You are currently browsing the tag archive for the ‘diabetes’ tag.

I hate to admit it, but I was wrong.

Back in April of 2010 I wrote a blog entitled “Life, Liberty, and the Pursuit of Fatness” discussing the fat acceptance movement. I questioned its motives, pointed the finger at what I thought were its unreasonable claims, and flat out refused to believe that being fat could be healthy. You see, like most people who have grown up in the “fat is bad” era, when I heard news reports claiming we are drowning in a nationwide obesity crisis (talk about a loaded expression), I jumped on the lifeboat.


It took a good amount of critical research, reading between the lines, and turning a deaf ear to the popular media fat-bashing machine before I would be willing accept the possibility that all my nutritional indoctrination might be wrong. But wrong I was.

A lot of current claims about the obesity crisis are based on misinformation. In 2002, Richard Carmona, the former surgeon general described obesity as “the terror within, a threat that is every bit as real to America as the weapons of mass destruction.” And how could it not be when the Center for Disease Control reported that more than 400,000 Americans die from being overweight or obese? This shocking statistic became the headline for thousands of popular media articles and pumped millions of dollars into scientific research aimed at curing obesity.

But in 2005, an updated report from the CDC acknowledged that the previous analysis suffered from computation errors and reduced the estimate fifteen-fold, taking the 400,000 deaths down to 26,000. Further separating “overweight” and “obese” individuals from “extremely obese” individuals (BMI over 35) decreases the number even more, as most deaths are clustered in the BMI over 35 category. When “overweight” individuals (BMI 25-30) are compared to “normal” weight individuals (BMI 18.5-24) an even more interesting statistic surfaces. Overweight individuals actually live longer than normal weight people.

Research from a Canadian national health survey following more than 11,000 adults looked at the relationship between BMI and longevity. Compared to people who fell into the normal-weight category:

– Those classified as underweight were 73% MORE likely to die
– Those classified as extremely obese were 36% MORE likely to die
– Those classified as obese had about the SAME risk of death
– Those classified as overweight were 17% LESS likely to die

Eric Oliver, a political scientist at the University of Chicago says the obesity epidemic is really “a relatively small group of scientists and doctors, many directly funded by the weight loss industry, (who) have created an arbitrary and unscientific definition of overweight and obesity. They have inflated claims and distorted statistics on the consequences of our growing weights, and they have largely ignored the complicated health realities associated with being fat.”

“So what?” you may be thinking. “Just because people are living longer doesn’t mean they are living healthier lives. Everyone knows fat people are unhealthy.”


While weight is a causal factor in a couple diseases, say osteoarthritis or sleep apnea, there isn’t much evidence that excess body fat itself causes disease. Instead other variables might be at play. For example, most overweight individuals report weight cycling at some point during their lives. A single weight cycle, think a failed crash diet, has been shown to damage blood vessels and increase the risk for cardiovascular disease. Rat studies indicate that obese rats that have weight cycled have very high blood pressures compared to rats that have maintained a consistent weight.

Additionally, there is a weak association among obesity and hypertension in cultures where dieting is uncommon. Could the “cure” for hypertension actually be the “cause?”

Research also finds that overweight people report feeling more stress and anxiety, both of which are a risk factor for diabetes and cardiovascular disease. In countries where there is less stigma attached to weight, overweight individuals are not prone to the same diseases associated with obesity in the United States. Additionally, when researchers looked at a group of more than 170,000 U.S. adults, they found the differences between actual weight and perceived ideal weight was a better indicator of mental and physical health than BMI. In other words, feeling fat has a stronger implication for health than being fat.

Research indicates that activity level, combined with other lifestyle choices like sleep and social habits, are more related to health than body fat percentage. For example, one study found that obese men classified as “fit” based on a treadmill test have similar death rates as lean men classified as “fit.” The obese fit men actually had death rates one-half those of the lean but unfit men.

What about type 2 diabetes? This disease, characterized by a reduced sensitivity to insulin, is much more common among obese individuals, and thus, obesity is often blamed for its emergence. But is it possible that insulin resistance causes obesity? In this classic which came first scenario, research suggests that high levels of insulin appear before weight gain in future diabetics.  This finding is consistent with the “thrifty genotype” theory, which views insulin resistance as a helpful adaptation for storing more fat during times of famine. Because fat cells do not develop insulin resistance as readily as other cells, they allow glucose and nutrients to enter, promoting excess fat storage and weight gain. The added weight gain further increases insulin resistance and the cycle continues. So is weight loss the answer?

I’ll give you a second to guess what my answer is going to be (cue the Jeopardy music).

What is a resounding NO!?! A review of controlled weight loss studies for type 2 diabetes shows that initial improvements were short-lived, and study participants returned to their starting values within eighteen months, even when they maintained their weight loss. In another study, women who underwent liposuction resulting in an average loss of twenty pounds of body fat did not show improvements in insulin sensitivity. What have been shown to improve diabetes time and time again are changes in nutrition and increased activity, even without any resulting weight loss.

What’s most unfortunate about our culture’s association between body size and health is that it paves the way for fat bashing, prejudice, and discrimination. We demonize fat, and as a result, view the people carrying it around as vessels for evil. In our quest to cure obesity, we ostracize a segment of the population. We confer them with labels like lazy, sick, bad, stupid, and unhealthy. We spend so much time trying to rid the world of “fatties” that we lose sight of what is really important: health. If we could refocus our attention on finding health at any and every size, and let go of the notion that only “average” or “normal” weight people can be healthy we could start to see actual improvements in blood pressure, cholesterol, diabetes, and a slew of other conditions previously linked primarily with weight.

In the end, by focusing so much on weight, we are preventing people from finding what every weight-loss venture promises to deliver: a long, happy, and healthy life.

Note: For further reading please check out the book Health and Every Size by Linda Bacon or refer to her blog at www.healthateverysizeblog.wordpress.com. Another great resource that promotes health and every size is thefatnutritionist.com. If you would like more information on the research I am referencing please comment or send me a message.

In the classic tale of the tortoise and the hare, the slow-going tortoise crosses the finish line ahead of the speedy but arrogant hare. “Slow but steady,” the tortoise says. By adopting that mantra in the race to lose weight, you are not only guaranteeing that you cross the finish with energy to spare and your vital organs in tact (more on that later), you are preventing yourself from having to rerun the same course over and over again.  Approaching weight loss more like a marathon instead of a sprint to one’s goal weight is the ideal way to ensure your body maintains optimal functioning.

One of the prime examples that comes to mind when I think of fast weight loss is the NBC reality show The Biggest Loser. Contestants vie for a chance to win $250,000 by adopting very low calorie diets and engaging in grueling 6-8 hour long workouts (all under doctor supervision of course), all in the hopes of dropping the largest percentage of their body weight and being crowned the Biggest Loser. What the viewing audience doesn’t see is that in addition to the money, every contestant walks away with another prize: a significantly slower metabolism. Maybe they should rename the show the Biggest Metabolic Loser?

In an abstract presented at the most recent Obesity Society Annual Scientific Assembly, Darcy Johannsen and friends reported that by week 6 Biggest Loser participants had lost 13% of their body weight and by week 30, 39%. More interestingly they reported that by week 6 participants metabolisms had slowed by 244 more calories per day than would have been expected by their weight loss and by week 30, by 504 more calories. (Source: WeightyMatters)

The term for what is happening is called metabolic adaptation, and under normal circumstances, it’s a great survival mechanism. Back when our ancestors had to go prolonged periods of time without substantial amounts of food, a slowed metabolism ensured survival. Today, when food is bountiful, it’s not quite as useful. What’s interesting to note is that this phenomenon does not occur when weight loss occurs at a rate of 1-2 lbs per a week, the amount recommended by MayoClinic.com medicine specialist Dr. Donald Hensrud.

These results have been replicated in studies with rats. In a laboratory study using rats that are prone to gaining weight (think your average person with a genetic predisposition to obesity), rats on a severely calorie restricted diet showed significant reductions in metabolic rate, measured as both 24-hour energy expenditure and sleeping metabolic rate. Eight weeks after returning to a normal feeding schedule, the metabolic slow-down persisted, thus setting the rats up to regain much of the lost weight. Sound familiar?

In addition to a damaged metabolism, side effects of extreme dieting include dizziness, fatigue, irritability, hair loss, malnutrition, muscle loss, and even in some cases diabetes. On a sufficient number of calories, most adults can get the recommended daily allowance of vitamins and minerals assuming they are choosing carrots over candy 90% of the time. With a sever calorie restriction, however, it is very difficult to get all of the essential nutrients, snowballing into many of the other accompanying problems. Take hair loss for example. Without adequate amounts of protein a condition know as Telogen effluvium, or the loss of more than half the hair on your head, can occur.

Who’s up for skinny and bald? I suppose Brittany Spears pulled it off.

Rapid weight loss can cause major fluctuations in blood sugar levels. A 1996 study in the “Journal of Diabetes and Its Complications” indicates that patients who lost weight very quickly developed diabetes most likely as a result of swings in blood sugar levels and stress hormones.** Additionally, when the body depletes its glycogen (blood sugar) stores it begins to fuel itself by breaking down muscle tissue, not fat. Dr. Linda Bacon points out that yo-yo crash dieting can eventually lead to heart muscle loss. It damages your blood vessels and causes micro tears that create a setup for atherosclerosis and other types of heart disease.

If you are in need of losing weight please consult your doctor or a nutritionist to learn the proper way to go about doing it. Become the tortoise in the race to lose weight and go about it slow and steady. Because in the end, even if you don’t win the race to fit into your bikini come this summer, you’ll win a much better prize: long term health.

**Small sample size and in need of replication. If you find another study that shows similar results I would be interested in hearing about it.

July 2017
M T W T F S S
« Dec    
 12
3456789
10111213141516
17181920212223
24252627282930
31  

Archives

What are you looking for?