As I work toward regaining control of my weight, I’ve had time to think about some of the perceptions we have, out there, about food.

I will admit, when I was at the doctor’s office a couple weeks ago, I felt a bit betrayed when he suggested that I go on a medically assisted very low calorie diet. I pointed out that even at low calories, the amount of time it would take for me to arrive at a healthy enough weight for knee replacement surgery (one of my big goals) would make surviving a shake-and-bar regimen a grueling task. It’s his assessment that I’ll need to lose another 100 pounds before surgery; I can’t begin to imagine consuming nothing but shakes and protein bars for a year… or more. With my metabolic issues, likely more.

If I’m going to stick with a weight loss effort, it has to be one I can live with long term. I have to be able to change my lifestyle permanently, as well as learn how to adapt to my changing body as I lose. While such a restricted method may work, I’ve also learned from losing a great deal of weight quickly, in the past, that my brain needs to adapt to my body’s changes, or I’ll sabotage myself. I’m no stranger to small stretches of adapting my eating plan to break a stall or get certain results, but not in the extreme.

I suppose one of the reasons this has been in the back of my mind is because of the assumptions made about obesity. I’ve mentioned in this blog, before, that there’s quite a large group that appears to believe that obesity is a character flaw; a sign of gluttony, of overindulgence, of lack of control.

I think this is exactly why, despite overall health institutions defining obesity as a disease, that most of us who are obese face so many obstacles when it comes to any kind of support. My insurance won’t support any sort of obesity-related treatments, despite obesity being a leading factor in a number of serious diseases that insurance must treat, including heart disease and type II diabetes. To me, assisting in treating obesity should be considered primary care — but it so often is not.

Perhaps the problem is in separating those that are obese because of underlying medical issues from those who are obese because of environmental factors… like Cheetos and Oreos. It happens. And unfortunately, people are probably correct when they think that the majority of obese people got that way because of plate-to-mouth overages. It doesn’t help when the media occasionally serves up morbid stories of people so incredibly obese that they’re unable to leave their beds, while enablers feed them a diet of multiple cheeseburgers for a snack.

Add to that, the growing concerns with the amount of absolute junk Americans consume on a daily basis; fast foods, processed foods, supersized meals… over recent decades, we’ve changed the way we eat, and the opportunities for overeating are greater than ever before. Our conveniences are our dietary undoing.

So when people, including the medical community, jump to the assumption that the majority of overweight people got that way because they didn’t limit their consumption of the wrong kinds of foods, they aren’t incorrect. Even those of us who have significant metabolic concerns complicate the matter by eating (and drinking) things we’re better off without.

Now, mind you, there are tests which will determine metabolic issues. As I was informed by my doctor, they are expensive — and the result is usually telling you what you already know: that you have an issue which makes weight loss difficult… and yet, the answer to resolving the issue is to lose weight.

So, knowing all this, I continue the uphill climb. The efforts I’ve made over recent weeks have brought my daily food intake under control, though I discovered it was not greatly out of control to begin with — I am a creature of habit, and my tendency is to eat the same foods in the same amounts, most days. I am still ten pounds above my low, but I am determined to keep working my way to the top, regardless of the speed I travel.