Overweight and Disease
Often overweight people feel guilty and sometimes angry.
There is an argument in favor of boosting self-esteem, a good idea for sure. The
argument goes something like, “It is OK to be fat. I am still a worthwhile,
loveable, productive person, so who cares? “ While it is true that extra fat
does not prevent you from being a productive, wonderful and loveable person,
being overweight usually reduces your opportunity to feel well and live a long
and healthy life. You can keep all of your personal merit and all your
self-esteem but you still have to lose weight if you want to feel good and
remain healthy. The issue of excess weight is not just cosmetic as some people
claim, but it is a key health issue for the 21st century.
The American Surgeon General's report on Nutrition and
Health asserted in 1987 that at least half of all deaths in the USA are related
to faulty diet and described: "... the convergence of similar dietary
recommendations that apply to prevention of multiple chronic diseases. Five of
the ten leading causes of death in the USA are clearly related to wrong food
choices. Diseases of nutritional deficiencies have declined and have been
replaced by diseases of dietary excesses and imbalances-problems that now rank
among the leading causes of illness and death, touch the lives of most
Americans, and generate substantial health care costs."
The World Health Report stated: “The world is living dangerously – either
because it has little choice, which is often the case among the poor, or because
it is making the wrong choices in terms of its consumption and its activities.
Indeed, there is evidence that these risk factors are part of a “risk
transition” showing marked changes in patterns of living in many parts of the
world. In many developing countries rapid increases in body weight are being
recorded, particularly among children, adolescents and young adults. Obesity
rates have risen threefold or even more in some parts of North America, Eastern
Europe, the Middle East, the Pacific Islands, Australasia and China since 1980.
Changes in food processing and production and in agricultural and trade policies
have affected the daily diet of hundreds of millions of people…Eating fruit and
vegetables can help prevent cardiovascular diseases and some cancers, low intake
of them as part of diet is responsible for almost three million deaths a year
from those diseases. At the same time, changes in living and working patterns
have led to less physical activity and less physical labor. (Thomson Prentice et
al. World Health Report 2002. World Health Organization).
Years later, the same concerns are voiced and the problems
identified years ago are more prevalent and more threatening than ever before.
These problems include diseases generally acknowledged diet-related, such as
heart disease, alcoholism, obesity, diabetes, and some cancers as well as other
common disorders not generally acknowledged to be diet-related.
Kaplan, for example, compared obesity in adults to a
cholera epidemic that requires community action. (Katan MB. Weight-loss
diets for the prevention and treatment of obesity. N Engl J Med 2009 Feb 26;
In a huge US study spanning 20 years the influence of
excess body weight on the risk of death from cancer was revealed.
The Authors stated: “In a prospectively studied population of more than 900,000
U.S. adults (404,576 men and 495,477 women) who were free of cancer at
enrollment in 1982, there were 57,145 deaths from cancer during 16 years of
follow-up… The heaviest members of this cohort (those with a body-mass index
of at least 40) had death rates from all cancers combined that were 52 percent
higher (for men) and 62 percent higher (for women) than the rates in men and
women of normal weight. For men, the relative risk of death was 1.52 (95 percent
confidence interval, 1.13 to 2.05); for women, the relative risk was 1.62 (95
percent confidence interval, 1.40 to 1.87). In both men and women, body-mass
index was also significantly associated with higher rates of death due to cancer
of the esophagus, colon and rectum, liver, gallbladder, pancreas, and kidney;
the same was true for death due to non-Hodgkin's lymphoma and multiple myeloma.
Significant trends of increasing risk with higher body-mass-index values were
observed for death from cancers of the stomach and prostate in men and for death
from cancers of the breast, uterus, cervix, and ovary in women.
Diabetes, The Sitting Disease
High caloric intake, lack of exercise and weight gain
appears to be the inter-related causes of diabetes 2. Physical work is good for
the human body. Lack of exertion is bad. Energy metabolism requires daily
exertions to work well. The combination of sitting, eating too much of the wrong
foods and weight gain causes diabetes 2. About 80 percent of people with
Diabetes 2 are overweight. Most overweight diabetics have adequate or excessive
amounts of insulin in the early stages of the disease rather than a deficiency,
but the insulin does not work properly and blood sugar regulation is impaired.
Blood sugar levels rise too high after eating and stay high longer than they
The first stage of diabetes 2 is sometimes called "glucose
intolerance" when blood sugar levels rise too high after eating food.
Fasting blood sugars remain normal and other signs of diabetes have not yet
appeared. As glucose intolerance progresses, high sugar levels become more
persistent and other problems appear. Paradoxically, overweight people with
glucose intolerance may also experience episodes of low blood sugar. You feel
dopey and want to sleep when your sugar is high. You feel irritable, anxious,
weak and tremulous when your blood sugar is low. The low sugar episodes tend to
occur three or more hours after your last meal.
The pancreas produces enough insulin but may not respond
promptly to rising blood sugars. When insulin is released, the body cannot use
the insulin effectively. The result is the buildup of glucose in the blood and
an inability of the body to make efficient use of glucose, its main source of
energy. While elevated levels of sugar are the leading edge of the emerging
disaster, changes in fat metabolism, liver and kidney function and circulation
impairment add to a cascade of dysfunction. 75% of the early deaths in diabetics
are related to coronary artery disease.
While you can blame many of the problems on high blood
sugar, there may be hidden, underlying causes of the complex of disasters that
routinely haunt the lives of people with diabetes 2. We have a hunch that
there are pervasive problems in the food supply. Eating sugar does not cause
diabetes, but once you have diabetes, eating sugar is a problem because blood
sugar levels are unstable. This does not mean you should avoid
carbohydrates because all the foods that are going to make you healthy,
especially plant foods, contain carbohydrates. Clearly, heroic efforts are more
that justified changing life-style determinants of the disease early on so that
the terrible consequences of neglected diabetes are avoided.