Fruitcakes: You who think diet pills work

I love fruitcake. Does that make me odd? Hey, anything soaked in rum long enough tastes like– well, rum! Yum, yum! I'm starting to tell all my patients, "If I see you before the holidays, make sure you bring me fruitcake– and your co-payment. Haha."

Most patients frown and say, "I'll gladly give you any fruitcake given to me as a gift." However, there's always the 1-in-100 jewel of a patient who says, "I make killer fruitcake." My immediate question is, "How long do you soak it in rum?"

Are the holidays all about eating?

I hear from my patients that I'm one of the rare doctors who actually comment (nag, complain, bicker) to chubby patients about their weight. I give every patient an "instruction sheet" with information about their visit: blood pressure, medications, medical issues, health maintenance tasks– and weight. People can't weight to see their weight typed in black ink. I've been fondly called "The Weight Nazi" by some patients. No Fruitcake For You!

 Now if I wanted to keep my medical practice more successful and busier than ever, I would serve fried chicken and Twinkies in my lobby. But I don't, because I'm into preventive medicine and want people to be healthy.

Two-thirds of American adults and over 20 percent of kids are overweight or obese. Children born after the year 2000 have about 45-50 percent lifetime risk of developing type II diabetes due to being overweight/obese. So I think I have the right to "encourage" patients to exercise, eat well, and live with a healthy weight.

What is a healthy weight? For those who are heavy, a "healthy weight" is something that is much higher than what I calculate it should be. I use body mass index (BMI) and percentage of body fat to determine a target weight for the patient. The response I almost always get is, "What? I haven't weighed that since I was an embryo! I'll look like I have cancer, AIDS, malaria, and bubonic plague all together if I weigh that. I'll look like Kate Moss on crack. You're just too skinny to realize that I look awful at that weight and will feel awful."

Feel awful? When someone is taking five million medications for high blood pressure, diabetes, arthritis, heart disease, high cholesterol, headaches, and skin problems, they aren't feeling that hot to start with.

I'm not skinny, by the way. I'm fit. I exercise five to six times a week including weight lifting, aerobics, and figure skating. Brian Boitano and Michele Kwan, eat your heart out!

So I strongly encourage people to exercise. Working out twice a week just isn't making the grade. Guess what the usual response to exercise is?

"Exercise? What vulgar language, Dr. Hong! I don't have time to exercise, so give me a pill that will make me lose weight." (I have a bridge in Brooklyn I can sell you. There is no pill!) Diet fads and pills fail 98 percent of the time within three years– at which point people frequently weigh more than they did when they started.

With the holidays around the corner, I know people are going to say to themselves, "I'll drink as much eggnog and eat as much ham as I can, and then I'll exercise and eat right after New Year's." I'm not against eating delicious foods, but I am against eating out of control. A portion of food should not be as big as Alaska.

NBC has an amazing show, The Biggest Loser. I think The Biggest Loser should be shown in every classroom, every break room, every vendor machine, and especially every grocery line. Watching The Biggest Loser should be tax-deductible. The morbidly obese contestants lose weight through hard work and lifestyle changes.

No gastric bypass surgery. No pills. No excuses. No fruitcake.