Beach weather is here, and so are the ads for snorkeling tours, diets, cellulite removers and liposuction, in addition to the tabloids posting pictures of what celebrity does or does not have a “great bikini body.” We are a nation obsessed with thinness, with what actress can squeeze back into her tiny clothes two weeks after giving birth, and what other actress has gained an ounce. Most of the time, when I see those “great bikini bodies” in the tabloids I think the women are too thin, but apparently this is what people want to see. One would think that with all the focus on being thin and looking good on the beach, that we’d be a country of fitness-obsessed skinnies eating salads and running marathons. One would think that we’d be healthy, look healthy, and live healthy. But the opposite has happened over the past couple of decades. Rather than looking at a longer life span as a gift to be valued and nurtured, it seems that many of us would rather live in the moment and not think much about what this moment will mean in 30 years when the sins of our youth catch up with us. Much has been written lately (see Time Magazine’s recent cover story) about how when we vilified fat in our diets we all started getting fat. How ironic. We encouraged people to eat Snackwells and lean chicken while cutting out oils and butter, and in the past 20 years the obesity rates have skyrocketed. Diabetes, a common consequence to being overweight and living an unhealthy lifestyle, has increased so much that you’d think these numbers are typos: in 1994, according to the CDC, 36 States had fewer than 5% of their population diagnosed with diabetes, and no States had more than 7%. In 2010, on the other hand, 31 States had more than 8% of their adult population diagnosed with diabetes, and only one State (Vermont) had fewer than 6% of its residents diagnosed with diabetes. In 1994 only two States even approached 7%. In 2010 not one State had fewer than 5% incidence of diabetes. One reason given by recent research is that when we cut fat we added in, rather than fruits and vegetables and other healthy foods, corn syrup and other rich sugars. So we replaced the porterhouse with two-liter sodas and wonder why diabetes is through the roof. In addition, over 11% of the general population has heart disease, and more than a third of us are obese. Not overweight, but obese, causing an estimated $147 billion in healthcare costs. Children are diagnosed with obesity at a rate of about 17% of the under-18 population, but this has, thankfully, started to decrease after increasing for many years. Think back—can you imagine nearly one in five of your school chums being obese? Of course not. The chubby kids stood out as aberrations. Heart disease, diabetes, and many forms of cancer are linked to obesity and a sedentary lifestyle, and therefore, at least in theory, are preventable. So, why is it that while we pine away for the perfect beach body, we continue with the unhealthy habits that put us at risk? Are we addicted to carbohydrates, particularly corn syrup? Some would say so—sugars cause us to make insulin, which floods the blood, and since carbs have a fast burn, meaning we digest them quickly, the extra insulin floating around begs for more food to balance things out. Usually, we crave more carbs. Think about your breakfast. If you have a couple of eggs or another good protein, you probably don’t think about snacking for hours. If you have cereal, plain white toast, or worse yet, a Pop Tart, you are hungry in an hour. People don’t have to be skinny to be healthy. My mother, due to some thyroid issues, was always more than a little overweight. But she walked everywhere, was active, never smoked, and ate lean proteins and a lot of vegetables. She died from something totally unrelated to diet or lifestyle, and it was unpreventable, but she was told that her cardiopulmonary system was top notch. Even though she would have liked to have been about 40 pounds thinner, her physical health until that point was apparently not affected by her weight because her other healthy habits counteracted her slow metabolism. Someone who wears a size four but has a sedentary life or eats fast food may be more likely to develop diabetes or heart disease than an overweight person who eats a healthy diet and gets moving every day. So what we see now, I think, is what statisticians call a bimodal distribution. One hump on the graph is the people who maintain a healthy weight, eat well, and exercise. These are the people I see running in the park most mornings, hauling bicycles on their cars, and walking to do their errands in town. This is my cousin and me, born only six weeks apart, so always having a spirited rivalry and competitive streak, comparing how far each of us has run, how long we can stay in plank position, and how many sit-ups we can do. This is the person who eats, as most nutritionists suggest, with the 80/20 rule. 80% of what they eat is healthy and 20% of what they eat is the indulgence that makes life worth living. For me it’s chocolate cake and red wine. For others it’s potato chips. The second hump on the graph is the people who are living unhealthy lives. These are the people who eat fast food, don’t exercise, perhaps drink to excess, eat triple the recommended portions, and very often have misinformation about health and fitness that comes from the changing trends and half truths in the media (eat fat/don’t eat fat/eat carbs/don’t eat carbs/ running is good for you/running is too hard on the joints/you can’t get fit without hard work/you can get fit in 30 seconds a day). I really can’t blame these people for their unhealthy habits—if you follow the media you’d change your diet and routine every day. It’s easier to just grab a pizza and go. I could say “live and let live” and not have any concern for those who are eating donuts for breakfast while I’m engaging in my daily exercise routine. But I can’t do that. Our country is on the road to ruin when it comes to our health. $147 billion dollars in medical costs based on something that is generally preventable is not chump change. Losing vision, limbs, and mobility to diabetes is nothing to sneeze at. Long-term effects of heart disease can cause a person’s later years to be painful and dreary. Not to mention that my patients feel better if they are healthy all around. When they lament about why the magic pill doesn’t exist for them or tell me they lack motivation, I tout the power of exercise, fresh air, and healthy food to make us feel better. Even just 20 minutes of walking a few times a week has long been proven to alleviate anxiety and lift mood, and every runner knows how great “runner’s high” (or “cyclist’s high” or “dancer’s high”) feels when the good chemicals start flowing through their brains. In addition to physical health, good habits help us mentally. When we think of dementia, most people think of Alzheimer’s, but there are many forms of dementia, including vascular dementia which is caused by poor cardiovascular health leading to decreased blood flow in the brain. In addition, Korsakoff’s Syndrome is a type of dementia caused by overuse of alcohol over time. So our bad habits can catch up with us later with not just diabetes and heart disease, but dementia as well. So, in this bimodal distribution there are those who will enjoy their older years feeling the level of health and wellness they always have. My horseback riding trainer, riding for 70 years, fell (off a horse) and broke her leg last year. Her recovery, while still long, as it was a bad break, was hastened along due to her years of riding. Her body is so fit from riding that, now in her late 70’s, she informed me that for the first time, she feels some stiffness and soreness upon waking. Imagine being nearly 80 before you feel the creaks and soreness of life! I see an older man in the Rockefeller park preserve most mornings, no matter the weather, power walking for an hour to get his blood flowing and his day started. Most of us would say that we’d like to age that way, but it doesn’t happen out of nowhere, and it doesn’t happen without a strong foundation. If you never took care of your health in your youth, it’s going to be a lot harder to find that good, pain-free health in your older years. Some of our indiscretions can be reversed, but many cannot. So, as we fire up the barbecues and splurge on burgers and hot dogs, we should be thinking about the long-term ramifications. I love a good, rare cheeseburger smothered in ketchup and mayonnaise, believe me, but after a weekend of barbecues I’m going to balance it out with healthier food and some added exercise to move that saturated fat out of my body. Likewise when I’m on vacation, I’ll go on eco tours that let me look at the scenery and walk around just as much as I will try their awesome food. I want to live a healthy life, but also a fun life, and that takes balance. The gooey burger makes me happy, so I splurge. But getting up in the morning and feeling fit and healthy makes me happy too, and for that, we have to work a little bit harder. [blockquote class=blue]Barbara Kapetanakes, Psy.D. practices child, adult, and family psychotherapy in Sleepy Hollow. Please visit her website and blog at http://www.bksleepyhollowtherapist.com[/blockquote]