In the 1980s, Bill Wagnon took hormone injections designed for pregnant women.
He was in his 30s, slumping toward his title bout with middle age and weighed 300-plus pounds. The shots were perhaps the most drastic of measures on his weight loss laundry list. He tried Jenny Craig and Weight Watchers. He went through hypnosis and thought about surgery. He lost a few pounds here and there but never enough to make him choose to stick with a specific plan.
The shots were meant to be a short-term fix, a procedure he kept hidden from everyone. “I didn’t tell anybody,” he says. “They didn’t sound cool to begin with. But there weren’t any side effects. I didn’t grow breasts or anything.”
Despite attempts to shed pounds, he says that his weight had for a long time been nothing more than an afterthought.
Living in Woodland with his wife and working for more than two decades as a chiropractor, he had no real reason to change anything, especially when his efforts seemed pointless.
The “if it ain’t broke” attitude is common among males, experts say, and one probable cause for the growing trend of obesity in middle-aged men. For the past 20 years, studies suggest that obesity rates in women have stabilized, but the battle of the bulge is turning more and more middle-aged men into prisoners of weight.
Some say this trend stems from technology and how the sedentary habits of surfing the Web and watching TV have trumped physical activity. Others point to geography and fast-food chains opening doors for high-calorie diets. There is no easy answer, but one thing is clear: The number of overweight middle-aged men is on the rise.
“It was pretty flat for a number of years through the ’80s, but then there was a bump up. I have no clue why,” says Dr. Judith Stern, a nutrition professor at UC Davis.
Obesity is a condition when excess body fat has accumulated to a point where it could cause health problems. It is defined by a body mass index of 30 or higher. This is different than being overweight, which is defined by a BMI of 25 or higher. Excessive body fat could lead to cardiovascular disease, Type 2 diabetes, high cholesterol, high blood pressure and some forms of cancer. It can also reduce life expectancy, making it one of the leading preventable causes of death in the world.
“Men tend to ignore it until something happens.”
— John Hernried, president and medical director, OTC Medical Group
According to a 2007 study conducted by the Centers for Disease Control and Prevention, adults ages 40 to 59 have the highest obesity prevalence in the country. About 40 percent of men in this age group were obese, compared with 28 percent aged 20 to 39, and 32 percent aged 60 and older, the study found. Because busy professional men traditionally avoid preventative care and have been known to disregard weight issues until something snaps or pops, this obesity trend is alarming.
“Since 1999, there appears to have been a leveling off in obesity among women, but the trend is less clear among men,” says Cynthia Ogden, a CDC researcher and lead author of the study. “We do know however that the gap between men and women has narrowed in recent years with men catching up to the higher rates among women.”
Stern, who is also the co-director of the Collaborative Obesity Research Evaluation Team, says the key cause of obesity is most likely “large portions of high-fat foods and high-sugar foods.”
She might be onto something as recent studies have suggested a correlation between obesity and land use patterns. Some research has shown that in places where there is an abundance of fast food and convenience stores, rates of obesity and diabetes are higher than those with more full-service grocery stores and produce vendors. In April 2008, PolicyLink, the Davis-based California Center for Public Health Advocacy and UCLA’s Center for Public Health Policy Research released a report called “Designed for Disease: The Link Between Local Food Environments and Obesity and Diabetes.” The researchers built on a January 2007 study, which concluded that California has four times as many fast-food restaurants and convenience stores as food outlets that sell healthier fare.
In last year’s report, the researchers constructed a “retail food environment index” by adding the number of fast-food restaurants and convenience stores in a given radius and dividing that total by the number of grocery stores and produce vendors. California and Sacramento have an RFEI of about 4.5, meaning that, on average, residents have four and a half times as many fast-food restaurants and convenience stores near their homes as grocery stores and produce vendors.
“Men look for the fix; women are more willing to go through the process.”
— Caroline Goddard, program director, Lighten Up! Inc.
“Sacramento had the fifth-highest retail food environment index in roughly a dozen cities [statewide],” says Stefan Harvey, assistant director of the California Center for Public Health Advocacy. “In those neighborhoods where there is a high RFEI, there are higher rates of obesity.”
Experts agree that a consistent diet of fast food not only plays a role in obesity but adds health risks to the existing health problems in obese adults. But Stern also says obese, middle-aged men are fighting symptoms of a condition that usually begins long before they enter their 40s.
“We know kids are getting fatter,” Stern says. “Fat kids usually become fat adolescents who then become fat adults. That’s independent of genetics. If middle-aged men are not going to be fat in the future, we’re going to have to focus on the kids.”
Health studies indicate that overweight adolescents have a 70 percent chance of becoming overweight or obese adults. That number bumps up to 80 percent if either or both of the parents are overweight or obese.
For years, obesity wasn’t a major concern until the weight led to other issues. Contrary to women, who experts say tend to want to lose weight for social reasons, men have been reactive rather than proactive when it comes to health.
“Men were continuing to say, ‘It’s not a problem for me; it’s OK,’” says Dr. John Hernried, president and medical director of OTC Medical Group, a regional weight loss and obesity treatment center. “Men tend to ignore it until something happens.”
At Lighten Up! Inc., a weight management center in Sacramento, Program Director Caroline Goddard says many men with weight problems have stayed away from treatment facilities because they don’t like asking for help. “Part of it is ‘I can do it on my own,’” Goddard says. “Help is a perceived weakness.”
At the same time, other men really don’t see obesity as a big issue. Despite potential health problems, Goddard says, they are happy with life, and “it’s exceedingly difficult to get weight off of happy people.”
When a man feels as if he’s got everything going right in his life, she says, losing weight seems futile; especially for men who are always looking for the short-term, get-it-over-with solution.
“Health is a very difficult long-term motivator because rewards are so far in the future,” she says. “Men look for the fix; women are more willing to go through the process.”
But in recent years — coinciding with the trend of higher rates of male obesity — both Goddard and Hernried agree that increased publicity and awareness has led to a reverse trend of more men actually coming in seeking help.
Ten years ago, 10 percent of OTC’s patients were men, Hernried says. Now, 25 percent of the patients are men, mostly 40 to 50 and some even in their 60s.
“Many of them were diagnosed with something and had a heart attack,” he says. “But we can get them out of risk very rapidly. For the most part, men lose weight nicely and easily. It’s great to see the beer bellies go away.”
“There weren’t any side effects. I didn’t grow breasts or anything.”
— Bill Wagnon, self-employed chiropractor
Wagnon, the chiropractor, did not need to wait to see the symptoms to realize the truth. He was already feeling bad when he got up to 335 pounds in his 50s. He was already ashamed that he was in the medical field and usually the biggest guy in the room.
Fortunately for him, the revelation that he needed to get help didn’t come as he lay under a knife on a hospital bed. His moment of clarity came one Friday morning three years ago when Wagnon woke up and walked past a mirror. Maybe it was the lighting that day or perhaps the way he was standing. Wagnon only knows that he looked at himself for what felt like the first time. “I was gray, and my gut was hanging out,” he says.
That morning, he turned to his wife who was still in bed and half-sleep and said, “Name some other 53-year-old that weighs 335 pounds.”
He waited for her response, but she had none. He couldn’t think of anyone either, not healthy anyway. “They were either pushing up daisies or in a wheelchair or they’ve got diabetes,” he says. “What for crap’s sake was I doing?”
Wagnon always knew he was a big man. (“I’m a doctor for Pete’s sake.”) But that morning, he realized that he would have to do something before something had to be done to him. “That,” he says, “was my aha moment.”
His father-in-law introduced him to OTC Medical Group. Wagnon says he lost 11 pounds in the first week and 120 pounds in six months. “I kept losing weight,” he says. “That’s what kept me going.”
Wagnon has been with the program for three years and now weighs 235 pounds. He wakes up at 4:45 a.m. to exercise an hour and a half before work.
“I was not a great exerciser at all before this program,” he says. “I never got into it. I would say, ‘I’m just too busy running my business.’ But that was just my lame excuse for not doing it.”
“If middle-aged men are not going to be fat in the future,
we’re going to have to focus on the kids.”
— Dr. Judith Stern, nutrition professor, UC Davis
Even during the workday, during his two-hour lunch, he now takes the time to do other tasks like visit people and write reports rather than eat. And when people see him, they hardly even recognize him.
“Patients come in and look at me,” he says. “I’ve had people want to know where I went, asking if I was the same guy.” And unlike with the hormone shots, Wagnon tells everyone how he lost his weight.
Waist Land
Land use patterns and correlations to obesity
As walkable communities have gained popularity for their convenience and modern design, they have also grabbed the attention of researchers.
Academic journals and trade groups are exploring the relationship between land use patterns and obesity, using data to push smart growth. Overall, they’ve found that residents in neighborhoods characterized by a mix of uses, connected streets, high-density residential and pedestrian-oriented retail walk more, bike more, weigh less, drive less and pollute less.
“We are at the point where our children are not going to live as long as us. A lot of it has to do with these factors that we are creating, and a part of that is the physical built environment,” says Matt Raimi, president of Berkeley-based urban planning firm Raimi + Associates. “A rich, dense, mixed-use environment promotes physical activity. It influences the way that people live."
So how do neighborhoods in the Capital Region stand up? Many aren’t great, according to walkscore.com, a website that ranks community walkability based on proximity to nearby stores, restaurants, schools, parks, etc. Most pockets of Granite Bay earn fewer than 10 out of 100 walkability points and are dubbed “car-dependent.” East Sacramento addresses are considered “somewhat” walkable and average 60 of 100 points. Midtown is a “walker’s paradise” with 92 points. By comparison, San Francisco has a walk score of 86; Seattle has a 91.
But Jeff Goldman, a principal at EDAW Sacramento, cautions jumping to conclusions on such data.
“There are a lot of studies out there that show compelling evidence that people tend to walk more if they have safe, direct and comfortable routes. I think there is a clear propensity for people to walk more, but it’s not necessarily a direct correlation,” he says. “I don’t think if you increase dwelling density by four times that people are going to walk four times as much.”
— Christine Stanley