When I was a young man, smoking was a choice. It was simple, like wearing brown shoes or black shoes. Some people smoked and others did not. It was just a preference without any deep implications.
On Father's Day, my brother and I, both terribly unoriginal, would give my dad a cartoon of cigarettes. Of course we loved him, but in those days, we didn't know better. We never realized that our gift encouraged a dangerous and potentially fatal habit. My father died years later of a heart attack. Thinking back now, I can only hope that our well-intentioned gifts did not substantially contribute to his death.
Times are different and I could never imagine anyone today giving cigarettes as a present to a loved one. Values have changed as well, not just in regard to smoking, but also in other areas of human behavior. I remember, for example, when hearing that someone had driven his car while intoxicated would result in only a disapproving chuckle. Now, if we find out that someone has driven his car while intoxicated, most of us would view that person as irresponsible, foolhardy and immoral. A generation ago, children were routinely left to bounce around in the back seat of moving cars. Today, of course, car seats and seat belts are universally used to ensure safety for these children in case of accidents -- not only because they are required by law -- but because their use is now viewed as the right thing to do. Those who fail to secure their children safely in their car, even if not ticketed, are regarded with universal reproach.
It is not amazing that values and morals are constantly evolving. They have always done so and the position that is held by smokers in American society blatantly reflects those changes. Many of us, including me, would consider offering someone a cigarette as an unkind and, yes, immoral deed. The act of smoking is costly and self-destructive that not only damages the smoker, but damages society at large. The public, in response, has succeeded in banishing smokers from most buildings, restaurants, and even bars and has restricted them to designated "smoking areas." Smokers are forced to leave their places of employment and go outside, even on cold winter days, to practice their unhealthy habits. No one, no matter how accepting and open minded he might be, comes to the defense of smokers. Times sure have changed from the days of the heroic Marlboro man. The effect of all this pressure is actually good with fewer people now choosing to smoke and fewer people dying from the complications of tobacco use. The tough approach seems to be working.
Today, we are witnessing yet another change in the evolving moral values of society, one that has to do with eating.
On a recent weekend, I was on call at our local hospital. One of my colleagues, a very over-weight physician, was also on call. Now anyone who has read a newspaper in the past two years is aware that America is suffering from an epidemic of obesity, a condition that causes heart disease, cancer, diabetes, arthritis, depression, and lung disease and can decrease life expectancy by 16 years. Obesity has replaced cigarette smoking as our number one public health hazard!
Well, my colleague has the custom of bringing boxes of sweet pastries to the nurses at each nursing station. (As you might imagine, he is also one of the most popular doctors with the nursing staff.) While I watched the nurses eagerly munching on cherry tarts and cinnamon buns, I had a revelation. I realized that in my mind bringing chubby nurses pastries was the same as bringing boxes of cigarettes to asthmatics! It was an act that reinforced harmful and potentially dangerous behavior. Promoting unhealthy eating, and the diseases that result from it, can undo all the advances that medical science has accomplished over the past generation. The country, aware of the threat, is striking back. Public sentiment and morality has changed and governmental policy is following that lead. The first lady, Michele Obama, has sponsored a program called "Let's Move" to combat childhood obesity. Municipalities are taxing unhealthful foods and food labels are being modified to disclose more completely food content. It is a battle that needs to be fought, one cheeseburger at a time. Perhaps it is time to restrict the eating of donuts and soda to certain designated areas in large buildings, like smoking areas. They could be termed, instead, "High Caloric Areas." The war must be waged! For what cigarette smoking was to the last generation, obesity is to this generation. Gluttony has now become the moral equivalent of smoking.
Blanche Lincoln: Saving Our Children
You only point your finger at the nurses that enjoy the food he brings in. Many physicians stop in for a bite as well, not all as svelte as they might be. By your reasoning we should do away for birthday cakes, at least for the chubby kids. And note the distinction between tobacco and food: I'm unaware of a danger of second hand calories.
I respect your concern for the rise in obesity, however, it's easier to point fingers if you've never faced the difficulty yourself. Furthermore, as others here have pointed out, there is an undercurrent of arrogance and contempt in your article. I find this offensive from a physician using the pretense of caring. Did you approach this colleague directly with your concerns? It would seem a more constructive and professional approach.
H. Speziale
My comment that the pastries had something to do with the doctor's popularity was tongue-in-cheek. He is certainly a very nice man and a conscientious and caring physician. I like him very much personally. All of us have our own demons to deal with. For some of us it is eating and for others of us it may be something different. This does not mean we are bad people and if I implied that, I am sorry.
I hope you and the other nurses had the opportunity to read my book or my other blogs as I often use true case examples to illustrate points. I probably should have camouflaged this example better because of the outcry at the hospital it caused.
However, it is wrong to encourage other people to adopt our unhealthy or harmful behavior.It is wrong with cigarettes and is wrong with unhealthy food. We are not saints but in a hospital we should try to maintain healthy habits as best we can.Please read my next blog, and show it to the other angry nurses(of whom, I gather, there are many) because obesity is contagious, at least in part, because of the sharing of unhealthy foods.
Thanks for your comments and for your courage to print your name.
Dennis Gottfried, MD
On one hand I work in a place that rewards us with high caloric junk food constantly. Cupcakes, cookies, Root Beer floats, fresh baked cookies , you name it. Never mind that the average employee is obese, and many morbidly /super morbidly obese. Since I stated losing weight it's bothering me more every time they do it.
But on the other hand I'm losing weight on a high fat diet. Many high-caloric things are healthy, and government changes to be too sweeping: Does that mean I'll be sent to the High Cal Zone to eat my macadamia nuts and avocados?
My approach to obese patients is the same as it is to smokers. It involves an attempt to modify the harmful behavior that produced the obesity and to treat the problems that arises from the obesity as best I can. Society is now beginning to place similar pressures on overeaters as it has on smokers. New laws will be passed to curtail the obesity epidemic hat we are witnessing. Hopefully this will have a favorable public health effect.
Dennis Gottfried
Obesity is deadly, make no mistake about that. I hope you or a family member never have to go through what I am experiencing now. It is horrible to watch a loved one die because of denial.
I bring fresh fruit to work to snack on, I usually make myself a sandwich and tend to only drink water, juice or milk. I eat well, I sleep well, I feel great and I stay in very decent shape by being active in my downtime. This is not a difficult concept, It's not a 3 month diet that keeps me healthy, it's a lifestyle that will always be part of me.
There are many obese people who want you to be miserable, they have an agenda it's clear as day, they want to convince you that being fat is actually healthy, that conveniently the only thing you need to change is nothing! What luck! And they have "science" to back up their claims so of course they must be right, since they found in on the internet!
One might say I have an agenda too, trying to get people to be healthy... how horrible of me.
www.fat-film.com
"Perhaps it is time to restrict the eating of donuts and soda to certain designated areas in large buildings, like smoking areas".
What gives you that right? It is this kind of paternalistic, infantilizing thinking that lead to disasters such as Prohibition. If you want to say that smoking and overeating are unhealthy, I would respect your opinion as a medical professional. If you want to say that young children who are unaware of the risks should be educated at an early age to make wise eating/lifestyle choices, I'm with you 100%. But this 'moral' talk shows that you lack a sense of respect for individual personal boundaries as well as a fundamental ignorance as to the difference between morals and personal preferences.
People have the right to do what they want to do. YES - even if it kills them.
(as long as they are not putting others in danger or hurting them)
I would, indeed, consider cigarettes an appropriate gift for a smoker. Just as I would hope someone who knew me would know that bringing me a giant piece of carrot cake on my birthday would be greatly appreciated and a very appropriate gift. It's not immoral to let people live their own lives and make their own decisions without lecturing and shaming them.
Stating that "No one, no matter how accepting and open minded he might be, comes to the defense of smokers." is patently false. Smokers have as much right to smoke as they have the right to do anything else that might harm their health even while they choose to do it. Look! here I am, coming to the defense of smokers! (There are others like me).
The reason that smokers must go outside to smoke is because some studies showed that their choice might have negative impacts on the health of OTHERS if done in proximity to them. Not because they have to be punished and be cold in the winter, those naughty, naughty, smokers!
Healthy habits are not a requirement for existence. If people choose, knowingly, to live a lifestyle that they enjoy, even if it might shave a couple of years off their lives, that is their choice and their right.
(In the interest of full disclosure, I am neither a smoker, nor am I, as you say "chubby".)
And is giving donuts to thin nurses okay? Or is it just the chubby ones that we should stigmatize?
Dr. Gottfried, I would venture to guess that if I could audit your life, I could find plenty of moral failings of your own, but it is neither my right nor my place to lecture you about the choices you make.
And finally, the emphasis should be on HEALTH not on weight. I know fat vegetarians, I know fat people who exercise rigorously. And I know thin people who neither eat healthy nor exercise in any form. You are setting up a false dichotomy of health and, as a doctor, you should be ashamed of yourself.
Peace,
Shannon
Atchka.com
FierceFatties.com
Denial. Denial. Denial.
"Now anyone who has read a newspaper in the past two years is aware that America is suffering from an epidemic of obesity, a condition that causes heart disease, cancer, diabetes, arthritis, depression, and lung disease and can decrease life expectancy by 16 years. Obesity has replaced cigarette smoking as our number one public health hazard!"
Anyone who hasn't dedicated their life to denying the truth...that is...
Also - please be careful of equating the scientific articles that show up in the mainstream press with the ACTUAL science done by the scientists. Mozart effect, anyone?
They have research, too.
But every reasonable person knows that global warming is real and obesity is the number one health issue in America.
Please stop spreading misinformation just to make yourself feel better.
I'm aware of both sides of the science coin. I read a wide range of research. I recently finished "How Fat Works" and "The End of Overeating." Your claims that I'm in denial are not based on reality. You deny EVERY SINGLE PIECE OF RESEARCH I present, yet I point to a renowned expert on fitness, Dr. Steven Blair, who has done decades of research on the subject of fitness and you dismiss him as a quack because you don't agree with his conclusion that you can't tell the health of a person by looking at them.
http://atchka.podbean.com/2010/07/07/on-hold-with-atchka-and-dr-steven-blair/
And there is TONS of research about the dangers of obesity precisely because it is that research that perpetuates the "dangers of obesity" and justifies the billions spent on drug research to "end" obesity. Do you even look at who is funding these studies? Or do you just read a headline and go "SEE, SEE, I'm right again!"
Peace,
Shannon
http://www.huffingtonpost.com/bridget-nielsen
He characterized those who ENABLE smoking as morally failing...not the addicted.
And good luck on getting those "High Caloric Areas" designated, as long as it's only you that your co-workers revolt against. Oh goody, Dr. Gottfried brought us carrot sticks to snack on! :P
The problem (HUGE problem) comes when the other 59% who are overweight or obese PRETEND to be or convince themselves that they are in that 1%.
Other folks face hormonal imbalances and other genetic factors that make it difficult to stay thin. Folks with inherited problems may be the minority of people who are fat in this country, but we exist.
Don't poo-poo genetics just because it didn't apply to you. I applaud you for getting off of your lazy butt and getting healthy, but not all of us have laziness as the underlying problem.