryant once said that ‘we all have self-doubt. You don’t deny it but you also don’t capitulate to it. You embrace it’. It’s easy to understand then why self-doubt ultimately kills more dreams than fear.

But the question is, when your alarm goes off every morning do you get up and go, or do you turn it off and try to get another few minutes of sleep? If it’s the latter then some form of self-reflection is advised because as unintentional as it may be, these lessons are erroneously transmitted to each successive generation. Breaking this cycle may someday perhaps be considered the greatest legacy that we can bestow upon our children; for their good and the good of the entire nation.

• Nicknamed ‘The Prince of Podiatry’, Dr Kenneth D Kemp is the founder and medical director of Bahamas Foot and Ankle located in Caves Village, Western New Providence. He served as the deputy chairman for the Health Council for five years and he currently sits on the board of directors for the Princess Margaret Hospital Foundation in his role as co-vice-chairman.