Published November 18, 2004 in issue 0346 of the Hook

BY JOHN HONG, MD

Monty Python's movie The Meaning of Life has a disgusting-- but funny-- scene at a restaurant where a morbidly obese man takes gluttony to a new level. At the end of his meal, the waiter forces upon him a "wafer-thin" mint. Despite his obvious lack of control over his eating, he reassures the waiter that he cannot eat another bite. But of course, the temptation of the wafer-thin mint is too much for him, and he eats it-- knowing he will get sick. You have to see the movie to see what happens next. It's unpleasantly explosive.

Thanksgiving, Hanukkah, Christmas, and many other holidays are upon us. Despite the religious "meaning" of the events, what's the main focus of every holiday? Food! Even in Charlie Brown's Thanksgiving Special, the focus is on the Thanksgiving dinner. Unfortunately, our hero, Charlie Brown, serves popcorn and toast, and Peppermint Patty calls him a blockhead.

In most hospitals, healthcare workers are prepared for the holiday's after-dinner onslaught: congestive heart failure, upset stomachs, and alcohol-related emergencies. The salt in the food will send thousands of Americans to emergency rooms, and many will have to be admitted to hospitals. Overeating will cause millions of Americans to burp up their holiday meals due to reflux.

Over the holidays, our medical office receives enough boxes of candy to make us look like Willy Wonka's Chocolate Factory. I have asked people to bring vegetables and fruit instead. However, to most Americans, offering celery as a holiday treat seems blasphemous.

"I brought you a 'Death By Chocolate' cake, and all you want are carrots? My grandmother would turn over in her grave!" is a typical refrain.

My overweight and obese patients struggle all year long to eat a healthy, balanced diet. However, from Halloween to New Year's Day, the temptation to overeat usually gets the best of them. At dinner parties, we all hear, "Would you like seconds? Thirds? The whole oven?"

If heavy hors d'oeuvres are served, then it's like shopping at Nordstrom's with an unlimited credit card! Spiral ham, roast beef, fried chicken, creamed corn, biscuits and gravy, mashed potatoes, sausage, greens with bacon, cakes, Danishes, cheese, crackers, chocolates. Lions, tigers, and bears, oh my!

Let's face it: Americans eat too much. Then during the holidays, Americans eat even more. Diabetic patients have horrible blood sugars for two months, heart disease patients get more short of breath, kidney failure patients get tired and swollen, and arthritic patients suffer more painful joint problems in their knees and hips from the extra weight they carry.

Airlines are now charging passengers more for their ballooning avoirdupois, which in turn has led to lowering the maximum weight of luggage. What is Santa Claus going to do with his extra weight? I don't know if Rudolph and the other reindeers will form a union and demand more pay, or if when he urges, "On, Dancer," they'll reply, "Santa, you need Weight Watchers!"

I personally have regretted eating too much at times. Yes, I'm guilty as charged. So before a big dinner party I mentally prepare my menu. I think about how much I would eat at home, and then I stick to that plan. If the party has a buffet, I look at the food and decide how much constitutes a single serving.

But even this pre-planning can fail in certain circumstances, like at my parents' house. My father and mother yell at me to eat more. "Here, eat! You're too thin," my dad will say, and then resort to guilt: "Your mother has been cooking all day for you."

Knowing what to expect and having a plan in place before you leave home can often help you avoid falling into the old traps. Sometimes it's helpful to trade off: "If I pass on the paté and cheese beforehand, I can have one small dessert afterward."

Holidays are about many things that don't pertain to food, like friendship, family, and the meaning of the holiday itself. I strongly encourage my patients to celebrate, but also to avoid being like the obese character from Monty Python.

Going home after a party in good health instead of to the ER in heart failure is the best holiday present we can give ourselves.

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