By Barbara Berkeley
When my husband and I were medical residents in Boston, we often would try to escape from the harsh world of the hospital by going to a place called “1001 Plays,” an early version of today’s video arcade. We’d try to drown out the stresses of the day by shooting things in the form of PacMen or Space Invaders. The silly sound effects and sparkly graphics usually worked, but only up to a point. Inevitably someone right near us would start talking about medicine. Their gallbladder needed fixing, or they were due for a stress test, or they weren’t sure if their thyroid medicine was the right dose. No matter where we fled, we couldn’t avoid being near someone who was talking about illness. We decided that this annoying phenomenon needed a name so, in honor of the father of modern medicine, Sir William Osler, we called it “Osler’s Curse.”
Now, many years later, I find that I am haunted by a curse of similar persistence. Perhaps The Atkins Curse? It seems that everyone around me is constantly bringing up the topic of diet. It doesn’t matter whether they know what I do for a living or not. Give them a minute and they’ll start talking about losing weight. This particular curse drives me crazy. Part of it is that I simply can’t get away from the subject. But for the most part, what truly bothers me is the offhand way people look at their overweight state. Most people complain about being too heavy, but treat it as trivial. They want to lose some pounds and are sure they know how to keep them from coming back. They’ll get to it one of these days. I generally listen politely. What I really want to do is take them by the shoulders and talk some sense into them.
There are two ways to look at fat accumulation. The general perception is that being overweight just means that someone has eaten too much and their body has stored the excess. Kind of like an overstuffed pillow. If you look at it this way, it’s hard to get very excited about being overweight.
But suppose you look at weight in a completely different way? Suppose that weight gain only happens when there is a real problem with how the body is working. In other words, suppose fat is a symptom of something else? If that’s true, gaining weight is an alarm that’s ringing; a flashing red light. It’s your first indication that something is very wrong.
This is the way I look at overweight. It may be caused by the behavior of overeating, but that behavior has led to a disturbance in the body; a disturbance that is showing up as fat accumulation and signals a problem with the way the body uses sugar, controls blood pressure and manufactures artery-clogging cholesterol.
Overweight trivial? What about this little item that appeared in the paper recently?
“In an age when the adult populations of most industrialized nations have grown significantly taller, the average height of black women in the United States has been receding, beginning with those born in the late 1960s…..The main culprit appears to be diet.”
The gap between the height of white women and their black counterparts is:
“Truly phenomenal,” according to John Komlos, an economist and historian who mas made a specialty of studying human heights. “Such a steep decline is practically unprecedented in modern U.S. history….The only reasonable explanation we can come up with is diet and the obesity epidemic among middle and low income black women.”
The article goes on to make the following point:
Over the last three decades, the prevalence of obesity among white Americans has tripled, while among blacks it has increased five-fold. Black females were hardest hit: almost 80 percent of black females are overweight or obese compared with 62 percent of the total female population, according to the CDC.
I found it interesting that this particular finding did not receive the wide publicity accorded to other obesity related news items. Diet and obesity can actually stunt growth! The fate of obese people who are of lower income or belong to a minority group tends to get less press. That’s shameful because we’re all headed in the same direction. Johns Hopkins University published a paper last year that predicted a whopping overweight and obesity rate of 86 percent in the population at large by 2030. The huge burden of disease that will come along with such an increase is expected to raise obesity related health-care spending from the current $100 billion to over $960 billion per year.
And what about this little article in the Internal Medicine News? A study from the NIH has shown that more than 40 percent (40 percent!!!!) of American adults have blood sugar that is too high. And right above that, an article documents a newly discovered connection between a diabetes diagnosis in midlife (common in overweight people) and a doubling of the risk of dementia.
These headlines represent a tiny fraction of the articles I read each day predicting doom and gloom from our modern obesity epidemic. I walk through my everyday world carrying this information like a heavy weight, while all around me, I am subjected to The Atkins Curse – the conversations about the latest diet book, whether a colon cleanse can help you lose weight, the vow to get serious about that belly just as soon as the next cruise is over.
Honestly. It’s time to get serious now.
