Fat

One of the things that stood out to me in America, and especially in Florida, was that footpaths were clogged up with wheelchairs and mobility scooters. What was surprising is that it wasn’t disability or old age that was keeping people in their chairs, but obesity.

Now, I’m aware that making such an observation is potentially judgemental and mean-spirited. There could be any number of reasons that an overweight person relies on a mobility scooter or wheelchair, and it’s not always clear which comes first, weight gain or injury/disability. Fat shaming is as bad as any other form of discriminatory abuse, and it’s made worse by my hypocrisy; by the fact that I’m a long way from being a Victoria’s Secret model myself. Whatever its cause, genetic or contextual, I suspect that most of the fat people getting about in chairs are as trapped in the psychological despair and cultural shame of their obesity as I am by the physical constraints of spinal cord injury. Even so, I confess that seeing people squeeze into chairs bugged me. I’m not sure whether I resented the fact that people had ‘chosen’ (as if anyone really has free choice) to live in a chair, and by doing so wasted the opportunity to exercise by walking, or that I was projecting the fear of my own weight gain upon those who shared my mode of transport.

Body pride (and its opposite, body shame) is really a strange conceit. We don’t make ourselves or shape our own form (even though we might have some influence on our body’s condition and tone), so we’re not really in a position to take credit for our own beauty or ugliness. Even so, pre-injury, I was one of those people secretly proud of my body; tall, slim, relatively athletic – I didn’t look too bad for a middle-aged man (at least that’s what Elly used to tell me). Since my injury, though, I’m loath to look in the mirror. One of the odd consequences of spinal injury is that my abdominal muscles have wasted away, resulting in a potbelly, and this is made worse by the fact that it’s difficult to exercise. As a result, I look as though I enjoy too many beers after work. While a round stomach may be beautiful on pregnant women, it looks hideous on me – especially as it sits underneath love handles and a sunken chest. Seriously, I try to keep my eyes shut when there’s a full-length mirror and I’m naked in the bathroom (pity my poor carers who have no choice but to look). I’m not generally self-conscious, but I hate my gut.

Seeing all these weighty people melting into mobility scooters has reminded me afresh of the danger of life in an electric wheelchair; that lack of movement and exercise puts me at substantial risk of obesity. It’s one of those frustrating ironies of life – that one of the things that spinal cord injury hasn’t stole from me is the ability to enjoy good food and drink, but it’s precisely in this area that I need to exercise self-control. The issue is not merely an aesthetic one. Obesity is the primary cause of heart disease, and fat people suffer constricted and shorter lives. In my case, there is the added strain that weight gain would place upon my carers, who already have the difficulty of shifting my nearly 100 kg frame. More importantly for me, research suggests that exercise (and weight gain) affects our brains. My son is studying psychology at University, and he’s had me reading books on the brain. If you’ll forgive me a lengthy quotation, In Brain Rules (a book I highly recommend), Professor John Medina notes:

A lifetime of exercise results in a sometimes astonishing elevation in cognitive performance, compared with those who are sedentary. Exercisers outperform couch potatoes in tests that measure long- term memory, reasoning, attention, and problem- solving skill. The same is true of fluid- intelligence tasks, which test the ability to reason quickly, think abstractly, and improvise off previously learned material in order to solve a new problem. Essentially, exercise improves a whole host of abilities prized in the classroom and at work.

Your lifetime risk for general dementia is literally cut in half if you participate in physical activity. Aerobic exercise seems to be the key. With Alzheimer’s, the effect is even greater: Such exercise reduces your odds of getting the disease by more than 60 percent.

All of the evidence points in one direction: Physical activity is cognitive candy.

The benefits of exercise seem nearly endless because its impact is system wide, affecting most physiological systems. Exercise makes your muscles and bones stronger, improving your strength and balance. It helps regulate your appetite, reduces your risk for more than a dozen types of cancer, improves the immune system, changes your blood lipid profile, and buffers against the toxic effects of stress. By enriching your cardiovascular system, exercise decreases your risk for heart disease, stroke, and diabetes. When combined with the intellectual benefits exercise appears to offer, we have in our hands as close to a magic bullet for improving human health as exists in modern medicine. So I am convinced that integrating exercise into those eight hours at work or school will only make us normal. All we have to do is move.

This is seriously challenging stuff, especially for those of us who spend their days in an electric wheelchair, but value the health of our brain. Most people at least manage to get incidental exercise, walking around the house and between venues. But if I put in the typically recommended half hour each day walking the dog, I don’t gain much from the effort of pushing my wrist against the joystick.

Even so, I can exercise. At home, I can strap myself to the arm crank and pedal. I also have a multi-exercise weight contraption that I can use with the help of my kids (Jake is a hard taskmaster). It’s honestly not much fun – I have to fight through spasm and I don’t seem to make much progress. But when I’m home, I’m pretty diligent, getting into it most days, probably because I’m scared stiff of getting any fatter. But I didn’t exercise while on holidays, and I must have set in place some bad habits, because I’ve not done much since returning home – and I’m feeling a little guilty.

As I’m writing this blog, I’m reminded of several images; being squished onto an elevator with a middle-aged woman in a mobility scooter wearing a Hawaiian shirt with enough real estate to give me a panoramic view of pine-tree lined beaches; a man on an airplane who was so large he travelled with an attendant carer; a queue of scooters and chairs waiting for a lift for 20 minutes while the adjacent stairway beckoned. It has given me incentive enough to eat wisely today, and to return to my habit of daily exercise.. In fact, I think I’ll probably miss the mobility scooter trend, since I’ll have to find motivation to watch my diet and exercise elsewhere – I might even have no choice but to open my eyes and look into the wretched bathroom mirror.