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Really, Santa Claus, It Is Time That You Go on a Diet and Begin Exercising

Dear Jolly Old St. Nick. You have a problem: You're obese.
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Dear Jolly Old St. Nick,

You have a problem: You are obese. You are a role model for kids and parents, representing the ideal of goodness and kindness in the world. Yet the example you set in taking care of yourself is anything but good. Sure, you appear jolly and energetic on the outside, but that belies the fact that those extra pounds probably are going to do you in sooner or later. Obese individuals have an increased risk of diabetes, hypertension, strokes, heart attacks, some cancers, arthritis, gout and sleep apnea. Is that the model we want people to aspire to? I think not.

You are not just a little overweight, but have reached full blown obesity, with a body mass index well over 30. Incidentally, body mass index (BMI) is defined as weight in kilograms divided by the square of the height in meters, and is used to define individuals as normal (BMI = 18.5-24.9), overweight (BMI = 25-29.9), or obese (BMI over 30). Santa, you are a medical time bomb.

Clearly your lifestyle is contributing to your problem. You live at the North Pole where it is freezing outside -- so you do not go out to do even minimal exercise like walking, let alone going for a jog or run. Instead, you stay inside and live a pretty sedentary life. After all, you have numerous elves working night and day for you, and all you have to do is sit at your desk and manage the inventory. You even installed a video camera system to allow you to view your toy factory from your computer, so you don't even have to get up and visit your workers.

We know that you have an insatiable appetite from the fact that year after year when you make your rounds to leave gifts, virtually every household leaves cookies and milk for you, and in the morning the cookie plate and milk glass are empty. This tremendous carbohydrate load cannot be good for you and will only contribute to a further increase in your girth and precipitate type 2 diabetes. I strongly suspect that you already have obstructive sleep apnea based upon your ruddy face and jowls, and, although I haven't interviewed Mrs. Claus,, it is quite likely that she would complain about your snoring.

You really need to take stock of your life, understand your risks and agree on a lifestyle change to counteract the deleterious effects of too much food intake and not enough energy expenditure. Also, please understand that your obesity combined with the planned around-the-world sleigh trip between dusk and dawn on the evening of December 24 carries a big risk for developing a blood clot in your legs. This could result in the clot traveling to your lungs as a pulmonary embolus, which could be fatal. And if this is not enough, you need to assess your increased probability of getting stuck in one of the millions of chimneys that you have to traverse that evening.

So Santa, let's get started with achievable modifications to your daily activity. Don't sit so much -- if you can't bundle up and go outside for a long walk, get a treadmill and exercise at least 30 minutes a day. Start slowly and work up to a more vigorous exercise regime which will not only help you lose weight, but will also improve your cardiovascular status. You also need to cut back on your calorie consumption. The laws of thermodynamics do hold true, and if you consume less calories than you expend, you will lose weight. Try cutting out 500 calories a day, which should lead to about a pound a week of weight loss (the recommended rate for most people). Also, don't skip meals -- eat your three meals a day, skip the bread, drink plenty of water, and lay off of the high calorie fruit juices and soda drinks. If you get hungry in between meals, try chewing on celery or carrots to help you over the urge to snack.

If you do these things, we will be able to keep you around for generations to come, you will feel better, and you will be sending a healthy message to all those impressionable children who look up to you.


Glenn D. Braunstein, M.D.