Obesity. Plumpness. Full figure. There are more euphemisms for this condition than any other medical problem. This is probably because it is not a medical problem at all. With the exception of a very few cases of true glandular dysfunction, such as with certain conditions of thyroid, liver, or adrenal disorder, being fat is an arithmetic problem.

When the numbers of calories in exceed the number of calories burned off, the body stores the difference. In other words, obesity is caused by eating too much, and/or exercising too little. On the very rare chance that your case may be caused by more than bad dietary arithmetic, a proper medical work-up can pick up most endocrine disorders, and, of course, the appropriate treatments can then be started.

In some cases, such as with thyroid replacement, or surgery on an overactive adrenal gland, the results can be dramatic. But for the vast majority of heavyweights, the problem is not related to luck, genetics, or metabolism. It usually all comes down to choice. That’s right, choice. Most fat people choose to be fat, in spite of their protestations to the contrary. When their eyes are closed, they see themselves as fat people, when they talk about themselves, they refer to themselves as heavyweights, and when they buy clothes, they look in the “full figure” section. They may try a diet, out of guilt at being faced with an increasingly lean lifestyle portrayal in the media. But without choosing to see themselves as thin, the dieter feels ill at ease with their new weight, and soon bounces back up to even greater heights.

Often the obese kid themselves into believing that they really don’t eat much, just because they see others eating more in public. But the food one sneaks without witnesses can do all the damage, even if one denies having eaten it. My old professor used to point out to her obese patients that “nobody ever came out of a prisoner of war camp fat”. Indeed, in circumstances where the freedom of choice in one’s diet is removed, such as with the post WWII rationing in England, obesity virtually disappeared from view (at least it made everyone suspicious of ration stamp forgeries if one showed up overweight). Indeed, during these periods, the incidence of heart disease, diabetes, back pains, sore knees and ankles, and a host of other obesity-related diseases all plummeted with the national weight. In the case of post-war British, the choice was made for them. But, for the rest of us, we still have that precious freedom. So, whether you consider yourself pleasingly plump, rotund, or “big boned”, remember that you are ultimately the only one to blame, and the only one who can make the choice to correct the problem. It has always been thus. Ever since the days of Shakespeare, the choice facing every dieter as he or she sits down before another meal has always been the same: “tubby, or not tubby, that is the question”.

Here’s an action tip:
If you are overweight, by which I mean ten pounds over the weight at which you look your best in a bathing suit, remember to exercise your freedom of choice, as well as to exercise your muscles.