CDC Reports the U.S. is Supersized

Robert Cucin MD JD MBA bariatric surgery, Diabetes, metabolic syndrome, obesity, technology , , ,

The CDC reports that 7 out of 10 Americans are overweight or obese and almost 4 out of 10 Americans are obese.

There is an underlying pattern of racial and ethnic disparity.  Almost half of Hispanics and blacks are obese with obesity rates for 2015-2016 of 47% and 46.8% for adult Latinos and non-Hispanic blacks respectively.

Obesity is most readily defined by Body Mass Index (“BMI”) which takes a person’s weight in kilograms and divides it by their height in meters squared.  For adults, those with a BMI between 18.5 and 24.9 are considered to have a normal weight.  A BMI between 25 and 29.9 is considered overweight and anything above 30 is deemed obese.  The NIH provides a calculator for you to determine your own BMI.

It is apparent to anyone following these statistics or even just walking down the street that current efforts to control the obesity problem have failed to reduce obesity rates.

We have learned that visceral fat or “belly” fat within the abdomen hijacks the metabolism by secreting the cytokine resistin.  This cellular hormone antagonizes insulin, blocking sugar from entering cells or reaching the brain.  It saps energy, shuts down the metabolism, causes brain fog, and hunger.    Cellular hormones are secreted directly into the portal circulation and the body’s protein factory, the liver, is commandeered to produce bad lipids which cause strokes and heart attacks.  Mesenteric fat thickness is closely correlated with carotid intimal narrowing.  Belly fat doesn’t just shorten your life, it reduces its quality with sleep apnea, gastric reflux, type 2 Diabetes mellitus, heart attacks, strokes, autoimmune diseases, and cancers.

New technology facilitates a new approach to the problem.  Rather than just starving this belly fat and letting it remain in place as do current bariatric surgical alternatives, removing it this visceral fat in a minimally invasive procedure may prove to be a simpler, more direct and permanent, safer and highly effective alternative.  Endoscopic visceral lipectomy could be just be what the doctor ordered.   It is clearly time to seek new approaches and fresh solutions as obesity rates continue to rise.

 

Exporting Obesity

Robert Cucin MD JD MBA Diabetes, metabolic syndrome, obesity , ,

The New York Times reports that over the past 35 years, Obesity has increased in the U.S. and Brazil by 2.5 times.  It has grown fastest in the countries throughout Latin America, Africa and Asia.  
Obesity has increased in China and Mali by 7.7 and 15.5 times respectively.

The shift to Western-style  processed food and sugary drinks is contributing to a new epidemic of diabetes and heart disease, chronic illnesses that are fed by soaring rates of obesity in places that struggled with hunger and malnutrition just a generation ago.


Obesity's spreadThe U.S. has been too successful at countering the world’s hunger and malnutrition problem with cheap high-calorie food.  Indeed, it might be said that one of the U.S.’s  major exports is obesity.

Classic advice for avoiding hyperglycemia and obesity is to eat healthy foods with vegetables, fruits, whole grains, and beans which are high in fiber.   Include foods in your diet that are low in fat, such as low-fat dairy (milk, yogurt, and cheese), fish, and lean meat and limit foods that are high in calories and sugar, such as sweet desserts, potato chips, and candy.  The latter comprises a signficiant portion of our exports.

Alas, a Western diet brings with it the health problems of the Western world.

Obesity Must Be Recognized As a Disease

Robert Cucin MD JD MBA Diabetes, metabolic syndrome, obesity ,

In a recent article in the Lancet, it was pointed out that Portugal has officially recognized Obesity as a chronic disease since 2004, but remains the only country in Europe to do so.

Although the UK as a whole does not recognize obesity as a disease, the Scottish Intercollegiate Guidelines Network did in 2010. The American Medical Association officially recognized Obesity as a disease and 2013 and the Canadian Medical Association followed suit in 2015.   In Canada, many Canadians who need obesity treatment must still pay for care because federal and local governments have not officially recognized the position of the Canadian Medical Association which has also recognized Obesity as a disease.

Recognizing Obesity as a treatable disease rather than a failure of will or a character flaw allows attention to be directed at correcting the chemical imbalance, a series of morbidies resultant from an accumulation of “belly fat, ” the visceral fat buried deep within the abdomen – sleep apnea, GERD, hypertension, Type 2 Diabetes mellitus, and an increased propensity for autoimmune diseases and cancers.  This visceral fat acts as an evil gland pouring its noxious cellular hormones directly into the liver and hijacking the body’s metabolism.

Recognizing Obesity as a disease clearly has economic consequences for national health care policies and insurance premiums in general.  But are not the impairments of GDP resulting from an impaired labor force and societal costs of ignoring the problem likely to be far greater if the disease is not recognized and treated early?   For example, the resultant Type 2 Diabetes is the most frequent cause of kidney failure requiring dialysis, the indication for over half of non-traumatic amputations, and a frequent cause of blindness.  These complications alone have devastating financial and social consequences.

Of course, Obesity must be recognized as a disease by all nations and attention directed to its early recognition and treatment.    This writer always capitalizes the “O” in Obesity to call attention to that fact and indicate it as such.