AP (3/8/17) reports that fewer obese people are trying to loose weight than in prior years and researchers wonder if fat acceptance could be one of the reasons. Given enlarging meal portions, mainstream plus size models, re-scaling of clothing sizes, and popular overweight leads in sitcoms, the hypothesis seems not just tenable but proven. The frequent inability of patients to keep weight off after losing it with diet and exercise, or sometimes even after bariatric surgery undoubtedly contributes to this shift. It is not at all unlikely that the political correctness to avoid the subject of weight also prevents some of the peer pressure that might conceivably reinforce the dieter’s decision to pass up that extra French fry.
Some studies have implicated some infections that could be partially behind the obesity epidemic. Researchers have found evidence to suggest that infection with the common Adenovirus-36 leads the body to create more and fatter stem cells. This observer concludes the AP report alone suggests that Obesity is at least socially contagious because the increased prevalence of Obesity has already spurred a change in social mores.
Obesity is not the morbidity itself though it does create a cardiovascular load, mechanical stress on the joints, and promote sleep apnea and gastric reflux. There are some healthy obese patients, mostly younger patients who exercise regularly, who haven’t yet developed metabolic syndrome or who are genetically gifted not to do so. The Public Enemy #1 is the Type II Diabetes associated with the metabolic syndrome which frequently complicates Obesity. There are an estimated 29 million Type II Diabetics in the U.S. Type II Diabetes is the leading cause of kidney failure needing dialysis, the most frequent indication for non-traumatic amputations, and a leading cause of blindness.
As it is the visceral or “belly fat” within the abdomen which secretes resistin, a cellular hormone which antagonizes the body’s own insulin to cause Type II Diabetes, reducing the size of that noxious cytokine factory which functions as a life-shortening gland with Endoscopic Visceral Lipectomy (EVL) is a direct approach to the problem. Incidentally, the patient might cinch his or her belt a notch or two right off the operating table and is expected loose a great deal of body weight afterwards. But the restoration of normal metabolism and amelioration of Type II Diabetes is the immediate goal of the procedure. Though less attention by patients to their weight is not at all a pleasing finding for physicians, it does suggest the public has already recognized the need to retarget our emphasis! EVL does so.
