I like to cook and generally do the grocery shopping. I never really know what I will choose when I stop into the local market. But, I stop in 3-4 times a week and grab a few things. Over the last month or so, I have routinely encountered a woman who also frequents the local market. She is hard to miss. She is probably around 40 years of age and is morbidly-obese (probably over 400 pounds). I am not sure how tall she is because I have never seen her stand. Instead, she rides the little handicap scooter the market provides. The basket on the handlebars is usually filled with cookies, ice cream, pastries, bread and similar fattening items. It is really quite sad. Today, I stopped in for some fruit—especially pears—I love pears. I saw her again rolling up and down the bread aisle. I decided to follow her.
She was very deliberate in her shopping. She didn’t have a list but looked like she knew what she wanted. As I sat back near the meats I saw people pass her. Some seemingly ignored her. Some would look into her basket and then at the fat extending off the sides of the scooter seat. Some shook their head as they walked past her. Two young prepubescent kids, unhappily shopping with their parents, pointed and laughed. The obese shopper continued her quest for carbohydrates seemingly oblivious to the stares and comments of others. Sadly, she is clearly on a downward spiral in terms of health.
Then, I started to think. If she were about to jump off a bridge, or swallow a hand full of pills, virtually anybody would intervene and attempt to save her life. If she were a drunk driver, some would take her keys away or call the cops. If she was a child who wandered onto a busy highway, people would risk their life to save her. If she were drowning in a swimming pool, surely somebody would throw her a rope. But, she is dying from obesity and the complications that occur therewith. Why the difference in human concern when confronted by somebody risking death by Twinkies compared to those risking death by a bullet? Is it the speed at which one dies? Why do people who may die quickly seem to receive intervention while those who die slowly are ignored?
I am really not sure what is going on. I have seen emergency physicians lecture people about unsafe sexual practices and smoking. I rarely see one confront a patient about obesity. An article several years ago in Annals of Emergency Medicine reported that approximately 10% of smokers would quit smoking if an emergency physician advised them to do so. While 10% seems low, what’s the down side for advising the patient? How many people would address their weight issues if a doctor raised the point in the clinical setting?
Our society ostracizes the obese when society has a great deal of blame for the obesity. Fast food and processed foods permeate the US diet. The healthier foods tend to be more expensive and require more effort to prepare. Food can be an addiction—just as bad as alcohol, crack cocaine, and gambling. Addictions are often due to serious underlying issues—abuse, depression, poor self-esteem, poverty, and similar things. Trying to treat the obesity problem with surgical techniques that do not address the underlying problem will only result in more surgical procedures later. Obesity must be addressed globally like other addictions—psychologically, socially, and spiritually.
I left the market feeling sorry for the obese women and her food addiction. What was it that pushed her over the edge? An abusive relationship? Poverty? Depression? She had the same look on her face that you see in the people who spend their lives (and savings) in the casinos—she had the blank stare. All she saw was the food. It was her way of escaping the trials and tribulations of her life I guess. It was sad.
So, you may wonder—did I go and speak to her about her life-threatening habits? No. I paid for my groceries, went to my car, and turned on XM radio and forgot about her—just like everybody else. And, now I kind of feel guilty