Obesity is far more complex than you thought

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How can a six month old be obese? More and more are today.

My interest in obesity is decades long. Personally, I was overweight as a teen. I spent years dieting, shopping in the “chubby” section of A&S (Abraham & Strauss), being hungry and failing…Weight Watchers, Snackwell cookies, you know.

Somehow, luckily, through the years I managed to learn about food, wean myself off of my beloved scones and bagels, give up the junk and add more healthy foods and daily walking. I don’t quite know how I did it, but I imagine I was partly spurred on by the improvement I saw in my blood sugar management, and the ease. I remember reading Dr. Richard Bernstein’s book, The Diabetes Solution, it was eye-opening. I vacuumed a good portion of carbs out of my diet and never looked back. My blood sugars improved and the weight fell off.

As I began eating less sweets and salty foods, my tastebuds changed and the craving for these foods disappeared. My husband says I was able to change my diet because through the years I became happier. Maybe, but the truth is I’m a different person today with a different body, and for me food is no longer an addictive pleasure but nutrition.

Researching and writing three books on diabetes I had to learn a lot about food and how it works in the body. I came to understand being overweight, while a risk factor for type 2 diabetes, doesn’t cause it. In fact for most people being overweight is a consequence, not a cause, of type 2 diabetes.

Our SAD (yes, our diet is sad, but the acronym stands for “Standard American Diet”) drives insulin resistance which in turn causes type 2 diabetes. Huh? Our modern diet, full of processed foods, sugar and refined carbs, spikes our blood sugar. This causes the pancreas to produce extra insulin to lower blood sugar and ferry the excessive amounts of sugar in our bloodstream into our cells for energy. These excess carbs get stored in our cells as fat. After all, insulin is a fat storage hormone.

Eating an everyday diet of these foods causes the pancreas to overwork until it can no longer produce enough insulin for the SAD’s needs. Poor maligned fat all these decades; eating fat doesn’t make you fat, a high carbohydrate diet makes you fat. I get it, I have for many years.

Then I read this article on obesity recently in the HuffPost and found it thought-provoking. Everything You Know About Obesity Is Wrong. I sent it to some friends, including a friend of mine who’s a health professional.

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Image by Finlay MacKay

An email exchange occurred between us, and while we’ve been friends for almost four decades, and she’s since told me she basically agrees with everything I wrote, during our exchange she reflected the knowledge and attitude many health professionals hold – while the problem is not only calories in and calories out, most fat people do eat too much and move too little. And, that it’s up to them, “individual responsibility” for them to lose the weight. “Adding to the problem,” said my friend, “I wasn’t taught anything about obesity when I went to school.”

She also said which I hadn’t thought about, “as a medical person I don’t want to be blamed for people being fat. The system isn’t set up for me to treat people’s runny nose, cough, frequent urination, sprained ankle AND their obesity in one visit.”

Who thinks about the pressure on the shoulders of our health professionals in the midst of this obesity epidemic? Not just to treat the fallout of obesity – type 2 diabetes, hypertension, cancer, dementia, heart disease and fatty liver disease – but  that they’re also supposed to get people to lose weight. Which frankly is basically impossible within today’s society.

And our American view – just pull yourself up by your bootstraps – doesn’t work here. Obesity is not a matter of willpower, it’s largely biochemical and far more complex. Most individuals alone can’t solve the problem.

We need societal-efficacy as well as self-efficacy. We need governments and big food manufacturers to make healthy food and activity affordable and accessible. We need to feed our soil and our animals the proper diet and create an economic system that allows people to get back into the kitchen to cook.

We are living in the perfect storm for obesity – cheap, portable food available everywhere, labor-saving devices so we no longer move, industrial feedlots and food scientists who chemicalize food-like substances to release dopamine in your brain when you eat them, and hook you. And a diet of highly refined carbohydrate foods, sans fiber, that spike your insulin and for most people will lead to insulin resistance and weight gain.

I close with a great and easy explanation in the video below, according to Dr. Robert Lustig, what we can blame obesity on. Lustig, a pediatric endo and professor at SFUC, is relentlessly fighting against what he sees as the biggest cause of obesity – sugar and processed food, and perhaps the most frightening of all, if your mother was obese. That means during utero, when you were a fetus, her high insulin levels were being passed to you and you then become designed to be obese. Thus, the baby above.

Now you know, and now you know too, there’s no easy fix. This 8 minute video is one in a series produced by UCSF: The Skinny on Obesity (Ep. 3): Hunger and Hormones – A Vicious Cycle




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