Life sucks. I’m overweight. I’m going to go binge watch Netflix…

I have heard a phrase much like this many times over the last decade. I don’t mean to pick on Netflix: there are multiple issues at stake in our overall health and some down time with the TV is not a bad thing. Same thing with multiple different platforms of social media. Facebook comes to mind more often then others, maybe just because of the demographic in my patient population. The funny thing is that I don’t think anyone actually thinks these behaviors solve anything. Why do we do it then and why do we feel strangely defensive about someone questioning our choice? Is this just human nature? Let’s try to analyze this and dig deeper – here we go.

First the phrase life sucks. What are we talking about here? It could really be anything: I’ve heard everything from my dog vomited in the kitchen to my child was arrested last night for prostitution to fuel a heroin habit. Both of these options are not good, but there are definitely degrees of bad luck and horrible outcomes here. Even then, the things that push us to engage in media are often much more subtle: family arguments, passive aggressive behavior at work, and the weather. I had a patient tell me that they watched hours and hours of TV one weekend to get caught up on a really popular show (I think it was Game of Thrones…) so that they wouldn’t feel left out in conversation with their friends. Maybe the real culprit in this mindset is the idea that I am not meeting expectations. I am not good enough. Regardless, a lot of things lead us to believe that life intrinsically is not good and there’s nothing I can do about it.

Secondly, we need to deal with bing watching. What does this mean? Let’s define it as more than an hour of constantly sitting with your attention on a screen watching more than 1 episode of the same show. It also implies the choice. You have to decide to binge watch – it doesn’t just happen to you. Why is this decision bad? Sitting and watching media is the worst of two worlds: first your body is just sitting – no activity. Secondly your body is likely barely working at function. Your heart rate is low, your metabolism is slow, and your movement is possibly even less than when you sleep. Then your brain is being fed stimuli – the media creates that for you. No work needed here, and no thought to figure things out in a complicated world. I notice, too, that binge watching TV often involves snacks, and not celery. More likely chips, candy, and any number of carbohydrate laden items. For many, adding alcohol to the mix tops off the evening, allowing for coping full steam ahead…

Thirdly, the unintended consequences of our behavior are the things all of us want to avoid.  Just sitting is an independent risk factor for different pathologies including atherosclerosis, hypertension, cardiovascular disease, diabetes type II, breast cancer, and colon cancer. Any extended time sitting decreases the odds of us meeting activity and exercise goals, and when you do this for a long time, there seems to be a compounding issue: 1 + 1 = 3. Personally, I really don’t like unintended consequences. It’s like the rogue wave of health. Years ago I was with friends on a beach in California doing some serious body surfing with some good waves. Suddenly, out of nowhere, a giant wave took me for the worst tumble I’ve ever had. It washed up the beach, farther than anyone expected, sending a few hundred people frantically running to high ground dragging their kids and gear with them. As far as I know, no one was seriously hurt that day, but I never considered the unintended consquences of just riding some waves on a beautiful day. Now, I always keep my eyes on the waves, watching and making sure that the rogue beast won’t take me out.  I would suggest turning your eyes carefully to your daily habits. Look for the unintended consequences that can be lurking in the choices you make that seem benign. 

Finally, most studies say that healthy lifestyles include increased activity, eating a healthy diet of lots of veggies, and avoiding alcohol. Take a close look at what we are doing here by binging TV: we are not doing anything healthy, and increasing negative behaviors by the truckload. We are creating a perfect storm, a term used in meteorology to describe the rare combination of circumstances that come together to create a horrible superstorm. Remember Hurrican Sandy? The metaphor is fitting in that we are bringing together massive risk factors, and then multiplying them with further negative behaviors. Not that this will become a significant problem every time, but repeating this behavior for three days a week times 30 weeks a year increases your odds incredibly. In other words, if you are a 20’s something who works out all the time, rarely drinks alcohol, and works for UPS delivering packages all day, and every three months watches the entire Lord of the Rings movie montage over the weekend with friends, this may not lead to doom. But if you have a BMI over 30, do not work out regularly, drink a bottle of wine or more a week, and have any number of office jobs, then all the science predicts you are in trouble independent of the binge watching. That weekend of coping could be a rogue wave of bad luck for your health.  

One of the phrases I’ve used that has shocked many patients is “I don’t care about your weight”. I then describe what I do care about, which is lifestyle, and what exactly we do every day to live a healthy life. I say “we” purposefully because they are not alone! This is everyone’s fight, and I am in it with them. I don’t need to point out what someone already knows, and likely feels shame about… I find the most success helping people understand that a few steps in the right direction means that you are then not stepping in the wrong direction. I always try to address the problem of coping and not feeling worthwhile. Weight in our culture is like a brand, and people feel trapped, devalued and hopeless about it. This can lead to poor choices. Let’s take weight out of the equation then, and talk about the next step for feeling better, being healthy, and enjoying yourself. The action steps are going to be the same, and in my experience, weight follows lifestyle. 

There are some caveats here: let’s say you already have metabolic syndrome (a combination of hypertension, hyperpidemia, elevatated blood sugars, and central adiposity). Maybe you already have been diagnoses with cardiovascular disease or have diabetes type II. If you are struggling with anxiety and/or depression, then this complicates matters as well. This is going to be a more nuanced and complicated discussion, which is beyond the scope of a blog. I recommend partnering with a primary care physician who can help you navigate these rough waters. Don’t do this alone!

One of my favorite stories is the incredible work of J. R. R. Tokien which follows the lives of a number of Hobbits as they graple with questions about safety, adventure, and how to live life. Of course the setting is one of imminent doom and horrible evil taking over the known world. Regardless, I like the metaphor. We are like the Hobbits: we have a choice to make in the midst of some difficult situations. Do I cope as noted above, and binge on something that is unpredictable and likely negative (and pulls you in like a magnet, or the “Ring”), or do I go on an adventure, where there are dangers and significant challenge, but also the chance to grow, change for the better, and have proud moments that I will never forget? 

In the end, I don’t care about your weight. What I do care about is you, and let’s sit here together, plot a course with some healthy steps, and see what happens… Small incremental change is proven to take big bites out of your risk for the unintended consequences of coping. Maybe you’ve been lying on the couch reading away the afternoon on your phone. Just put it down, get up and take a walk… breathe. Take some steps in the right direction.