I Demand A Refund!

Going out on Saturday morning, pulling a couple of discs from the shelves to play in the car, happened upon Curtis Mayfield doing a live session for BBC Radio 1, back in 1990 (a collectors' rarity, it was nice just now to see the price its going for on Amazon, given that I picked up my copy in a charity shop - how on earth did it find it's way there? Surely, it would only ever have been bought by a fellow collector, and our records do not end up in charity shops. Ever. - for £1 or £1.50). Everything was going fine until we came upon that great song from the Superfly soundtrack, Freddie's Dead. I know it's different from Freddy's Dead, but most unsettling nevertheless. When I got back home, just felt I had to immerse myself in blaxploitation soundtracks for a while: I believe it's rather good for one's soul periodically so to do, so down I most definitely got. Good God, y'all.

In yesterday's Sunday Times, there was a lengthy feature on the work of the 'grandfather of the paleolithic diet' Arthur De Vany, accompanied by a very interesting set of photographs of a naked young cave-woman, who was obviously doing well on the diet. I'd give you a link to the online version of the Sunday Times, but Rupert don't allow no free looks no more. I notice that Arthur charges for access to most of his site too. I know the guy's got a lot of credibility regarding his ideas and that, and that he is an astonishing physical specimen for any age let alone 72, but I'm not sure there's that much taste around, judging by the photos (those jeans, those shoes, etc). That shouldn't make any difference, I know, but it does. It's the way I'm wired, I suppose. However, I really must retract them claws and say that I was intrigued by what I read and look forward to diving into his recent book The New Evolution Diet: What Our Paleolithic Ancestors Can Teach Us about Weight Loss, Fitness, and Aging (a title straight out of the school of Ted Nicholas, but there you go). I suppose there's a bit inside me that doesn't feel comfortable with the rah-rah of marketing hucksterism: as soon as I see people trying to employ the well-honed techniques on me, I start to get very suspicious about how else they might be trying to manipulate me. Maybe I was born paranoid, or was it growing up through the Cold War, or perhaps I never quite got over reading The Hidden Persuaders at the age of 14. Whatever, I respond better when people talk reasonably to me, and get my quills raised when they shout.

I was talking very reasonably one night last week with a consultant surgeon working with the illnesses affecting fat folk in my part of West Sussex.

He seemed to be largely in agreement with the ideas I read over the weekend in Gary Taubes' new book Why We Get Fat: And What To Do About It. It certainly seems that the tide has turned on the simplistic low calories / low fat myth. I always suspect that subtle solutions deliver a truer reading than any broad brush approach, and I'm not convinced that weight loss is really down to a tussle between low cals and low carbs, but the critical importance of carbohydrate limitation is certainly establishing itself as part of the orthodox pantheon, much to the annoyance of the many who have done very well for themselves out of misinterpreting the science for so many years, and thereby living well off the fat of the land.

This is my second time in weight loss (and today is a day of minor celebration: I have lost 112lbs, leaving only 112 to go - downhill all the way to target!). The first time I got within a few pounds of where I wanted to be and plateaued, dammit. That was going down restricting only calories.... I did a bit of research and discovered Dr Atkins (and this was around a dozen years ago, before the explosion). I tried to make the thing work, but had one or two difficulties: basically I couldn't understand quite how to translate what I ws reading to what I had to put on my plate. When I went to my available health care professionals (both mainstream and alternative) seeking advice, guidance and support (you know the kind of helpful thing - no online forums in those days, you see), they warned me to run away from that dangerous charlatan as quickly as I could before he killed me with his dangerous quackery. Gee thanks, you guys. The upshot being I never quite reached where I was going, and, after a period of stability, I started that inexorable climb all over again, double dammit.

My consultant chum told me that, in his profession as a whole - not just his specialism - the big bogie man of the moment is diabetes. OK, this shouldn't come as a bombshell to anyone who's likely to happen along and read this. I suspect that all of us who are committed to radical weight loss are very aware that we are reclaiming our health on a number of fronts, and massively mitigating the risk of diabetes will always be right up there near the very top of the tree.

I first really encountered diabetes when I was around 18. I had a girlfriend (later a distinguished professor of mycology) whose father was a master patissier. He'd go off to work around 2 every morning - usually around the time I too would be leving his house... - and produce the most astonishing cakes, and lots of them. Working for a small independent bakery, his boss let him bring home about half a dozen of these wonderful confections every morning. I particularly remember these puff pastry things with a mountain of whipped cream on top with a big juicy apricot perched on the pinnacle. English bakery-bought cakes are generally awful, disappointing at best. Leslie's stuff was magnificent, and by far the best cakes I've ever eaten in England (when I still used to eat cakes, that is). Trouble is, Les was by that time four years into being an injecting diabetic, and he couldn't eat a single one of the damned things. Bloody near broke his heart. He was a small slender guy. I heard it killed him in his 50's.

[An online search just now tells me that the bakery in question, W G Woods of Chase Side, Enfield, survived the intervening 42 years under the same family ownership, but its empty premises are now available to rent, presumably another victim of the economy and another victory for the conglomerates. Shame.]

The other one that really brought things home to me, was the death a few years back of the legendary John Peel. Here's a link to a rare recording of The Perfumed Garden, beaming live from out on the North Sea on the 12th July 1967, hippie radio at its finest, even if the sound quality isn't. I would have been listening to this broadcast at the time. It was unmissable radio. Peel died very suddenly at 65. He should have lasted forever.

So I've long been aware that diabetes was diabolical, and I'm delighted to have escaped falling in its rapacious maw when I was truly fat. My personal risk recedes with every passing, slimming day. Hurrah, but I step carefully.

Just to clarify, type 2 diabetes occurs when the body doesn't either produce or respond to the insulin necessary to process sugars in food, and being fat is a major factor in it it choosing you as its next victim. The more sugar you eat, the more insulin is needed to deal with it (and to put my personal escape into perspective, around 15 years ago, I almost checked out as a result of a really odd and nasty pancreatitis - nil by mouth for nearly six months!!! - so, I'm more than a little glad my pancreas recovered enough to keep churning out the insulin, despite the relentless, endless onslaught of the grub and booze I was constantly, indiscriminately shovelling down my neck).

It appears that the incredibly clever healthcare prognosticators and the insurance actuaries are all expecting cases of diabetes to triple by the middle of this century. Triple! That would mean a third of adults being diabetic in countries like the USA and the UK. Diabetes is already the number seven killer in the US and looks determined to force its way right up the charts, leaving a trail of consequent heart attacks, strokes, kidney failure, nerve damage, wet gangrene, and blindness in its wake. Nice, eh? Diabetes healthcare in the US already costs $170billion per year. How much by the time the rate (and the costs) have tripled? And who's going to have to foot the bill, and how?

What I was told was that healthcare professionals and their directing bean-counters are petrified of this tsunami of potential cost that's rushing toward them, since all these nasty conditions brought about by diabetes, and of course the diabetes itself, are extremely expensive to treat and manage (and do note the emphasis is entirely on cost: you'll look hard to find evident concern for patient suffering - you know what it's like when you stop being a person and instead become a 'case'). Their largely misdirected attempts to wean us all off our hard-won over-fed sedentary life-styles having by and large failed, they've realised that if they can't persuade us to sort out our weight issues by traditional routes, then they are going to have to come up with something radical, effective, and cost-effective.

And they have.

Going online and searching out the costs of having a gastric band inserted, it looks as if you'll be spending around £5000 on laparospic surgery, though I imagine that a flight to Warsaw, Budapest or Bombay might reduce that to, say, £3k if you're lucky.

It seems that it might only be a matter of a very little time before, for instance, the National Health Service in the UK as well as the leading private insurers such as BUPA will be routinely offering gastric bands to their overweight customers because, although they can be circumvented, on the whole the things work and do what it says on the tin insofar as weight loss is concerned. They have taken the decision that the costs of providing gastric bands ad lib is likely to slash their overall spend by substantially mitigating the diabetes flood-tide and the nigh-on unfathomable costs associated with it.

Well, I don't know how you feel about this but I'm a little ambivalent. Actually, no, I'm downright miffed. I've been hard at this diet since July, not done too badly, racked up some substantial costs in uninsured fees to LighterLife at £70+ a week (don't begrudge it), generally behaved myself and controlled my eating, cut out the booze entirely. Put in a bit of effort.

Meanwhile all these fat and feckless ne'erdowells and hobbledehoys who haven't taken a moment's responsibility for managing their own circumstances and shifting their own lard, they are going to be entitled to waddle along to their quack and get themselves signed up for surgery either on the NHS or through their insurer, but in either event being funded by me, through my NHS contributions or my health insurance premiums.

I don't mind, and that. I wouldn't wish the diabetes on anyone, if you know what I mean. It's just that, I'm not mean or petty but what are they going to do for those of us who've already taken the initiative and got ourselves sorted out ahead of the herd? I think we, you know, deserve a refund, or something, in recognition of our valiant efforts. I mean, don't you think, it would only be fair. On the one hand, we're each of us saving them a whole pile of money and paperwork, and on the other, we're helping them fund other people's health care: isn't that good of us?

[Parenthetically, in all the recent toxic debate in the States about 'socialist medicine', people seem to have overlooked one thing: in both an insurance-funded and an NHS-funded medical system, the same rule applies - mutuality. The money gets pooled, and spent in response to perceived need. The only really individualistic private medicine occurs when you turn up with a fistful of dollars - hard cash - and say, 'cut my leg off, Doc.' Private insurance and state-run insurance are basically the same thing, and the individual has to be prepared to tussle with a parsimonious bureaucracy in order to get out of whichever system that which they believe to be their right. Or am I completely wrong-headed on this one, too?]

Private insurance or NHS, somehow, I just don't see either the mandarins or the bean-counters hurrying themselves to hand down the largesse like an inebriated Oofy Prosser on a spree, so perhaps we'd best console ourselves by noting that, as a result of our brilliant foresight and persistence, we have managed to avoid the scourge of diabetes as well as the indignity of laparoscopic surgery.

Of course, much of the advice in favour of the gastric band is coming from people who will themselves benefit by making, selling, inserting and managing the things (and correcting them when they go wrong). The healthcare industry and professionals. I'm not cynical. Honest.

Might there not be an even cheaper alternative? Stop pedalling the government-approved overly simplistic 'low calorie, five-a-day, high fibre, high carb myth'. Stop bolstering the sugar-laden processed food industry. Sack all this badly-trained generation of incompetent and ineffective nutritionists*. Devise and initiate a high intensity programme of teaching people the truth about their dietary requirements? Back that up with appropriate legislative mechanisms. Or does that sound either too much like hard work, or too opposed to engrained vested interests? And isn't it on a par with the treatment we've rightly been handing out to the toxic tobacco industry for years?

[* Query: given that UK hospital nutritionists talk to their customers in terms of aiming to lose a good and steady (mighty!) 1/2lb a week, what damned good is that if, like me, you were 224lb overweight? That's a little under 9 years to dump the load. That would keep a chap motivated! And that, of course, is assuming that 1/2lb a week actually worked: one recent study showed a GP-directed average loss of 6lbs! IN A YEAR!!! Which would have taken me 19 years to lose what I've already lost in 5 months. Nearly 38 years in total to get to my target weight. I'd be 98 by then. Only I wouldn't be, because I'd have died - in my early sixties; basically any day now. Give me strength! That's why I use the word incompetent. Sack them.]

While you digest that lot, and contemplate how other people decide to spend your money in both the public and private health care sectors, there are worse things to do in this world than enjoy the lamentably late Kenneth Williams and the still extant Lance Percival in the not entirely irrelevant bank robbery sketch from the West End revue One Over The Eight, written by the equally lamentably late former Greatest Living Englishman, Lord Gnome himself, Peter Cook (aetat 21!!!). 1961. Unmissable.

Missing you already till the next time (and looking forward to reading your comments in the interim),

Your old rugged pal,

Fred