Ah, the addictive power of modern food.  Never underestimate it.

On a recent trip to New York I happened to be flipping through the channels on my in-flight TV when I ran across Mike Huckabee doing an interview on Fox News.  I was surprised to see that he had gained his weight back.  The former governor of Arkansas and presidential candidate had staked quite a bit on the success of his 100 pound reduction in 2003.   He ran marathons, wrote a book about diet and made obesity and healthy living a central issue in his political portfolio.  He was appointed to expert panels and interviewed endlessly about his success.  Yet even this very public and seemingly committed person could not avoid regain right in front of our eyes.  In other words, he did an Oprah.

Huckabee’s weight loss was motivated by a doctor who told the Governor that he would likely die in less than 10 years if he remained obese.  To his credit, Huckabee took this message seriously, lost the weight and became a flag bearer for the healthy living movement. What could have caused him to put it all back on?

I have worked with enough maintainers over the years to know that even long term, successful POWs (previously overweight persons) fear that they are just one wrong spoonful from total regain. Huckabee’s weight saga and the many other cautionary tales that play out in the public arena validate this concern.

Did anything that Huckabee said during his lean years foreshadow his return to obesity?  I believe he left some clues.

1. In an interview with CNN’s Sanjay Gupta, Mr. Huckabee said this about his weight loss:

I had to learn that it was a change of lifestyle. And my goal wasn’t to lose weight. And that’s why this time I was successful, as opposed to previous times in my life. And I would lose weight, but then gain it back and add some to it.

Whether it’s Huckabee speaking or someone else,  there is rarely a discussion about weight loss that doesn’t include the words “change of lifestyle”.  For me, this phrase is a red flag, a shorthand for nothing.  Governor Huckabee’s words sound very reasonable because they restate the conventional wisdom.  But conventional wisdom can often be just that: conventional.  Few realize that it is crucial to delve into the details of “lifestyle change”.  The assumption is that it means fewer calories and more exercise.  But truly successful maintainers would tell you that a maintenance life is something quite different.  It is a well-reasoned, controlled existence that is structured around a healthy avoidance of specific trigger foods.  It involves a specifically designed and executed eating style, a reliance on supported environments, specific and consistent exercise routines, and the maintenance of extreme vigilance.  This is because modern food is addictive, and it takes several layers of planning to oppose it.

2. In 2010, when Huckabee’s weight regain was already apparent, he wrote an opinion piece for Fox called, In Praise of McDonald’s.  It was written after efforts by the Center for Science in the Public Interest to eliminate toys from Happy Meals.  Here are some excerpts:

Blaming the packaging of a toy for overeating and under-exercising of kids makes silly what ought to be a serious issue: Obesity is a serious problem that has stunning health consequences and staggering economic consequences. But it hasn’t been caused by toys and won’t be resolved by getting rid of toys.

When a person is overfed and then under-exercised so that more calories are consumed than used, there will be weight gain. A 3-year-old probably isn’t counting calories, but parents can. The 3-year-old probably isn’t measuring activity levels and aerobic activity, but parents should.

Unless you take your kids to McDonald’s and drop them off to be parented, it’s stupid to blame McDonald’s because they put a toy in a Happy Meal. When I was a kid, there was a prize in the Cracker Jack box, but I really can’t blame my own weight challenges throughout my life to overdosing on Cracker Jack because I was digging for the prize. A person would have to be addicted to crack, not Cracker Jack, to blame the toys in the box for eating too much stuff in the box.

What makes my Happy Meal happy is that as a corporation, McDonald’s didn’t cave to the pin-headed pressure to political correctness, but pushed back to the loons on the left who seem to forget that Americans not only have personal freedom, but personal responsibility.

This also sounds logical.  Parents should protect kids.  Toys don’t cause obesity.  But it reflects a crucial misperception of the larger problem.  Toys in Happy Meals are just one of the many marketing ploys used to lure buyers to an addictive drug: modern, processed food.  And the practice is a particularly heinous example as it plays on the vulnerabilities of kids.  It also sets up an unnecessary situation which pits the child’s desires against those of a concerned parent.

The misperception is in play when we shift the argument to personal responsibility.  If we believe that a lack of personal fortitude causes obesity,  we can hoist Huckabee on his own petard.  He talked the talk, led the charge, and failed.  By his reasoning, he must be weak…just like all those parents who give in to the Happy Meal.  I don’t believe that.

Karen Tumulty, who  interviewed Huckabee in February for the Washingotn Post observed this scene:

Huckabee was tucking into a breakfast of eggs and butter-slathered pancakes at a trendy New York hotel overlooking Times Square. His much-discussed diet – he famously lost more than 100 pounds after a diabetes diagnosis in 2003 and wrote a book about eating right – is apparently on hiatus.

What are we to make of a man who has been told he has a possible death sentence if he’s over-fat,who writes books about the importance of avoiding obesity,  who stakes a political career on advocacy for better habits and then goes ahead and chows down in front of a reporter for a major newspaper?  Unlike Huckabee, I wouldn’t call him irresponsible.  I’d say he’s acting like someone with an addiction.  An addiction that has re-established itself.

What else but a powerful, powerful urge could motivate someone to behave in a way that makes him look foolish?  To betray an entire belief system once espoused?  To perhaps give rivals a powerful wedge against future political ambitions?

The key to successful, permanent maintenance lies in a healthy respect for the damaging effects of the food that got you fat.  To avoid being overwhelmed again, each maintainer needs to build many walls of defense.  Otherwise, and sadly, he might easily find himself eating more than his words.

Barbara Berkeley is an internal medicine physician and board certified bariatrician who blogs at Refuse to Regain.