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Diabetes Watch: It Is Possible to Break the Sugar-Salt Addiction

Mary Annette Pember
4/16/13

A little over a year ago, I noticed an overweight woman about my age riding through the grocery store on a motorized shopping cart. I’d seen such people many times before and silently pitied them, reassuring myself that I would never let myself get that big. This time, however, the sight knocked the wind out of me—I was that big. That lady in the cart looked a lot like me.

At this time, I was finding that there were several things I could no longer do—or was too embarrassed to do—because of my size. I really wanted, for instance, to kayak around the shores of Lake Superior and Madeline Island and see the beautiful and mysterious sea caves, but I was secretly afraid that my rear end would become lodged in the kayak seat, evoking a scene out of the film What’s Eating Gilbert Grape, in which Johnny Depp’s obese mother draws a crowd when she goes to town.

The short-term pleasure of overeating (baked goods are my special weakness) was destroying me. Although those little rewards of sugar and fat that lifted my spirits seemed benign, they were killing me. I was 90 pounds overweight and taking medication twice daily for type 2 diabetes. I felt awful. Walking my son the two blocks to his school was exhausting and each visit to the doctor was filled with helpless fear as I watched my glucose, cholesterol and blood pressure numbers inch upward. It was the physical pain that finally got me to take action. I found that I could no longer stand for extended periods nor could I run around carrying camera equipment on photo assignments without experiencing crushing exhaustion and pain. I realized I was sick.

I was presented with a seemingly impossible choice: either take care of my body and closely monitor what I eat or eat what I want and be confined to a motorized wheelchair, forever abandoning my dream of kayaking the sea caves. Diabetes, with its accompanying illness and immobility, was staring me in the face. I couldn’t ignore it any longer.

On November 8, 2011, I got sick and tired of feeling sick and tired and joined Weight Watchers (not a recommendation, just my particular weight-loss strategy). I also began to exercise daily, slowly at first. March 5 was a milestone—in 14 months, I had lost 90 pounds, which places my weight at the recommended BMI (Body Mass Index) for my height. I’m at the very top of that scale, mind you, but I am there. Best of all, I feel great! I still have aches and pains but nothing compared to how I felt before the weight loss. Funny how I didn’t realize how miserable I was until I started to feel better. Feeling bad had gotten to be a habit. I work out most days doing Zumba, spinning or walking, as well as weight lifting. At first, I could not keep up with the Zumba class and stayed in the back row. Although embarrassed about my size and limitations, I found that crazy Latin beat irresistible and I just kept going back to the class, where the other women encouraged me. I kept shaking my old thing and can now grind with the best of them, much to the shame of my teenage daughter.

The best rewards, however, are the small things—such as effortlessly walking the two blocks to my son’s school and bending down with little or no pain. I also get to shop in the regular-size women’s clothing department. What a gift!
What was my secret? All I had to change was everything.

The Sucker-Punch of Desire
I embarked on my Weight Watchers plan and was doing pretty well for the first couple of weeks, but as so often happens to addicts early in recovery, I was unprepared for the sucker-punch of desire that overwhelmed me when suddenly faced with my “substance of choice.” My son had wandered over to the doughnuts conveniently placed on an end aisle of the grocery store. As I gently pulled him away, something caught my eye and my knees buckled a little. Some fiend had invented red velvet cake doughnuts and topped them with cream cheese frosting and placed them at eye level. I had forgotten that I still had to visit enemy territory for those of us trying to lose weight and eat healthily. I have children and I do the food shopping for our family, so I have to visit the grocery store—a high-tech trap designed to entice us to overeat junk food—regularly.

In his new book, Salt Sugar Fat: How the Food Giants Hooked Us, Michael Moss exposes in painful detail what he described in The New York Times as the food industry’s fight for America’s “stomach share—the amount of digestive space that any one company’s brand can grab from the competition.”

Moss quotes food science experts who paint a “grim picture of the public’s ability to cope with the [food] industry’s formulations—from the body’s fragile controls on overeating to the hidden power of some processed food to make people feel hungrier still.”
In his four years of research, Moss uncovered what amounts to a plot by the processed-food industry to get the public hooked on convenient, inexpensive foods. He describes how food companies create the highest level of craving in their foods in their tireless pursuit of the “bliss point.” The bliss point, Moss explains, is the exact combination of sugar, fat and salt to add to foods in order to elicit the greatest level of desire from consumers.

According to the data cited by Moss (and many others), the industry is winning in a rout. The Centers for Disease Control and Prevention reports that 35.7 percent of all Americans are obese, and 17 percent of children are obese, triple the rate from one generation ago. As of 2010, 25.8 million people—8.3 percent of the U.S. population—have type 2 diabetes, which is closely associated with obesity.

Native peoples are among those most afflicted. The U.S. Department of Health and Human Services Office of Minority Health reports that American Indian/Alaskan Native adults are 1.6 times as likely to be obese than non-Hispanic whites. According to the CDC, 16.1 percent of the American Indian and Alaska Native adult population served by the Indian Health Service has type 2 diabetes. Rates vary by region, from 5.5 percent among Alaska Native adults to 33.5 percent among American Indians in southern Arizona. Overall, American Indians/Alaskan Natives are twice as likely to have type 2 diabetes as Caucasians, according to the Office of Minority Health.

As Native peoples incorporate more of these unhealthy, processed foods into their diets, they are unwittingly killing themselves. Asking people to ignore their “bliss point,” however, when choosing foods is a tough sell.

Pray for Forgiveness
Folks who haven’t seen me in a while congratulate me and invariably say, “How did you do it?”

I note a distinct expression of disappointment pass over their faces when I answer, “Diet and exercise.” It’s as though they had hoped that some new technology or drug had emerged that allowed me to effortlessly improve my health. Nope, at least not for this Indian. OnProcessed foods are brilliantly and insidiously engineered to make them addictive. (Q. Sakamaki/Redux) that November day, the Creator gave me the gift of willingness to step through my fear, anger and pain and embark on one of the most important journeys of my life.

As a well-known 12-step program proclaims in describing those of us who struggle to overcome addictions, “self knowledge avails us nothing.” This has been true for me. I have written extensively about diabetes and health and spent countless hours reading research and interviewing health-care professionals. Perversely and inexplicably, however, I did all of this while maintaining my unhealthful habits. I didn’t always eat to feed my body; I often ate to medicate myself. I ate for most of the same reasons I drank and drugged—for comfort, for reward and to deaden pain.

Willpower, determination, knowledge, moderation—none of these concepts worked for me in my efforts to control my eating. It was only when I surrendered to my anger, fear, pride and shame that I was able to see how I was using food in an unhealthy way. At last I surrendered and asked for some help. I prayed, I joined Weight Watchers, and I began to exercise. I began to feel better.

As I look back at that November day, I recall that my mother had passed away about a month earlier. So much of my self-image, self-worth and emotions were bound up in that tiny, tough, old woman. She was not an easy person to love. I drank and drugged for years over the many wrongs I imagined she had done me. Several years ago, however, I began to pray for her, to pray that she might find some peace. That simple act of prayer has been the magical formula that continues to free me from the “dis-ease” that had infused my life. I pray for forgiveness, acceptance, patience and love, not only for my mother and family but also for myself. The longer I prayed for her, the more I was able to mother and care for my well-being.

In order to reach a point at which I could begin to heal, I had to face my personal version of the historical trauma that plagues so many Indian people. As I came to know my—and my family’s—painful history, our struggles with addiction, abandonment and the perverse shame that we somehow brought it all on ourselves by the simple fact of being Indian, I have started to heal. Knowledge of my and Indian peoples’ history has given me authority over the cycle of addiction. For me, the seemingly unyielding spirit of addiction has diminished, and I am free.

Eating as Self-Medicating
Food was the final frontier of my addiction. Although alcohol- and drug-free for many years, I still held on to the need to medicate myself. That gnawing addiction spirit continued to rule my life with the notion that consuming something would make me feel better. Like alcohol and drugs, however, food proved to be a false friend. For a long time eating worked for me, soothing the pain and anxiety of life. But like all false friends, food betrayed me, leaving me obese, diabetic and in pain.

Diabetes education is crucial to combat the effects of processed foods. (AP)Changing the way I lead my life hasn’t been easy. There are forces at work in this world that want us to buy and over-consume food that is bad for us. Not only are these forces powerful, they know our weaknesses and they have no mercy. They know only profit. As Moss notes in his book, the processed-food industry appears to be immune to morals in their avaricious pursuit of our collective “stomach-share.”

The industry has now boxed itself into an ugly corner. As America begins to take note of the relationship between nutrition and obesity and diabetes, the processed food industry has responded by offering low-fat and low-sodium versions of some of their products. But consumers trained to seek those “bliss points” don’t like the healthier foods. And not only is the industry working to trim the bad stuff but, in the best capitalistic tradition, it has begun increasing efforts at marketing their products to poor, vulnerable communities, from New Orleans to the favelas in Brazil. Junk food and convenience foods offer a quick, cheap, feel-good blast of fat, sugar and salt to a population suffering the pains of poverty, addiction and despair. I can attest to feeling instant, although fleeting, relief from my emotional pain by wolfing down a wad of fat and sugar. Offering a quick, legal and cheap fix for emotional pain seems like a hell of a successful marketing strategy. It has also created a perfect type 2 diabetes storm for American Indians.

Many Native people live in marginal, isolated communities where the simple struggle to survive too often trumps family efforts to find healthy food. It is easy to understand how such a population—with its high rates of alcoholism, addiction, suicide and poverty—succumbs to a cheap treat of processed food. “I feel like Walmart should have a banner over the front door announcing, ‘Welcome to diabetes,’” scoffed an Indian Health Service–hospital endocrinologist I interviewed a couple of years ago.

The food-processing industry has brilliantly tapped into our tendency to self-medicate. We have become the perfect consumer for their finely calibrated poison.

The availability of processed food has clearly contributed to our growing rates of obesity. Unfortunately, obesity is often depicted as the result of bad choices, of laziness, of a lack of moral fiber and self-control. As more information emerges, however, we are learning that determination and willpower have a slim chance of success against the artificial craving generated by the devious geniuses who created Pringles and Oreos.

Making the Change
How was I able, then, to lose weight and attain a normal blood A1C of 5? The A1C is a common blood test that diagnoses type 1 and 2 diabetes and also gauges how well a person manages their diabetes. Before I was able to pray, I had to feel safe, both emotionally and physically. This sense of safety, love and support was crucial to my success and the ability to make such radical changes in my eating and activity. Unfortunately, far too few of those living in our Native communities exist in safe and secure environments.

In order for us to successfully address the high rates of obesity and diabetes in our communities, we need to address our most basic needs for safe homes and families. This change can begin by including real-life nutrition information and education for families and ensuring that good, affordable food is as easily available as the donut at Walmart.

In his book, Moss quotes a vice president at Kraft foods who suggested during an industry meeting in 1999 that if only in the interest of self-preservation, the processed food industry is in a unique position to use its knowledge of what makes people overeat to “make a sincere effort to be part of the solution.”

Not surprisingly, his suggestion was not well received by most of those at the meeting. They insisted they were simply giving the public what it wants, ignoring the fact that they created the addicting desire for processed food. Letting these people off the hook in the name of good old American capitalism is like giving drug dealers a free pass for creating addicts.

If we want to break this cycle of eating ourselves to death, we need to be fearless. We have to face the dis-ease that makes it permissible to medicate away the pain of living.

All we have to change is everything.

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Comments

ken chester's picture
ken chester
Submitted by ken chester on
Mary Annette and others need to pick up a copy of "End of Diabetes" by Josh Fuhrman, MD. Let's stop IHS from pushing unnecessary drugs!

ken chester's picture
ken chester
Submitted by ken chester on
Mary Annette and others need to pick up a copy of "End of Diabetes" by Josh Fuhrman, MD. Let's stop IHS from pushing unnecessary drugs!

Rouillie Wilkerson's picture
Rouillie Wilkerson
Submitted by Rouillie Wilkerson on
Brilliant article, sums up my own, personal, health initiatives to avoid the fate of my parents. Thank you for this, masha'Allah (deep gratitude).

Tom Freeman's picture
Tom Freeman
Submitted by Tom Freeman on
Ms. Pember, This was a very interesting article that certainly caught my attention as I read further and further into the article. I'm not native American, but I'm in recovery and have recently lost weight (20 lbs) in an effort to improve my lifestyle as you did yours. I would appreciate the opportunity to read more of your work and research and possibly make contact with you directly either by email or phone. Look forward to hearing back. Tom

Terry Siewiyumptewa's picture
Terry Siewiyumptewa
Submitted by Terry Siewiyumptewa on
I hope this encourages more people to go back to growing their own food. Even if you live in an apartment you can use containers to grow good healthy food all year round. We need to get closer to our food sources and understand where it comes from for our own safety. Diabetes runs rampant in both sides of our family; I can only hope the choices I have made raising our children make the difference.
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