Hey guys I’ve always loved how you are trying to improve public health and spread high quality information. I’ve been having some real struggles with finding hope with changing these things though. I say this because of all the issues with obesity, diabetes, etc. our society faces.
I also have read a whole lot about behavior through the lense of Robert Sapolsky’s work through different ways. I have a question about how family history and environment affects behavior. My father recently passed away at the age of 54 due to dilated cardiomyopathy from complications with excess alcohol use. He also had sleep apnea and history of drug use and poor diet as well. I know he had many traumas as a child and also lost his father before he has born. His biological father was only 36 when he died from complications from gall bladder surgery and there likely seems to be some kind of history of cardiovascular diseases as well.
I don’t know all the details but it seems my family also has a history of mental disorders like obsessive anxiety disorders and depression. I think of how stressed my father was as well during his last two years of life and strangely enough his mother died this year at the age of 92.
I have had my issues with obesity and poor diet as well as depression and anxiety, I’m 27 and about 267 lbs with a 44” waist. I’ve had a history of exercising and eating well but I can never seem to do it for long, although I’ve never had real issues with alcoholism or drug addiction, I’ve had this issue for a long time.
I guess my question is, how does my dad become an alcoholic who dies at 54 while his mother dies at 92? Is it just the way genes are expressed in the specific environment they are in? I’m thinking about seeing a different doctor and switching my insurance due to open enrollment coming up since I’m unable to get coverage for anti obesity medications. What kind of physician would you recommend I see? I’m also struggling financially and haven’t worked for 8 months now, living off savings. I’ve also tried talk therapy for behavior change and none of that has really worked.Is it just hopeless? I’ve also struggled with the idea of free will and if any of my behavior change attempts even matter since I’m making decisions and doing things based on more primitive parts of the brain anyways. I know this is a complex topic/question but I appreciate everything you guys do, thanks!
Thanks for the post and sorry to hear about your father passing. I imagine that’s been tough, to say the least. My condolences.
As you might expect, I don’t have an answer to your question regarding your father. Yes, there are genetic influences in vulnerability to alcohol use disorder. It’s currently thought somewhere around 50% of the risk may be attributable to genes. On top of that, there’s environment, personality traits, and cognitive inputs here.
Regarding what kind of physician you should see, it’s likely that this is a decision that will be made for you. Getting in to see a specialist without a referral and no recent visit to a primary care doc is unusual. Establishing care with a primary care physician would be a good idea, perhaps with a referral to mental health professionals. Talk therapy has a broad meaning and I wouldn’t be quick to rule it out as potentially beneficial. It’s like a person running a single program and not getting much stronger, then concluding that exercise didn’t work for them. In any case, seeing a professional is likely to be beneficial.
Regarding free will and behavior, I don’t think this stuff is black and white. Rather, some behaviors seem to have more conscious control and others less. Whether that’s an illusion, I’m not certain.
I seem to remember reading your log that was active for a number of years. You were very consistent and STRONG! Life is challenging for us all, none of us have perfect genetics or environments and perhaps you may have more challenges than the next guy, but that doesnt mean you cant overcome them. I am not one of the Docs you are seeking advice from, but I do have personal experience with alcohol abuse and anxiety. What helped me was to “win the day”… making one small decision after another throughout ONE day. Otherwise I just got too overwhelmed trying to make plans for the future and set goals that were too distant and seemed insurmountable. Once I started focusing on doing the little things throughout the day, they collectively made me feel better. I mean waking up and going for a walk to get some sun. Then preparing a healthy meal. Then looking online for a job and sending just a couple of resumes or applications. Later planning to call mom and just talk for a few. Focusing on these small Activities of Daily Living are what helped me. You will have bad days but once you start stringing more and more productive, good days together, life becomes more manageable.
We met at a seminar once, and while you may have some challenges in your DNA, I can say that you also have some gifts. Focus on the positive and start to make some progress again both physically and financially, and I think you will come around. Maybe some medications are necessary, I dont know, but I do know there are things in your control that you can do today that will improve your situation. Start today with one thing at a time, and good luck my friend!
Thanks guys, I’ve tried to do everything and figure out everything but I think I might just need to keep things simple and take it slow and focus on one thing over a slow time, appreciate the support, haven’t responded here for a while either as this life gets complicated, and Coke yeah I remember the seminar we met at as well, hope you’re doing well too.