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Curing Fat Man

by Robert L. Seltman
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Page 4

Combating the
Symptoms of Obesity
Table of Contents

Introduction pg. 1
pg. 2
Pathology of Obesity
pg. 3
Combating Obesity
pg. 4
Pragmatic Planning
pg. 5
pg. 6
Nutrition & Diet
pg. 7
pg. 8
Author's 2006 Chart
pg. 9

Exercise Essentials pg. 10
Ann Wigmore Inst. pg..11
Body weight Review
pg. 12
Autumn Weight Gain
pg. 13
Conclude 2006 Dietary Study

Information here is written by a layperson and not a medical doctor. The author's primary qualification is his own experience and research as a person who has suffered from many of these symptoms, due to his own obesity.

Next Page 5
Back Trouble

Many of us store fat in the front as 'beer bellies' (the apple shape verses the pear). This added weight overtaxes the lumbar region of our lower back. A back brace (like an elastic girdle), pain medication, or a strategically placed pillow while sitting or when lying fetal-like in bed with the pillow between our knees, can moderate the pain. But eventually the weight needs to be lost and the muscles realigned, through gentle physical exercise. We need to retrain and strengthen our muscles to properly support our frame. Long-term use of the brace, medication, or pillow support is not recommended. Weight loss and appropriate physical therapy (exercise) is best.

Excess uric acid in the blood, often attributed to red wine, red meats, cream sauces, and other foods, crystallize settling in the joints, most often the toes and feet. Monitoring consumption and medication (for example, allopurinol) can keep it in check. A vegetarian non-alcoholic diet with appropriate breathing and aerobic exercise (to promote circulation) would be a permanent non-toxic solution.

For both men and women to be labelled as less than attractive within the bedroom is an emotional disaster. With a poor self image a partner may also avoid sex or lose performance, distracted by their own feelings of inadequacy. While extreme obesity may influence performance, our psychological vulnerability is the main culprit. Since the relationship may have been initiated when partners were at a different weight and shape, returning sexual vitality will require an open willingness of both partners to communicate and apply strategies (available from a wide assortment of sources) to bring back passion and/or mutual gratification.
Lack of

As we gain weight, we feel less and less incentive to bend and stretch. We don't use many of our 'secondary' muscles and so eventually lose them. This pulls our posture out of whack and discourages even further motion as we compensate for joint pain and develop a sedimentary life-style. This trend can be reversed at anytime, taking into consideration appropriate heart-monitoring. There are many stretches and simple exercises that can do wonders in a very short time to revitalize under utilized muscles and create a structural balance again.
Easily Tired

Fat people work harder, though the popular image is we are slothful and gluttonous. Unfortunately much of that work is in our hearts, which must pump extra hard, twenty-four hours a day, to compensate for build-up in and around the heart. Also many of us suffer from sleep apnea, preventing a good night sleep (explained below). If we are not getting enough exercise we are not sleeping as well as we could. Eating too late in the evening, or foods poorly combined, will also prevent proper rest.
Fat Jokes

Type 'Fat Jokes' in your web browser and be reminded of all the silly sad moments when an inadvertent stab at humor resulted in embarrassment or anger. Emotions bounce around in our head until they settle to the bottom, as unresolved feelings of shame and rejection. Jokes are like stones thrown breaking the bones of our inner confidence, stimulating a patchwork of rationales and an obsessive urge for oral gratification. Hurting secretly within doesn't help, nor does over-reacting in anger. Only a self-created plan of action, including motion, spiritual reflection, and dietary awareness will set the score straight... allowing us the last laugh as we giggle through adversity.

Retention of water, sometimes created by medicine prescribed for various other symptoms, needs to be mentioned to your doctor. Varicose vanes are also sometimes attributed to obesity, as well as from pregnancy, constipation, aging or 'birth control' pills and should be examined by your physician. Please be sure to mention all of your physical (and emotional) symptoms to the doctor when you visit, it may be just the information the doctor needs for an appropriate diagnosis.
Joint Pain

Arthritis, muscle misalignment pulling bones out of place, accumulation of crystallized uric acid, poor exercise routines, inadvertent strain, work related repetitive motion (like using a computer keyboard all day, conveyer-belt employment or driving professionally), or just too much weight are all villains. Taking the time to reevaluate your posture can help. For example stand with your back to a wall. When your shoulders and rear end touch the wall, where is your head? Does it touch as well? If not, the head may be leaning forward. Do appropriate stretching exercises to realign your back. This balance needs to be maintained throughout our skeletal structure. Muscles are what align our bone so motion and awareness are needed to alleviate pain, not surgery or perpetual medication. Find a book that will teach you how to stretch or seek counsel from a trained teacher or physical therapist.
with Food

I am very impressed with behavioral techniques employed by the latest generation of Neuro-Linguistic programmers, weight issue therapists, and hypnotists, particularly those who combine nutritional training, exercise incentives, and awareness to the emotional and spiritual aspects of food addiction. The latest suggestions toward 'normal' eating, 'Am I hungry?' techniques, and methods now used in many spiritually-oriented workshops are apparently helpful.

Finding a peer group, as well as both researching and applying various training programs works. Weekend or week-long workshops (available as audio lessons or in book form) can do wonders. I find Anthony Robbins particularly helpful. A stay in a hospital, specializing in examining my physical symptoms, helped to interrupt my eating pattern and establish a fresh perspective. Ruts run deep for food lusters and will require a herculean transition for measurable recovery, yet every little bit helps.
Fear of Heart Attack

Fat people are justified in fearing heart trouble, statistically we are prime targets. Lowering cholesterol counts would begin with educating ourselves to the various types of fat found in food and changing our diet to accommodate. Lowering our blood pressure by reducing our saturated fat intake (salt also is a factor), getting our aerobic exercise, and taking the added burden off our heart (not by doing less but doing more wisely) we can reclaim a hearty multi-chambered blood pump. We need to let our doctors know what we are up to, but inevitably survival depends on our own vigilance. Of course all this needs to be fun to work, so using our imagination with food and exercise is key.
High Cancer Risk

Cancer kills, we all know this, having lost people we love, sometimes unbearably too young to die. Unfortunately there is a direct correlation between obesity and cancer. If you would like the gruesome details you can research this or simply read the newspaper. Journalists love to remind us of the perils of modern living. They are not exaggerating. The environmental, food-related, and stress-related data is in. We are riding a very sick planet, caused in part by our creature comforts and oil consumption. We romanticize ourselves as air-conditioned gypsies on the road, but here is where we are gluttons, feeding off the indigenous communities, who sleep above our opiate, oil. Moderation starts at home. Walk more, drive less. Consume less (both in mechanized contraptions and processed food) and move more every single chance. I write this more to remind myself than to chastise, we are all actors in this morality play.
Stroke Anxiety

There are exams to check blood vessels in and around the eyes as well as in particular parts of the head and neck. Your heart should be checked thoroughly, and blood pressure monitored. Get help to quit smoking today. Diabetes increases the risk so lose weight. With atrial fibrillation, irregular heart beat, an upper chamber quivering instead of beating, the blood forms pools and then clots. Any other kind of heart trouble makes strokes more plausible. A high red blood count thickens the blood and increases risk.

African Americans have a potential for sickle cell anemia and so strokes. Also, by often being poorer, Black and Latino Americans statistically are more prone to eat the less expensive 'junk food' products, less likely to have park facilities nor health clubs for exercise, and also lack proper health care thus increasing their health risk. High blood cholesterol, physical inactivity, obesity, alcohol and intravenous drug use along with cocaine, all contribute toward strokes.
Unwillingness to Join In

Being the last to be chosen when sizing up teams, being relegated to anchor man during the picnic tug-of-war pull, not being able to climb rope, or hurdle high places, the litany of laments continue until we just don't want to try any more. We choose class clown, or class bully, or simply sulk to the side and watch the parade go by. We begin to associate pain and embarrassment with physical exertion and spiral down into the muck of anti-social behavior. We find it better to say "No thank you" no matter how loudly our hearts yell "Yes!" To break this pattern we need to rediscover our sense of play and move in circles which are supportive and fun. We are lovable but we need to learn where best to express ourselves, many circles suffer from fat friend intolerance.
Peer Pressure

We are a target, so big and so round, and where it is difficult to measure true performance or character, fat is easy to detect. There is a joy too to having a fall guy, someone to joke at, to bolster your own insecurities by finding someone else to push under you. And since you don't have an issue with weight, or are blessed with a reaffirming relationship with exercise and no major eating issues, why can't the rest of the world be just like you. So you cajole us, belittle our eating, our sweating, our clothing size... and, after all, it is all only for our own good. If only we would stop being so gluttonous and lazy perhaps then we could be as beautiful as you.

Dyslipidemias are disorders of lipoprotein metabolism, including lipoprotein overproduction or deficiency. These disorders may be manifested by elevation of the serum total cholesterol, "bad" low-density lipoprotein (LDL) cholesterol and triglyceride concentration and a decrease in the "good" HDL. Diabetes is often associated with this problem. Obesity is one way to predict disorder with your lipoprotein metabolism, so a conscientious doctor will be on the outlook for this and other blood related diseases when you visit. So be sure to go and have your blood checked from time to time.

We are not guilty of anything by being fat, yet we are made to feel guilty. Since inevitably we are responsible for our own feelings, and now understand how they shape our lives, we know we need to face these and other derogatory sensations. In my case the only way to counter act the anxiety and shame I feel about my condition is to create structures for change. This helps empower me and allows me to experientially confirm my own self worth. The source of our original guilt is less important than the proactive measures we are taking today to rectify our low self esteem. Exercising and dieting can help with the right behavioral modification and personal awareness. Guilt may serve some social function, and perhaps there was some wisdom in it's application when we were children, but now we are adults and we can not let negative emotions keep us from our aspirations.
Sleep Apnea

Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Snoring is one tell tale sign, as is tiredness after a nights sleep. The therapy is a breathing devise which pumps room air into the nose while sleeping, regulating breathing, and preventing the disturbed pattern.
Fatty Liver

Most people who do not abuse alcohol and have fatty liver are obese. Fatty liver is called steatosis, and fatty liver with liver inflammation is called or steatohepatitis. Steatosis and steatohepatitis can be caused by alcohol and other drugs, and patients with diabetes mellitus. Steatohepatitis not caused by alcohol is sometimes referred to as non-alcoholic steatohepatitis or "NASH." The factors that determine who will develop fatty liver are not known. Some mildly obese and occasional non-obese patients will develop fatty liver while some who are severely obese will not. Steatohepatitis can progress to cirrhosis. Diet and exercise may stop this progression.
Metabolic Syndrome

Syndrome X, as Metabolic Syndrome is sometimes called, is a combination of these symptoms; Abdominal obesity (excessive fat tissue in and around the abdomen), Atherogenic dyslipidemia (blood fat disorders — high triglycerides, low HDL cholesterol and high LDL cholesterol — that foster plaque buildups in artery walls), Elevated blood pressure, Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar), a Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor–1 in the blood) and a Proinflammatory state (e.g., elevated C-reactive protein in the blood).

People with the metabolic syndrome have increased risk of coronary heart disease and other diseases related to plaque buildups in artery walls (e.g., stroke and peripheral vascular disease) and type 2 diabetes. It’s estimated that over 50 million Americans have it. To stop progression; weight loss (BMI less than 25 kg/m2), increased physical activity, with a goal of at least 30 minutes of moderate-intensity activity on most days of the week, and healthy eating habits that include reduced intake of saturated fat, trans fat and cholesterol.

Blood pressure is the force of blood against the artery walls. High blood pressure (hypertension) and low blood pressure (hypotension) can both cause cardiovascular problems. Usually medicine is used to help regulate pressure, but diet and exercise are equally important. Wristband and other pressure monitoring devises are available to keep a closer eye on your pressure as you exercise and diet. In my case, medication may have been the source of water retention in my lower legs and ankles, this was remedied by a change of prescription.

Undressing in a pool or gym locker room has become uncomfortable since becoming large. Even more so is finding clothes that fit. I live in Japan where most scales, medical apparatus, and sports equipment are calibrated up to only 100 kg. My weight is much more than that. As I walk, my pants ride low, pulling my shirt out in front, awkwardly exposing my under garments. The same is true in back, when I squat or bend. In my attempt to avoid such awkwardness, my muscles have atrophied, and so now I am even more awkward when stretching up or down. It is common for Japanese people to comment, as a sign mostly of naive astonishment and friendliness, on my size. The tradition of Sumo wrestler is a cultural precedence for size equating strength, yet I still feel a bull in a china shop. The remedy for shame is perseverance and humility, and the hope that I will be compassionate when the table turns.

Insulin is a hormone secreted by the pancreas.  It helps the body utilize blood glucose (blood sugar) by binding with receptors on cells "like a key would fit into a lock."  Once the "key" insulin- has "unlocked the door", the glucose can pass from the blood into the cell.  Inside the cell, glucose is either used for energy or stored for future use in the form of glycogen in liver or muscle cells. Insulin resistance occurs when the normal amount of insulin secreted by the pancreas is not able to "unlock the door" to cells.  To maintain a normal blood glucose, the pancreas secretes additional insulin. When the body cells resist or do not respond to even high levels of insulin, glucose builds up in the blood resulting in high blood glucose or type 2 diabetes. If you are pre-diabetic you still have a chance to reverse this trend by losing weight to about the 25 BMI level and increasing your physical activity.

Fat people are funny, at least that has been Hollywood and television's take on us throughout the last century. The darker side, as more and more of us blossom on the horizon, as begun to shift this to comic tragedy, as we laugh at ourself culturally. Yet still the only solution to obesity for many is to abuse verbally those inflicted with this disease. The solution for some victims of abuse are support groups. NAAFA: National Association to Advance Fat Acceptance is one such group though there are others. Group or private therapy may prove effective in combating the trauma associated with social ostracizing and other weight related issues, but in the end, we must face ourselves and the choices we have made.

Primary polycythemia; Polycythemia rubra vera; Myeloproliferative disorder; Erythremia; Splenomegalic polycythemia; Vaquez's disease; Osler's disease; Polycythemia with chronic cyanosis - Myelopathic polycythemia; Erythrocytosis megalosplenica; Cryptogenic polycythemia, a disease by any other name would smell the same.

Polycythemia vera is an acquired disorder of the bone marrow that causes the overproduction of all three blood cell lines: white blood cells, red blood cells, and platelets. The disease usually develops slowly, and most patients do not experience any problems related to the disease after being diagnosed. However, the abnormal bone marrow cells may begin to grow uncontrollably in some patients leading to acute myelogenous leukemia. Patients with polycythemia vera also have an increased tendency to form blood clots that can result in strokes or heart attacks. The objective of treatment is to reduce the high blood viscosity (thickness of the blood) due to the increased red blood cell mass and to prevent hemorrhage and thrombosis.

Occasionally, chemotherapy may be given to suppress the bone marrow. Other agents such as interferon may be given to lower blood counts. Anegrelide may be given to lower platelet counts. Aspirin is a common anti-platelet therapy but is considered controversial as it may cause stomach bleeding.
Lack of Self-

The late Rodney Dangerfield's trade line was 'I get no respect.' He delighted audiences with his self-deprecating humor. << I went to see my doctor... Doctor Vidi-boom-ba. Yeah... I told him once, "Doctor, every morning when I get up and look in the mirror I feel like throwing up.  What's wrong with me?  He said, "I don't know, but your eyesight is perfect." >> A sense of humor is essential for big people, the road toward verification is tough enough.

Just before the dawn of each day is a darkness that chills the bones and seems to last forever. Often the obese are convinced that any and all effort toward change is futile. Obesity is a life sentence locked in a body of all encompassing drudgery. Only when the 'goose gets out of the bottle' will we believe that life is free and fortuitous. Finding small successes on the path toward realizable goals may tip the tide to advantage. The depths of despair loom on either side, as we walk the razor's edge, reforming old patterns into new beginning.
Sterotype Pre-
We make due with a bit more charm, candid humor, flirtatious smiles, and a trust in the possibilities, even though experience tells us different. We take responsibility for our choices and stare down those who feel we are not capable, not man enough to run the gauntlet. Let people judge, we have the spiritual strength to manifest all we can be.

Zorro's Sergeant Garcia

Sgt . Schultz
Who has not seen a Western action film where the fat snoring guard is duped out of his cell keys by a trim and agile hero? Zorro had his fat Sergeant Garcia. Sgt. Schultz was the amicable fat man guard in the comedy Hogan's Heros. Sgt. Ernie Bilko had his lovable fatty. Snoring is one way we know the obese and find them amusing. Most likely our snoring is Obstructive Sleep Apnea (OSA).

Phil Silvers Show

Couch potato, computer nerd, home-bound recluse, trailer park hermits, lonely-heart hotel residents, these and a hundred other ways of hiding, a victim of our own devices, weight is a personal struggle and companionship sometimes seems impossible. But we continually reach out, because fundamentally we are people persons, longing for companionship and love. The solution, getting out and moving, sometimes provides a way into another person's heart. Food is a fickled lover that jealously guards her victims, yet with a mad defiance we can sometimes break the chains.

You have diabetes when your body no longer produces or properly uses insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy. The exact cause is still not known, although genetics, obesity and lack of exercise play a role.
Type 1 diabetes is when the body's fails to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel our cells.
Type 2 diabetes is from insulin resistance (the body fails to properly use insulin), combined with relative insulin deficiency. Most people have this kind.
Gestational diabetes affects about 4% of all pregnant women.

Those people who already have diabetes need a good doctor to learn how to continuously monitor their blood sugar and correct it to a healthy level. The lifestyle shift can be made easier with counseling and/or peer group participation. Generally the whole family can help, though invariably self-education and body awareness are most important.
Pre-diabetes occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. To avoid progressing to type 2 diabetes exercising and losing weight is essential.

Obsessive-Compulsive Disorder (OCD) is one of the most common neuropsychiatric disorders and also one of the most treatable. Obsessions are thoughts naturally invisible to anyone else. Our thoughts create distress so we try and stop these thoughts. Usually they are not based on anything truly worrisome in our lives, yet they occur over and over, usually hundreds of times a day. A person spends so much time thinking about these things they have a hard time doing their work, taking care of themselves, or relating to others in a normal way. The person attempts to ignore or suppress such thoughts, impulses, or images to neutralize them with some other thought or action. Usually there are also related compulsions.This is why some people seem to eat (or do other habitual acts) contrary to their actual hunger.

Our use of the term 'Oral Obsessive' can be misleading and it may be important to distinguish between those who use eating as an emotional crutch to combat suppressed feeling and end up in a habitual rut verses those who are truly compulsive. In either case therapy would be helpful, as well as self-education to appropriate eating and exercise.
Brunt of

Yo mama so fat the only pictures you have of her are satellite pictures.

Yo mama so fat she jumped in the air and got stuck.

Yo mama so fat she put on some BVD's and by the time they reached her waist they spelled out boulevard.

Yo mama so fat she sat on a dollar and squeezed a booger out George Washington's nose.

Yo mama so fat that when she sits on the beach, Greenpeace shows up and tries to tow her back into the ocean.....

Yo mama so fat that she would have been in E.T., but when she rode the bike across the moon, she caused an eclipse.

Yo mama so fat in a resturant, she looks at the menu and says "okay!"

Yo mama so fat when she wears a yellow raincoat, people say "Taxi!"

Yo mama so fat she had to go to Sea World to get baptized.

Yo mama so fat she got to iron her pants on the driveway.

Yo mama so fat she got to pull down her pants to get into her pockets.

Yo mama so fat when she bungee jumps, she brings down the bridge.

Yo mama so fat when she sits around the house, she SITS AROUND THE HOUSE!

Yo mama so fat when she steps on a scale, it read "one at a time, please."

My mother was so fat she died too young and never got to see her grand
Kidney Risk

People who are obese have an excess amount of body fat. In contrast, people who are overweight have an excess amount of body weight that includes muscle, bone, fat and water. Some people, such as body-builders or other athletes with a lot of muscle can be overweight without being obese. Men with more than 25 percent body fat and women with more than 30 percent body fat are considered obese. More than 60 percent of Americans aged 20 and older are overweight, and 25 percent are also obese.
People who are overweight or obese have an increased health risk for chronic diseases like Type 2 diabetes, high blood pressure, kidney disease, stroke and heart disease. Because diabetes and high blood pressure are the leading causes of chronic kidney disease, your chance of developing kidney disease is greater if you are overweight or obese. Women whose waists measure more than 35 inches or men whose waists measure more than 40 inches have a higher health risk because of their fat distribution.
A weight loss of five to 10 percent can help to improve health by lowering blood pressure and cholesterol levels. Weight control is considered the single most important factor in the prevention of high blood pressure. In addition, recent research has shown that a weight loss of five to seven percent can prevent Type 2 diabetes in people at high risk for the disease.

Short term success is the bane of the obese. So much of what we are fighting is psychological (habitual behavior) and when we have cycled too often from success to failure, failure feels a more pleasurable place to stay. We need to affirm change which will stick with us for a life time, temporary solutions are not solutions at all but often part of the problem. Diet pills, starvation diets, and work-out crazes are all well and good for diversity and experimentation... but in the end, change must penetrate down into our soul, challenging some of our core assumptions and patterns.

Erectile dysfunction is the repeated inability to get or keep an erection firm enough for sexual intercourse. Due to the sensitive nature of the condition, it is difficult to estimate how many men it affects. However, it is believed about 5% of 40-year-old men and up to 25% of 65-year-old men may have the condition. A successful, sustained erection requires a sequence of events to occur in a precise fashion. Anything which disrupts this sequence can lead to problems either getting, or keeping an erection.
The most common cause of erectile dysfunction is damage to the tissues, either the nerves, arteries, muscles or fibrous tissue. This is often linked to diabetes, kidney disease, chronic alcoholism, multiple sclerosis and cardiovascular disease. You and your doctor may consider psychotherapy, drugs, vacuum devices, and surgery. One drug in particular, Viagra, has become popular worldwide. The drug Sildenafil does not directly give a man an erection. It works by boosting the natural mechanism that leads to an erection. Check with your doctor first.
Loss of

There are so many reason why obese people may feel low in energy and feel exhausted so quickly, when climbing stairs, doing sports, or just trying to keep our life on track. In the morning we may wake already feeling tired. This happens when sleep apnea, bad food mixing, emotional anxiety, or any number of other factors disrupt proper sleep. This in turn may lead to depression. Low energy will effect us emotionally as well as physically, some might even say spiritually. Our heart is already working overtime, compensating for our added bulk. Fat people's hearts, unlike normal-weight individuals, never slip into a proper rest mode, but continue to pump vigorously even when we are in bed.

Our muscles throughout our bodies are atrophying if we haven't some fitness program to counter this. Also our quest for emotional gratification through overeating has had our stomach and digestive tract also working overtime all night and day. In our passion for carbohydrates we likely have neglected balancing our diet, testing our metabolism with questionable sources for vitamins and appropriate fats. Clogging of cholesterol in our arteries does not help either.

What is required is a kind of fanaticism, a vigilance over eating, at appropriate times and in appropriate proportions, and an established exercise routine which includes more aerobics. For this, walking is most often recommended, though an assortment of physical activities will keep it more interesting.
Diet Drug

When I was young I found stimulants to be amazing. What I first learned was that others found my behavior while on these drugs obnoxious, and my mood swings lost me valuable friends. When I started to take seriously the hazards, I soon realized I was risking my internal organs, my social standing (often these drugs are illegal and can create anti-social behavior), and, most important, their usefulness was short lived. People with incorrect eating and exercising patterns will just get fat again after stopping, and those who did not eat too much would go the other way, looking painfully thin and unhealthy. The only sensible diet is one sustainable without medication. Most drug based diets are delusional and counterproductive, i.e. stupid. If you still want to experiment, see your doctor, he may end up being your only friend.

There are several ways obesity impacts a relationship. If you are dieting sometimes a partner may become an 'enabler', someone who needs you as your fat self, and so will discourage you in a hundred subtle ways. Perhaps they enjoy the leverage your obesity provides them, or they simply might enjoy having you to share in their oral pleasures and obsessions... Couch potato love seats.

Another painful issue is body aesthetics, and this of course relates toward rejection and verbal abuse, both publicly and in the bedroom. Changing yourself for the better may result in a radical shift in your relationship, as it effects how you eat, entertain, feel, look, think... etc. Leaving the spouse with a completely new partner to contend with, for better or for worse.

Dialogue throughout the process would be ideal, as would be compassion and cooperation... but, in the end, a dieter must establish goals and activities that may leave some friends and even some partners behind.
Earlier Death
Obesity means a shorter and, towards the end, a less pleasurable life. Change your life style, rediscover the joy of fresh air, clean water, nutritional moderated eating, and feeling physically fit.

Obese people often settle for unhappiness because we can't imagine any other way. We must dare to imagine, see ourselves as we'd like to be, and then make this dream our goal. We can create manageable short term objectives that keep us on track toward a healthy balance, enjoying ourselves all the while. Forget the doubters and drop the despondent, find a community and resources that support your campaign, and lead the way for others to follow.
Being overweight during one's early 40s increases the risk of Alzheimer's disease. It is never too early to diet and exercise, in fact, I'd recommend it.
Typical Obese Symptom Medication