The expressions "obese" and "obesity" are not pejorative terms. They are scientific terms, determined solely by the Body Mass Index scale, which combines a person's height and weight in a mathematical formula. A number of 30 and above denotes "obesity."
An obese American is a person who uses large amounts of yin in the form of excess food and enlarged fat cells to maintain some semblance of sanity in an otherwise insane environment of excessive yang. That yang excess takes the daily form of copious amounts of worry and hurry. This is especially true for populations of lower socio-economic status, as several studies have confirmed.
According to a graph published in 2006 by the U.S. Center for Disease Control and Prevention, the rate of obesity began rising in the United States between 1976 and 1980 and has continued growing ever since. This was the period when economic growth from the World War II boom began slowing. But while profit-taking became more problematic, worker productivity kept increasing as wages began stagnating. Today we find that those Americans lucky enough to have full employment are worked like field slaves, often performing the work of two or three while just getting by on subsistence wages.
The reason 70-90% of Americans eat more food than they need is because the American shen is seriously confused and bothered. Of the Five Substances, the shen is the one whose function it is to choose behavior that is appropriate to the moment. Since excess yin is pathogenic and its accumulation in the absence of approaching famine or a long hard winter is inappropriate, and since the body itself warns the shen the moment it reaches its eating comfort level, the logical conclusion is that the shen of an overweight person is often misled, bewildered, and in error.
Our challenge is to help our patients who suffer from yin excess, which includes swollen fat cells, hyperlipidemia, neoplasms, and impacted fecal matter, discover the kind of yin that their body/mind craves, the kind that causes no ill effects, the kind that we as Licensed Acupuncturists are so good at helping them find. Our patients will learn to stop worrying and to stop hurrying, using natural yin-enriching methods such as Taoist philosophy, breathing exercises, getting adequate amounts of sleep and rest, and listening to the eating instincts of hunger and satiety. As this takes place, the pathological yin will drop off automatically and stay off, because it's no longer needed.
The Sedating Effects Of Eating And Excess Body Fat On The Shen
Excess yin and liver qi stagnation create a film of phlegm around the heart where the shen resides. This phlegm dulls and distorts the information that the shen receives and uses in order to determine behavior. A thin coat of phlegm is called "neurosis," while a thick phlegm covering is called "psychosis."
The shen receives information from the yin/body and the yang/mind. The yang/mind supplies memory and rational thought, while the yin/body provides data from the five physical senses and the emotions – mad, glad, sad, scared, and bored, and their avatars.
Dulled senses, emotions, and thoughts were essential for the survival of our Stone Age ancestors who might have had to hibernate for long periods in wintery cold. Successful hibernation requires a high degree of energy conservation, including the weakening or absence of the hunger feeling, which would be counterproductive in a food-scarce environment. Spleen qi deficiency, with its fatigue and weakness, is an automatic result of spleen damp and would be advantageous for energy conservation as well.
Hunger is often mistaken in this country for
appetite – the mental desire for food, for whatever reasons
starvation (yin deficiency) - a deadly condition found mostly in hospitals and poor countries
rising stomach heat, often pushed down with the heaviness of food
a nervous stomach or other body part – qi stagnation of the liver, which will relax and activate in order to receive and process food
a large variety of rising heat symptoms and conditions (common hypoglycemia for example) which are controlled with food and enlarged fat cells
weakness and fatigue, which are actually the result of lack of sleep and rest as well as the carrying of excess pounds of yin.
This misunderstanding is true for scientific researchers as well as for the general public. Hunger is only one thing: An empty feeling in the upper abdomen which motivates and empowers animals and people to go to work, secure food, prepare it, and eat it. Those animals and people closest to an optimally lean state have the strongest hunger (and the least amount of pathogenic damp) because they have the least amount of stored energy while at the same time being the most fit for securing food.
Hunger also increases the power and receptivity of taste buds. All food – forager/hunter, agricultural, and processed - is delicious (and digestible) to a really hungry person, since "hunger is the best sauce"! At the point of satiety, the tastiness of food diminishes, no matter what the food.
Obesity keeps the mind calm, an important factor when trying to sleep and lay about for months on end amidst a clan of relatives. In April of 2009, researchers from the University of Arkansas and the National Taiwan University found that the fatter children are, the less subject they are to bouts of sadness, anger, and depression. Fat cells themselves secret estriol, a form of the hormone estrogen. Estrogen encourages the body's production of serotonin and endorphins– powerful calming agents – as well as reduces heat in the brain by dilating blood vessels. The bigger the fat cells, the more pathogenic damp there is in the body. The more damp, the calmer the mind.
Researchers at NYU School of Medicine revealed in the September 3, 2012 online issue of Pediatrics that obesity is associated with cognitive and brain impairments in adolescents. Forager-hunters who had to hibernate did not need to waste a lot of precious energy with the thinking process.
They also required conservation of body warmth. Body fat is not only a great insulator against cold, but also causes inflammation all by itself (stagnation leads to excess heat), according to a March 2013 study published in the journal Cell Metabolism. So while obesity keeps the mind cool and calm, it also keeps the body warm.
The eating of food delivers a huge payoff for rattled Americans. A team of American scientists in 2006 who performed brain scans on seven overweight people found that the regions of the brain that controlled satiety of food were the same regions that light up for drug addicts after a fix. This means that the addictive payoff for eating a meal, especially for overweight people, is similar to taking a euphoria-producing drug. The larger the meal, the bigger the mental reward.
Another study, this one by the U.S. Government's Brookhaven National Laboratory in Upton, N.Y. and reported in the Oct. 25, 2007 issue of HealthDay provides evidence that dopamine - a brain chemical associated with reward, pleasure, movement, and motivation - plays a strong role in the development and maintenance of obesity.
U.C. San Francisco researchers have recently demonstrated that increased abdominal fat sends a message to the brain that turns off the production of fight-or-flight hormones. In other words, overweight Americans unconsciously use large amounts of yin-estrogen to calm down and stay calm in an attempt to stifle fear, anxiety, boredom, and any other unacceptable emotions. Excess body fat also serves as a social buffer for many Americans, especially women and people of color, protecting them from fearful interactions with others.
Eating is used as an excuse to take breaks from work or other anxiety-and-heat-producing activities. The mere act of taking a break from activity is very cooling, relaxing, and shen-calming. Commonly, overworked Americans cannot simply give themselves permission to take breaks without feeling guilty or getting into trouble with their employers. However, in the most overnourished country in the history of the world, many cling to the irrational belief that if they do not eat every day or several times per day, they will get sick and even die. And so, Americans can always make time to eat.
Recent evidence from the Yale School of Medicine suggests that the act of eating slows down the hyperactivity (excess heat) of autoimmune diseases, when the too-busy wei qi is attacking the body itself.
Food itself is very yin-weighty and sits on top of yang - anxiety, heat, wind, and rebellious qi of the stomach (nausea and gastro-esophageal reflux disease), pushing it down. This sedating effect of food can be felt by everyone and anyone who has just finished a meal. Food will induce a sense of calm and relaxation, and in fact a large meal will make most people drowsy. Six to eight percent of obese people in the U.S. suffer from Night Eating Syndrome in which food is regularly used throughout the wee hours as a nighttime tranquilizer. The heavy yin of food is habitually used by Americans to calm the wind and heat that are features of modern American life.
And finally, food is tasty and has interesting textures. Even with the dulled senses of a damp spleen, eating offers some oral pleasure in an otherwise stressful existence, especially if the food is loaded with the survival tastes of sweet, salty, and fatty. The regular consumption of this "spiked" food helps Americans cope with modern American life.
Diet, Exercise, And Nutritional Knowledge Are Dead-End Roads
Albert Einstein's definition of insanity: doing the same thing over and over again and expecting different results. For 30 years, we've all been told to eat "healthy" foods, to not eat "unhealthy" foods, to exercise in order to lose body fat, and to stuff our minds with as much nutritional science as possible. This advice is the essence of a "diet consciousness" and has done nothing to stop or slow the obesity epidemic in America. In fact, I will show you that this commercially-inspired dogma is part of the problem of shen confusion and excess weight, not part of the solution.
First, there's the issue of "fattening foods." There is no such thing as a fattening food, i.e. a food source that mysteriously increases the size of fat cells. The science for this widely-held assertion is just not there. There are calorie-dense foods that, if eaten in excessive quantities, will easily enlarge fat cells, perhaps quicker than low-calorie foods. But still, it boils down to calories in and calories out – the amount of food qi stored in a food source versus the amount spent in daily activity. All of the so-called "fattening foods" were readily available and inexpensive during the 1950s and '60s – sweets, burgers, potato chips, French fries, TV dinners, pizza, and Wonder Bread – and still there was no obesity epidemic until the late 1970s.
Conversely, there are no known foods or food constituents that magically reduce the size of fat cells, although food and supplement companies have certainly spared no effort or expense to find them or sell them.
The belief in "fattening foods" and "reducing foods" is the essence of yo-yo dieting. Fixed judgments on foods lead to orthorexia, a common American neurosis wherein self-esteem revolves around "being good," which inevitably transforms into "being bad," like yang into yin. This then causes people to have feelings of guilt and self-loathing (junk food for junk people), exacerbating the shen problem.
When dieting, Americans use will-power to limit their food choices and deprive themselves of food they want, until they reach their desired goal. And then the food rewards start again, because the dieters haven't done the simultaneous shen work necessary to stay at the target weight. Lean is clean, but it is also mean. "Successful" dieters then find themselves climbing the walls without their favorite sedative – "bad food," and once again they become "bad people" and quickly or eventually regain the body fat. It has been estimated that only 5-10% of American dieters manage to keep the weight off for a year.
But still the call goes out far and wide to educate the public even more about the "science of food." American food advertisers sell food through phony and irrelevant health claims about carbohydrates and fat and vitamins and omega 3, ad nauseam. These intellectual distractions only serve to shout down the eating instincts, and to fill us with guilt when we eat the "wrong" food. They do nothing to stop overeating.
The French, who are notorious for eating rich food, have a far lower rate of obesity. There are no health claims on the packages of food in French stores. Instead we see advertising like "Fresh," "Extra rich," "Extra creamy," and "Super delicious!" The average lean French person doesn't know a carbohydrate from a carburetor, and doesn't want to know.
The popular claim that a diet of "junk food" doesn't supply adequate nutrients and therefore keeps Americans "hungry" and makes them overeat is false. Where are the national epidemics of scurvy, night blindness, rickets, pellagra, kwashiorkor and beriberi that do plague poor countries? Where are the blood tests that support the contention that large numbers of Americans, including the obese, lack nutrition of any kind?
American eaters of food need to leave the science of food to the scientists and advertisers, and instead concentrate on listening to themselves and their own eating instincts, just as nature intended.
Second, there is the widely held belief that lack of exercise is responsible for the obesity epidemic. There are many excellent reasons for engaging in strenuous exercise, such as having fun, and getting strong, fit and flexible. But weight control is not one of them. Many studies confirm this fact. One such study in 2008 by the Physical Activity and Weight Management Research Center at the University of Pittsburgh followed nearly 200 overweight or obese women aged 21 to 45 through a two-year treadmill exercise program. While some weight was initially lost, most of it was gained back by the six-month mark. Plainly, exercising on a treadmill does not prepare the mind for the pressures of a lean life in modern America.
It is just too hard to burn off 7oo calories performing aerobic exercise and too easy to consume 1,000 calories afterward binging on potato chips and ice cream as a reward.
Actually, lifting weights will augment or maintain muscle and bone mass (healthy yin), thus increasing the percentage of body fat (unhealthy yin) metabolized between meals. But lifting by itself will accomplish very little in the area of weight loss. It certainly won't burn any fat that lies atop the muscle being worked, since "spot reducing" is plainly a myth.
Special Obstacles For Obese Americans
The severity and long-term nature of an obese person's weight problem is a general indicator of painful psychological injuries in the past that have not healed, but are instead covered over with dangerous and self-destructive habits. As in all such cases involving serious addiction, forward progress using our methods of health coaching, meditation, and awareness training might be slowed down or even hit a brick wall without the assistance of professional psychological counseling or its equivalent.
In addition, since an obese person's actual feelings of hunger (an empty feeling in the stomach area) might be many months off in the distance, standard advice about waiting for hunger before eating, while just great for the body, would be counter-productive for the mind. It would be like quitting heroin addiction cold turkey – very painful and usually of temporary value. Only a long-term program of shen-calming techniques combined with consistent retraining in the areas of self-awareness and self-trust will allow the kind of progress that is as stable and difficult to reverse as a slow-moving freight train.
E Douglas Kihn, OMD, LAc practices Chinese medicine and wellness coaching in W. Los Angeles and can be reached through his website. For details on the Hunger Awareness Training protocol, download the free pamphlet "Beyond Dieting! Hunger Awareness Training for Licensed Acupuncturists" at www.drkihn.com/my-books.html.