By Richard P. Holm, MD
As a teenager, like many others, I yearned for independence and resisted my parents’ rules and restrictions. Now I realize my parents struggled with how much freedom to allow me while best guiding me into adulthood. It’s an old story: kids want freedom; parents are reluctant to give up control. Think back when you first obtained a driver’s license and borrowed the family car. Remember, after some error in judgement or indiscretion, how the car-privilege was taken away and, even when justified, how devastating that was?
Now the tables may be turned, and the aging parent is threatened or devastated by losing the car-privilege after some error in judgement or just because of advanced age. As a Geriatrician, I have heard too many adult children ask me to tell their parents to stop driving. To the adult child, this is protecting his dad. To the elderly person, this is a double blow: losing the car-privilege feeling of independence AND the freedom to be mobile. Think about it, who’s more dangerous on the road: an 18-20-year-old male in a muscle car, a 16-year-old female with a cellphone, or grandma?
There are three lessons here. First, elderly persons who are ‘competent’ should be allowed to make their own choice when to stop driving. In my years of practice, I have advised many competent elderly people, “If you think you might be putting others or yourself at risk, then YOU decide when to stop or cut back on driving.” When night vision is poor, neck flexibility is reduced, reflexes are slowed, hearing is poor, posture is bad—then think about it. If you can’t decide or this is a borderline question, consider a ‘Driver Improvement Course for Seniors’ through the American Automobile Association (AAA) and test yourself. Then you make that choice.
The second lesson: elderly persons who are NOT ‘competent’ shouldn’t drive. When their ‘learn-a-new-thing’ memory is poor and when accidents start piling up, then it’s time for someone step in. The elderly person first needs to see the doctor for evaluation. Afterwards, if declared incompetent, it means no driving, will-making, check-writing, or consenting to an operation.
The third lesson is for everyone and every family to realize how important is the freedom to drive, especially for individuals trying to grow up with independence OR age with dignity. We should all recognize what a precious freedom and right it is to drive.[i]
Isn't it strange that in this era when there is an epidemic of obesity, our society seems to define beauty as thin? When there is such a difference between what's expected and what's real, it leaves people desperately in search for a solution to their problem. To add to the perceived beauty issue, several severe medical problems result or worsen from obesity, including diabetes mellitus, sleep apnea, weakness, and immobility, making weight loss as an important goal to enhance health not just for cosmetic reasons.
There seems no easy solution, not for any individual, and not for society as a whole.
Multiple studies show weight loss, even in highly motivated people, happens in about 30 out of a 100. After one year, only ten have kept it off, and in five years, only one. I know there are exceptions to this rule, but in general losing weight and keeping it off is a very difficult task.
Repeated studies show that for the most part adopted adults weigh what their biologic parents weigh, not their adopted parents. In the case of body shape, nature wins over nurture, as it seems we are destined to look a lot like our parents.
In addition, it's human nature to eat more than we need, and to rest whenever we are not required to move. That's old-world survival behavior that comes already set into our hard drives. However, it's a new world where too much food comes with too little effort. What’s more, our hormonal and metabolic systems seem to manipulate hunger, metabolism, and activity to maintain or even gradually gain weight, but not to allow weight loss.
Is this overweight destiny completely out of our hands? Does our hunger have to drive us to the fast food restaurant, or could we serve our family smaller portions of a healthier fare, especially with non-starchy vegetables? Does genetics chain us to that couch, or are we still free to get up and get moving with a daily 30-minute walk. Studies show that a heavy person, in condition and eating right, lives as well and healthy as a thin person.
Bottom line: we should not set our expectations toward looking like someone we are not, rather toward living a healthier lifestyle. We should do our best to avoid the up and down and up again weight rollercoaster, which can be harmful physically while worsening self-image. We can choose to realize that beauty is not defined by weight or size. Beauty is ‘health,’ which comes from exercising well, eating right, and then loving ourselves for it.