its an epidemic

a large part of my job as a primary care provider is managing chronic health conditions. what that usually means is managing high blood pressure, high cholesterol, and high sugar before and after it results in diabetes. all of these conditions can, for the most part, be avoided by living a healthy lifestyle. yet they are some of the most common things i treat.
tomorrow i have two people on my schedule, each of whom i diagnosed with diabetes with sugars in the 400s. since an initial diagnosis of diabetes is made when sugars hit a mere 126, this means they have had untreated diabetes for many years. on top of that diabetes takes years and years to develop, all along causing irreversible damage to your body. for those of you that don't know, diabetes causes strokes, heart attacks, blindness, kidney failure, erectile dysfunction, and its the leading cause of leg amputation. does any of that sound fun to you? it surely doesn't sound fun to me.
so its really hard for me to get why that guy on friday, who watched his dad lose limbs and then his life to diabetes, didn't really care when i told him he was on the verge of developing diabetes. he couldn't understand why he had a problem with his sugars, when he never ate lunch. but every morning, EVERY MORNING, he gets a sausage mcmuffin, coffee, and an orange juice from mcdonalds. he couldn't begin to wrap his mind around why orange juice was not a healthy choice for a person like him. even though i was reviewing many ways in which he could make positive changes to his diet he just kept saying, "i've never heard that orange juice was bad for you."
and here's another thing, if you weigh over 300 pounds, why would you argue with me that you get enough exercise walking around at work? you clearly don't get enough exercise. i don't solely blame these people though i do think some god dammed personal responsibility is in order here! i blame a society that makes the worst food the cheapest. that makes us feel that we are not satiated unless we are completely stuffed. that is set up for us to drive our cars everywhere instead of walking or riding bikes. that cuts physical education from schools.
if you are reading this right now you know i really like food and i eat a lot of it. i don't not exercise as much as i should but i do actually move my body on a regular basis. and i eat GOOD food! i think most of the food that my patients are eating is disgusting -- white bread! egg sandwiches from the gas station! mountain dew! without sounding like michael pollan i have to ask if these are really even food!
i don't want you to think i am a heartless care provider because i am not. but as the obesity epidemic is at the intersection of two things i am very passionate about, food and health, i can get a little worked up.