agonyaunt | (no subject)

(no subject)

My husband, 53, finally stopped smoking after 30 years — not because of my prodding or refusal to buy him cigarettes (which he called self-righteous), but because he could no longer breathe easily. That was two years ago. Since then, he has gained a lot of weight. He is now obese, according to the body mass index. He can’t even bend over to tie his shoes. His father and uncles died young, and I am worried about him. Still, he expects me to buy him highly processed junk food when I go shopping. I see this as a slow death wish, and I want no part in it. Is it reasonable for me to refuse to buy fattening, sugary treats without nutritional value? He can always buy them himself.

SPOUSE

I sympathize with your worries and even with your frustrations about your husband. (You love him!) But your tone strikes me as a bit harsh, and that may not be productive here. In all likelihood, you made the choice to marry a smoker long after the harmful effects of cigarettes were well known. Yet I detect no “Hurray!” in your report that he finally kicked the habit.

I hope you can applaud your husband’s healthy choices — even if they don’t happen on your timetable. Breaking addictive behaviors can be rough, but he did it. It sounds as if he may now be compensating for the loss of cigarettes with sugary snacks. That’s not uncommon.

If I were you, I would try to shift from policing his diet to giving him more positive reinforcement. Go with your husband to his next doctor’s appointment or encourage him to meet with a nutritionist. That way, you can cheer his healthier choices, consistent with their recommendations, rather than carping about missteps or refusing to be complicit. Your husband knows he’s fat. No need to remind him. Finding a way to support him, though, may be a big help.

https://www.nytimes.com/2023/04/12/style/my-husband-is-obese-can-i-refuse-to-buy-him-fattening-snacks.html

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1. I refused to get my mother cigarettes starting from the age of six, and I stand by that decision. She was, after all, able to get her own until the start of the pandemic, when she finally quit. If LW really feels morally opposed to buying this or that, Husband surely is capable of buying his own things. Perhaps they should alternate shopping. However

2. The issue here doesn't seem to be that LW is morally opposed to chocolate or whatever, but that LW thinks Husband is a fat fatty who just needs more self control, in which case, somebody ought to remind LW that tobacco is an appetite suppressant.

3. Also, I'm just going to say, I don't know what exactly Husband is eating, but LW does not seem to have the healthiest relationship to food I've ever seen in an advice column.

Oh dear sweet goddess, I want to yeet the whole notion of "self control" into the photosphere.

It's right up there with "personal responsibility" for me.

Isn't it well known that nicotine induces weight loss and that a common effect of stopping smoking is weight gain, not necessarily because someone changes their diet but because they no longer have nicotine in their system? Or am I misremembering?

Also, LW sounds fun.

You'd think it would be well known, but I think it's not?

Fun fact: France has a much higher tobacco consumption rate than the USA. Anytime somebody starts to tell me how the lifestyle in France or the parenting in France or the food in France is much healthier because, after all, they weigh less, I bring that up.

Has anyone ever charted the decline in smoking in the US over recent decades against average weight? I bet it would be interesting.

LOL! Probably!

Though, to be fair, I doubt that's the primary cause. Did you know that zoo and lab animals have gained weight over the past four decades?

Probably not, but I wouldn't be surprised if less smoke is a notable part of it! It would make a nifty correlation anyway.

There's definitely a lot of causes but I've strongly suspected for awhile that a main reason is just that people are generally healthier (for many reasons), and have been for several generations now, and being healthy makes it easier to put on weight (even people who aren't "healthy" are probably better off than they would have been with the same condition even thirty years ago) - have you seen the studies where average body temperature in the US has also dropped significantly because people aren't constantly running a low-grade fever from infection anymore? (That would probably also cover a lot of what's up with lab and zoo animals, because we've learned to care for them better and put a lot more effort into doing it well.)

My working theory is that the weight gain on lab animals (which have had controlled conditions for the time period, same food, same labs, same treatment, same meds, in long range studies) means it's something in the water, and we know that tap water is full of both microplastics and medication now, so it's probably one or both of those. (Both of those hypotheses are being studied, I believe.)

Microplastics and complex organics and BPA and so on in the water supply are all very scary, it's true, and we only have the very beginning of understanding what they do.

But I feel like there's a tendency to skip right to "cause of the obesity epidemic is BAD SCARY THING" when what has actually happened is that average American BMI has gone from 24 to 27 over the last 50 years, and people with a BMI of 27 actually live longer and are generally healthier than people with BMI below 25, so just as much of the shift is probably on fewer unhealthily underweight individuals. You don't hear people blaming increased heights on hormones in the water, for some reason!

So it could be microplastics in the tap water, but if they're not filtering the water they're probably not filtering the air, and lead levels in air and dust (and water) anywhere near American roads has dropped dramatically in the last fifty years, and lead poisoning causes difficulty in weight gain even in minor amounts (also I wouldn't make any bets on whether there was tobacco smoke in the animal labs in the 70s...) And no matter how carefully you've controlled procedures, cultural shifts have meant that I bet your lab techs are handling the animals with more care toward emotional comfort than they did before, even if it's minor things like talking to them differently as they're handled, which would lower stress. And even if you have filtered air and water and made sure all animal handling and medical care was identical, it's not the exact same animals, and even if you've controlled for genetic drift, there's increasing evidence that generational epigenetic effects lead to the parents' and grandparents' level of care and stress changing children's phenotypes.

So it could be bad scary new things; it could be that most people (and lab animals) in the US are now more generations away from trauma and starvation and old-fashioned pollution than they were a few generations ago.

Edited 2023-04-27 15:28 (UTC)

yah, just to be clear: in my context, I strongly do not think the increased weight gain of the population and of animals is a bad scary thing, and I feel strongly that all the obesity is rising!!!eleventy! fear-mongering articles ignore the fact that, until covid, global life expectancy had been rising since the industrial revolution. As you say! And in countries with functional health care systems that aren't plagued by a form of racism where white people would rather live in poverty without health care then live in comfort if black and latinx people get healthcare as well, it still is. Life expectancy has rebounded in most wealthy countries. Again, as you say.

So when I say "weight is increasing in ways that might be connected to microplastics or medication" (or for that matter air pollution), I'm not in any way referencing a bad scary thing, I'm observing something interesting and wondering what we will find to explain it. Air pollution, epigenetics, etc could explain it too.

In an outside-of-dw context I would be way more careful in how I talk about it but in general I feel like DW and this comm in particular are a safe space to assume that most people don't think fatness equals poor health, poor morals, or lower life expectancy, so I don't need to ObDisclaimer the post.

Oh, no, fair enough, and for the record that I didn't read your post as scare-mongering, I was just pointing out a general tendency about this overall that I tend to rant about. And how much we just don't know about what "normal"/healthy is - all the body stats (not just weight) we've been taught to consider normal have been based on measuring small populations of people in really time-dependent conditions. (Like, I'm still mad about vitamin D deficiency too, if you're doing studies showing that 50% of healthy young people with no symptoms who take in lots of vitamin D in their diet, are deficient and need supplements, maybe the problem is in your standard and not in the population you tested???)

I am in fact kind of scared about the things people are finding in the water that we don't understand, but then I think about all the things we found in the water around when I was born that we *do* understand, and I feel better (until I read about all the politicians trying to put them back.)

They have, and concluded that only a small proportion of weight difference is likely to be from smoking cessation. (There have also always been a considerable population of people who've never smoked, and their average weight has gone up as well.) But I think for a minority of people coming off tobacco there's a diversion from one obsessive activity to another, and he may indeed be substituting snacks for tobacco. Whether that's actually what's causing his health problems if any is not necessarily clear. There are thin people who do the same thing and don't get crap for it because they don't gain very much. (There are also a whole lot of people who suddenly gain weight in their mid fifties without having stopped smoking or changing their eating habits.)

Personally I am a big fan of making deliberate lifestyle changes TO do things rather than framing everything in terms of quitting this or that. So not so much on the "never eat cookies" but rather "what would make it easier to get a good amount of fruits and vegetables," and not "never sit down," but "what would make it easier to take walks or go swimming or something."

Also it's not just the appetite suppression, but the fact that nicotine is for many people a fairly effective anti-anxiety med. People who are anxious and jonesing often eat erratically. Getting disapproval from a spouse is, shall we say, not conducive to being less anxious.

Fair, but the considerable population of people who've never smoked are still being exposed to significantly less smoke in daily life! (It would probably be hard to separate that from overall air quality improvements, though.) I'll have to look for some studies.

But yeah in terms of the LW it's pretty much irrelevant - part of it might be quitting smoking, part of it might be choosing snacks instead of tobacco, a *significant* part of it is probably that he's *having breathing issues*, which is probably resulting in reduced activity levels, sleep disruption (which can cause weight gain) and probably also other health issues related to whatever's causing the breathing problems (like, I know people who are very, very obese, according to BMI, and some of them put it on over just a few years, but they can all tie their shoes; he probably has stuff going on other than just weight gain due to increased calorie intake.) And stress and anxiety from all of it put together, which spouse is not helping.

Nicotine often acts as an appetite suppressant, so yeah, people who quit smoking are very likely to gain weight in the process.

Certainly true for me when I quit about 20 years ago.

You remember entirely correctly.

I didn't know this. I thought people quitting nicotine tended to snack as a substitute for the cigarettes. Something to do, I guess.

That's not not part of it, but also, tobacco reduces the appetite.

I got on my mother's case about this so much when she was going through chemo, btw, in a way that in our family translates as "friendly joking" rather than "being mean to a sick person". I kept asking "If you have to smoke, why tobacco? Why not something which will improve your appetite?" (She lost so much weight, it was terrifying.)

She did, actually, have an answer for that. Apparently, she lived so far out away from all her friends in high school that by the time she got to the party, everybody else was already high. At which point, it just doesn't seem very fun, not like, presumably, getting high with the crowd.

My understanding is that sometimes people replace one habit with another but that it should not be. Assumed of any given person.

“Go with your husband to his next doctor’s appointment”

Unless the problem is that you believe someone is mentally incompetent (dementia, etc.) and want a doctor’s neurological assessment, I have a hard time imagining any reasonable reason for one grown-ass adult to invite themselves to another grown-ass adult’s doctor appointment. If your husband wants you there, he’ll tell you, LW—-but it sure doesn’t sound like he wants you there.

Um. It's totally normal in my extended family for several family members to go to a doctor's appointment. YMMV.

Uninvited? Without the consent of the person having the appointment? Because that’s what the columnist is proposing, and any doctor I’ve had would boot them out of the office if they weren’t there by the invitation of the person whose health was under discussion. It’s a blatant violation of medical privacy laws to barge in on someone’s doctor appointment against their will.

I read it as giving LW's husband moral support.

I apologize; I was missing that context. No -- certainly only with permission for sure.

I have kind of mixed feelings here.

OP has an unhealthy relationship with husband's consumption habits ["my prodding or refusal to buy him cigarettes (which he called self-righteous)," "I see this as a slow death wish, and I want no part in it"] and needs to let go of the delusion that dying young is a punishment for breaking rules and if you behave properly you're safe.

There's obviously already a control issue in the relationship, which would be the subject of the conversation where the husband said "self-righteous."

Best case, you introduce a lot of pointless bitterness and conflict into a relationship when you try to control someone's consumption; worst case, they try to regain control of their lives by breaking your rules to spite you. Ask my about my teen relationship with my mother some time.

But on the other hand ... well, I wouldn't buy anyone cigarettes, either.

Still, from a practical perspective, I think what would be least harmful would be for OP to back all the way off. Buy what's on the list, say nothing about what anybody eats, let the husband work out his appetite and his health by himself. Possibly split up cooking and grocery shopping chores between the two of them, to take the OP out of the position of Manager Of The Kitchen.

On one hand, LW does not have a kind or productive attitude. On the other, her concerns are not unfounded, and I have a hard time arguing that she is obligated to buy unhealthy snacks. I guess she has to figure out how her decision will affect her relationship and whether it’s worth the cost.

Yeah LE is both right in some ways and wrong in others. To oversimplify.

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