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Coming up on "Life (Part 2)," "The Boomer Belly." Why the most informed generation in history has such a tough time losing weight, and what to do about it. And later, he may just be     the most likeable politician in America, Governor Mike Huckabee on losing more than 100 pounds and gaining confidence. Plus, "Vanity Fair" writer Maureen Orth on her personal role model for healthy and sexy aging. All coming up on "Life (Part 2)."    

(woman) Major funding for "Life (Part 2)" was provided by The Atlantic Philanthropies-engaging many to improve the lives of and achieve health and economic security for older adults. And by MetLife Foundation-- celebrating the wisdom, talent, and experience of older adults. MetLife Foundation proudly supports "Life (Part 2)."   

[bass, & plucked strings play in playful rhythm; bright in tone]   
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(Robert Lipsyte) Welcome to "Life (Part 2)," I'm Robert Lipsyte, and I've prepared all my life for Boomer belly and geezer gut. I was a fat kid. How fat? I had my own zip code! You see, I learned early to make jokes about myself before you did. I became a fiction writer, so I could create worlds in which skinny people died horribly. My wife Lois, who writes about mental health, thinks that inside whatever body I'm wearing, Bobby the fat boy lurks, hungry for positive attention and comfort food. I think Lois is right. I think all of us who were, in our own minds at least, too fat or skinny, tall or short, somehow unhappy inside our skins as children carry that trauma into adulthood. Now, while I sympathize with the Boomer search for svelteness, I really think we're wasting money and energy on diets and shrinkage when we should be trying to expand our understanding of why Boomers are, in Michael Pollan's words, "the best-fed and worst nourished generation in American history." Now that's a shame, but the obesity of our children is a crime. We just roll over for the fast-food industry. We stuff fatty burgers into whiney mouths for our convenience. Meanwhile, we allow school gym periods to be cut. Well, if the kids survive, when they grow up they can go on the latest fad diet and get a personal trainer as we do, and if we're lucky they'll forgive us for not having done our job. Science tells us it really is difficult to control our weight as we get older. Biology, psychology, our consumer culture, the diet industrial complex are all conspiring against us. But we've enlisted support in our struggle. Clinical Psychologist Patrick O'Neil is a Professor of Psychiatry and Behavioral Sciences at the Medical University of South Carolina in Charleston. Jennifer Lovejoy is Vice President of The Obesity Society, the premier North American organization for obesity research. She's also Executive Director at Free & Clear, a private health organization that uses cognitive behavior to change eating habits. Dr. Michael Jensen is Director of the Obesity Treatment Clinic and a Professor of Medicine at the Mayo Clinic. Welcome everyone to "Life (Part 2)." An intimidatingly trim bunch here, so you will probably will not be able to answer my first question personally, but professionally. 55 years old, never really had a particular weight problem, and suddenly you do. This seems kind of common. Why?

(Dr. Michael Jensen) Things slow down when you get older, except maybe your eating habits. So if you eat the way you've been used to eating and yet you're not burning as many calories, it seems like quite an abrupt shock that you seem to be doing everything you used to and now you're gaining weight. But I think in truth, people aren't doing everything they used to, they are burning fewer calories, and there's the lag time between the realization to make some thoughtful, mindful changes as opposed to just doing what comes naturally.
 
(Robert Lipsyte) So the Boomer belly really does exist, but we could be doing better. Is it different for men and women?

(Jennifer Lovejoy) Yeah, I was going to say the other thing too, particularly for women, is menopause. So in our research with women going through the menopause transition, we've found that with the changes in hormones, women drop about 100 to 150 calories a day. They burn fewer calories than someone their same age who hasn't gone through menopause. So there's this very abrupt hormonal shift. Men have hormonal changes with aging too, but much more gradual over a much longer period of time, and so the weight tends to creep on as opposed to what women many times experience between 45 and 55 where suddenly there's a lot of weight, and there's particularly a lot of weight around the middle. So hormones definitely play a factor.

(Robert Lipsyte) That middle, that's the apple versus the pear. Could you demystify that for me, the fruit complex?

(Jennifer Lovejoy) The fruit complex! The weight that we carry around the middle, and it is the Boomer belly because as we age, as our hormones drop, as things shift, we tend to deposit more of that weight around the middle, and it's a concern because that is the kind of fat deposit that's associated with more health risk, higher cardiovascular risk, higher diabetes risk, and so we're worried about that even in someone whose absolute amount of weight may not be that high. Maybe they're 15, 20 pounds overweight, but if they've got that apple shape, we've got to be concerned because of the higher health risks.

(Patrick O'Neil) But that's a form of fat distribution that's much more common for men too, which is the other issue.

(Jennifer Lovejoy) Well, before menopause though, after menopause it shifts. So younger women have less to worry about because the fat distribution tends to be more pear. Men have the apple, they're at higher risk. After menopause, suddenly women are getting this apple distribution, and lo and behold their risk for cardiovascular disease goes up to be like men. The risk for diabetes and all of that changes. Again, that sudden change at midlife that if you keep doing what you did before, it's not going to work.

(Robert Lipsyte) You've suggested that men are not as attentive to this as women.

(Patrick O'Neil) Men tend to pay less attention to their weight, I think. They tend to define themselves less in terms of their weight compared to how women see themselves.

(Robert Lipsyte) As a famously formerly fat kid, while I hate to be overweight, I'm not shocked when it creeps up on me. Is it harder do you think for people who do not have had-- I mean a skinny guy like you, if you suddenly got fat, you'd be shocked. You'd do something about it.

(Patrick O'Neil) I actually think "creep" is the operative word here because a lot of the obesity or the increase in weight that we see in middle age is sometimes a creeping obesity, where it's 5 pounds here, 10 pounds there, and I think people tend to ignore it or rationalize it away. One of the rules of thumb that we give our patients is that it takes about 3500 excess calories to create one excess pound of body fat, and if you work back from that math, eating only 100 extra calories a day or drinking 100 extra calories a day above what you burn...

(Jennifer Lovejoy Or having your hormones causing problems.

(Patrick O'Neil)...or having your hormones cause you to be out of whack by 100 calories a day, at the end of the year you could be the owner of 10 brand-new pounds of body fat.

(Robert Lipsyte) One of the things that I found with myself is that after a perceived insult, something not quite going right, I would go to the refrigerator. I would give myself, I guess, some sort of assuaging treat or gratification. Is that common?

(Patrick O'Neil)Prozac on a plate? Sure, lot's of people turn to food.

(Robert Lipsyte) "Prozac on a plate?"

(Patrick O'Neil) Lots of people turn to food for comfort, for reward, for distraction, for entertainment. Food serves all these other purposes in our lives, in addition to nutrition and nourishment.

(Robert Lipsyte) Now, somehow that seems harder to change, that kind of behavior. To be constantly mindful of why you are eating something and it has nothing to do with hunger.

(Patrick O'Neil) It's difficult unless you can identify what those specific cues are and then try to find some other way of obtaining comfort or obtaining reward or gratification.

(Jennifer Lovejoy) It's human nature to want to maintain the status quo. It gets back to the creep idea as well. And when I started getting the creep as I got a little bit older and was beginning to deal with some of the hormone changes myself, it was wow, what do I have to do differently? And fortunately I was primed because this is why I got into obesity research and menopause research, so I'd be prepared when it happened.

[all laugh]

I'd know what to do. So I kind of knew what I was facing. But you do have to change, and suddenly I'm looking at well, what do I have to do differently here? Gee, I gotta bump up my exercise. I have to change a little bit of the way I'm eating, and not just eat less, but eat different types of foods. So I'm-- eat more  fiber, stay more full, do more protein, kind of mix things up, and we're resistant to that. Even when we can look at life and say, well, of course. Logically, we don't expect that throughout our whole life from birth to death that everything is going to stay the same, day to day, hour to hour. We'd like things to stay consistent and not to change; we resist change. So I think to really be successful as we age in maintaining weight, we've got to accept that constant change and look at, what do we do now? Someone recently said to me that being healthy is not a birthright. It's something we have to practice every single day. And I think that practice changes dramatically over time and certainly as we go through midlife and aging.

(Patrick O'Neil) The other issue about needing to make changes and how important that is is not just the change is necessary to lose weight, but the change is to maintain that weight loss, because so many people look at a weight loss effort as something with a beginning and an end after which they revert to baseline behaviors, and we know from lots of experience and lots of data that doesn't work.

(Robert Lipsyte) We kind of concentrate here on Boomers, Pat, and there seems something paradoxical here. On the one hand, this is supposed to be the most entitled, self-indulgent generation in American history. So how would they lose weight? And on the other hand, it's a generation that tries to be in control, even in full control, but can't control itself-- they're fat.

(Patrick O'Neil) It's very difficult to handle weight as you go through middle age and beyond, so it's not unique to the Baby Boomer generation. But I think if you look at the combination of perhaps a lifelong pattern or expectation of being able to get gratification fairly quickly, fairly immediately and easily and a world which now offers excess gratification in the form of food and beverage with very high calorie content, it really does look like those two things can come together and create a problem.

(Robert Lipsyte) Well, other than eat less, walk more, could we have some tips, some Boomer tips?

(Dr. Michael Jensen) I usually try to talk to people about what is your life going to be like? How are you going to live at your good weight? What are you going to be doing; what are you going to be eating? Then we look at where they are now and say okay, how do we move you from where you are now to where you want to be, and let's take the first step or the first couple of steps. You're not going to get there all at once. We're gradually going to make changes in eating habits and activity habits, so that by the time you get to where you want to be, you're used to doing what you need to do to stay there.

(Jennifer Lovejoy) I think it's one of the keys things to address upfront is, what are the person's expectations of what life is going to be like, and if they're completely unrealistic, as is often the case, to do some upfront education and reframing and rethinking, partly because that can have immediate benefits. I think the other thing in terms of Boomer tips and the piece-- because it's not just all about eating less and moving more. I think we've overemphasized that because we know it's important, but it's too simplistic. We've got to look at the bigger picture. Stress is a huge thing, and we know that particularly at midlife, stress levels spike. We're dealing with aging parents, with younger kids. Maybe we're becoming grandparents, taking care of our children's kids. There's all this stress going on, and the stress in and of itself, both the stress hormones that get released as well as the psychological aspects of stress, really contribute to weight gain. And so to look at simply nutrition and exercise without factoring in the stress piece, without factoring in the bigger picture of what are your goals, what are your values, what do you really want to do, is unlikely to be sustainable for the long run.

(Patrick O'Neil) Well, one of the things we try to encourage our patients to do is actually set up some rewards for themselves that they can give to themselves immediately or shortly after meeting one of their behavioral goals. So if I go out and walk 4 days this week for at least 20 minutes, then I'll rent a DVD that I wanted to rent, or I'll go out and buy the CD that I wanted to buy.

(Robert Lipsyte) And speaking only for myself, only for myself, I think that my weight issues really come from lack of willpower, from self-indulgence, and from refusal to eat mindfully, and having made that concession, from here on in, I'm only going to eat with you guys [laughter] because you are the trimmest panel we have ever had! Thank you so much for joining us on "Life (Part 2)."

(all) Thank you.

(Robert Lipsyte) One famous weight-loss role model we're currently watching is former Arkansas governor Mike Huckabee, who dropped 110 pounds and has managed to keep most of it off. According to former President Bill Clinton, that yo-yo dieter, Huckabee did well in the 2008 Republican presidential primaries because he is that rare politician who can give a speech, spin a story, and tell a joke. I'll vote for that. I can't remember having more fun talking to a politician.

(Robert Lipsyte) Mike Huckabee, welcome to "Life (Part 2)." In the last couple of years as the country has been taking your measure, you have been taking the country's measure, and we're kind of interested in this Boomer generation. What's your sense of what people are like out there?

(Mike Huckabee) I think Boomers are for the most part people who have had an extraordinary American experience. We have lived through so many major moments of American history. Most of our parents were of the World War II era, and they came away from that experience, many of them having gone through both the Depression and World War II, with a sense of our kids are going to have a better life than us-- whatever it takes. And they made great sacrifices, and I'll often say they have a right to be called the Greatest Generation, because they didn't so much think about themselves; they really thought about their kids. We've got to now assess, are we going to do for our children what our parents did for us? And I hope that we decide that we will. I'm not sure that that's been the collective decision so far.

(Robert Lipsyte) What do you mean? In the sense that we're not giving them the entitlement that we had?

(Mike Huckabee) My concern is that if you look at the federal budget and how we've structured government, what we've really done is we have borrowed obscene amounts of money against the future, and unlike our parents' generation who said okay, we'll shoulder the burden so our kids won't have to, what we've said is we're not going to shoulder the burden. We're going to let our kids deal with this.

(Robert Lipsyte) The other thing that you've really talked a lot about here is the denial of aging. Your generation of Boomers have been in denial about their aging-- the plastic surgery, the fitness. I mean, you've been through that yourself.

(Mike Huckabee) Yeah, I have, I think there's a sense in which Baby Boomers maybe more than any other generation are grabbing on to being young and fit and somehow vibrant. One thing is because we know we're going to live longer than people have lived before, and so we want to live better. We see people who have aged not so gracefully. A generation ago, those people wouldn't have lived. People would've died with the things that people live with now. But we're also living in a time when the last 18 months of life sees the average American spending 85% of their lifetime medical expenses. Not because they're living great. It's because they're basically limping to the finish line. But I think Baby Boomers see that and say whoa, I don't want to finish like that. So we start thinking about this as we get in middle age, and many of us are saying I've got to find a better way to end the game.

(Robert Lipsyte) Which made me wonder, you got up to around 300 pounds, and what seemed to have made you reinvent yourself, to lose half yourself, was health issues. You weren't thinking looks, were you?

(Mike Huckabee) No. When you're as ugly as I am, you give up on the looks long ago. You just sort of say, you've gotta accept that.

(Robert Lipsyte) A cue from a cute guy, Governor!

[Mike laughs]

(Robert Lipsyte) No, but I mean, what was in your mind?

(Mike Huckabee) Well, I knew that it was really not about how I looked. It was about whether I was going to live or die in the next 10 years, and when my doctor put it to me in those blunt terms, and he basically said you either change your lifestyle or you're entering the last decade of your life. Then he did me a great big favor. He described that decade. But what he described was a progressive state of poor health that was going to take my lights out and do it in a decade.

(Robert Lipsyte) Okay, so now you've decided, you've been shocked, then what seemed amazing to everybody in America was that you lost at least 100 pounds in what seemed like 15 minutes!

(Mike Huckabee) It was a little longer than that. More like probably 14, 15 months, over a period of time. I did it the old-fashioned way, which was essentially changing nutritional habits, changing exercise habits. In essence, I went through a detox, which I think a person almost has to do if they are, as I was, addicted to food.

(Robert Lipsyte) Yeah. And there was exercise involved too.
    
(Mike Huckabee) Right.

(Robert Lipsyte) Did you change in any way during that period, I mean emotionally, spiritually? Did anything else happen?

(Mike Huckabee) I think there were changes in 100% of me. First of all, the obvious changes were physical. And some of the changes were emotional. I started feeling better about myself. I think when a person can control appetite and start exercising...

(Robert Lipsyte) But let me stop you. You always seemed like a person of enormous self-esteem.

(Mike Huckabee) Huh! Yeah.

(Robert Lipsyte) It's hard to believe that you needed more in that category. But something must have happened.

(Mike Huckabee) I think even if you are a person that's driven to accomplish things, there's still deep inside of you a sense in which you know that's an area of your life out of control. So you just compensate for it by trying to do really well in other areas. But it doesn't mean that you're not utterly frustrated. Believe me, every time I looked in the mirror it was frustrating to know that I shouldn't be this size. I'd get on an airplane and I'd barely get the seat belt around me, and it was frustrating. Or tying my shoes, [grunts] and what an effort that was. All of that is demeaning; it's frustrating.

(Robert Lipsyte) But the idea that you're a godly man, there's a greater power. Not only that, but you're the manager of a state. And yet there was an aspect of you that was out of control.

(Mike Huckabee) Totally. Yeah.

(Robert Lipsyte) You had to think about that sometimes too.

(Mike Huckabee) Well, I did. First of all though, I think that in all of us we recognize there's no such thing as a person who has achieved perfection in every area. Part of even my faith had given me an understanding of--  that's what I say to people, I'm a grace Christian, not a law Christian, I don't go around judging everybody-- hey, they're not perfect, you ought to be like me. I tend to be more of the kind of person who says but for the grace of God, there go I. So there was a side of me that I could be forgiving to myself because I tended to be pretty forgiving towards others, but I also knew that here I was, I could govern a state, there were many things that I could do, but I didn't seem to be able to manage this appetite.

(Robert Lipsyte) The whole idea of aging gracefully, do you have role models up there? Are there people that you've seen that you've admired and think can teach us how to get older?

(Mike Huckabee) Ronald Reagan, I thought was a great example of a person who not only aged in a very graceful way, but I think that one of the most poignant moments of my life was when I read the letter that he wrote when he revealed that he was suffering from Alzheimer's. I think that the candor, the brutal honesty that he portrayed there in talking about an issue that touches so many Americans who are aging gave us a sense of, really, his character and his capacity to look at himself with an honesty that we all needed.

(Robert Lipsyte) Which is certainly something that you do in all your reinventions.

(Mike Huckabee) [laughs] I try.

(Robert Lipsyte) Thank you so much for joining us on "Life (Part 2)."

(Robert Lipsyte) Maureen Orth is a special correspondent for "Vanity Fair" where she's written about everyone from Russian President Vladimir Putin to fashion designer Karl Lagerfeld. Orth is the widow of Tim Russert, who was the host of "Meet the Press." Her life has been filled with glamour, success, and tragedy, which may be why when it comes to issues of aging, her role model is another woman who's seen it all.

(Maureen Orth) As we women age, we pay particular attention to how some of how our favorite celebrities pave or do not pave the way for the rest of us. My own champion of aging, well, is the incomparable Tina Turner. I wrote about Tina Turner years ago for "Vogue" and "Vanity Fair," and I recently saw her in concert. "The Washington Post" headline said it all. "What's Age Got To Do With It?" Tina is now 69 or 70 depending on which research material you use. When I wrote the "Vanity Fair" cover story on her in 1993, Tina was a Buddhist Baptist  who loved Armani suits, champagne, and looked forward to getting off the stage to enjoy the good life in Europe. But now here she was back on stage 50 years after her debut with her then husband, the wife-beating musical genius Ike Turner. She was on fire! A cat on a hot tin roof! Her blonde wig was the size of a lion mane. What a show! A few nights earlier, I saw The Eagles in the same venue, and while they still played great music, their identical black suits and another day at the office demeanor made them seem like a corporate barbershop quartet compared to Tina.
By the time she gets to her closer "Proud Mary," Tina Turner, whose life has seldom been "nice or easy," makes you understand how much there is to be said for having lived 7 decades of struggle, triumph, and rock and roll. So here's to the queen of rock and amazing aging, or whatever else Tina Turner wants to be.

(Robert Lipsyte) Right on! What does age got to do with it? For now, that's it for "Life (Part 2)." Thanks for joining us. I'm Robert Lipsyte. See you next time, older and better.

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(woman) Major funding for "Life (Part 2)" was provided by The Atlantic Philanthropies--engaging many to improve the lives of and achieve health and economic security for older adults. And by MetLife Foundation-- celebrating the wisdom, talent, and experience of older adults. MetLife Foundation proudly supports "Life (Part 2)."

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