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Friday, October 21. 2016Fat, Satiety signals, and Insulin"A third of Americans are obese"? Really? I don't think so but I do not see very many obese people in my life. I could think that a third might be fat, though, aka "overweight." Being overweight is a bad idea because it slows you down, damages your joints, and plays a role in some diseases such as breast cancer and heart disease. Also, it is widely viewed as unattractive and as a sign of poor impulse control in Western cultures rather than a sign of prosperity as it is in some. Donald Trump "fat-shamed" his employee "Miss Piggy" for being "an eating machine." Mr. Trump, who is fat, was attacked for that by Mrs. Clinton - who is fat and getting fatter. As for fat-shaming, even your doctor will do that to you when you visit. I do not view being overweight or obese as a disease. They are physical "conditions." All behavior has physiological consequences and correlates, which does not make them diseases. We over-pathologize things these days in an effort to let people off the hook for their behavior or, sometimes, in search of an insurance code. In my view, if you do not mind being fat, that's fine. Your choice as long as you accept the consequences. Being underweight frightens me more, medically. I'll briefly discuss two physiological correlates of overweight and obesity. First, satiety. A sense of satiety is managed by chemical signals from the gut to the brain. The signals are slow to inform you that "That's sufficient." Thus fast eaters do not get the memo in time to stop. Furthermore, some people have weak signaling, or just learn to ignore the signals. Heavy-duty eaters also have expanded stomachs which are less-readily satisfied and always seem to have room for more. Recreational eating is what I call that. I think many people seem to ignore or misinterpret all sorts of physiologic signs and signals. Also, hedonism is, by definition, fun. My second physiologic correlate for today concerns insulin. An excess of carbs (more than you need to stay alive that day) gradually causes "insulin resistance." That is not diabetes, but just an adaptation to the amount of carbs a person consumes. It is discussed here. It explains how carbs effect energy levels and fat accumulation. Trackbacks
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If you don't think a third of Americans are obese, you haven't been in a Walmart recently.
This effort to label more and more people as obese or overweight began intentionally. In 1998 health care professionals changed the way they determined overweight and obese and began using the BMI as a measure. The BMI is arbitrary and based on a time and place that actually caused people to be suffering from famine. It was at that time that they choose the 'average' weights for various heights.
This is not to say that today fat people are still indeed fat and obese people are indeed still obese. The difference that needs to be understood is that with the new standard the number of 'obese' doubled overnight without the need to gain a single pound. Similarly you will find that the statistics often cited to show this huge gain in obesity takes advantage of this timing without any explanation of the data and measurement change. True obesity, i.e. weighing over 350 lbs or so is NOT simply a result of eating too much or eating too many carbs. It is genetic pure and simple. They cannot easily loose the excess weight and if they manage to lose it keeping the excess weight off is often impossible. Most fat/overweight/obese people do not want to be overweight. Most of them are at the weight their genetic code has set for them. Most people who are simply overweight can fairly easily lose that excess weight. I would avoid all of the fad diets and follow the simple rule of reducing portion size and ending snacking between meals. While a fad diet or a Jenny Craig kind of diet 'may' work what do you do after you have lost the weight? Stay on that diet? Gain the weight back? It would be far wiser to learn to control the portions you consume and eat your 'normal' food. I read somewhere that the "explosion" of diabetes was due to moving the goalposts.
Diabetes was previously identified as a blood sugar level of above 140 milligrams per deciliter. A few years ago, though, it was redefined as having blood sugar equal to or above 120 mg/dl. Doubled the diabetes rate overnight. Windy obsessively peddles that nonsense here all the time, Fert. It's a thing.
Yup, that's exactly what happened.
Same with the "obesity epidemic". By redefining "obesity" to a much lower BMI (itself a pretty bad indicator, but that's another story) they made the number of obese people suddenly go up by an order of magnitude. And of course the whole diet and fashion industry don't help, with their constant hammering that everyone who's not (almost) anorexic is obese, that if you can't see your ribs sticking through your skin you're obese. Another factor in the diabetes epidemic is that about half of the people with diabetes are undiagnosed. These are mostly younger people and those whose diabetes is not as severe. The health community began an effort a few years ago to identify these people earlier because the earlier you begin treatment the better the outcomes. However with these seemingly increased numbers of diabetes came an opportunity to make it appear that the rate of diabetes was increasing. This gave everyone with an agenda a tool to use to push their diet/health scare/lifestyle agenda. The rate didn't change but the total numbers of those diagnosed did change.
I graduated from high school in 1964, yes I'm old. However, when I look at my old yearbooks everyone but a couple of kids are very thin. How did those skinny bodies produce inherited fat bodies in the decades following the 60's (I don't think it due to heredity most times)? Fast food, non home cooked meals and television are three of some of the fat producing culprits . Most people were thinner unless the were over indulging in the "good-life" if they were wealthy. Just my observation and at the 50 year reunion most were heavier with age but not obese.
I think it's time for a healthy dose of "medicine shaming." In fact doctors don't have a clue about the causes of obesity - they just try to treat symptoms. Imagine a doctor that treats all fevers with cold showers. That would be thermodynamically correct but would miss the larger point that a healthy body regulates its temperature. In the same way doctors that seek to treat obesity by having patients inflict themselves with starvation are missing the point that healthy bodies regulate calorie intake and body fat. They resort to gross thermodynamics.
One bit of evidence - dex fenfluramine, which "magically" reduced the point at which satiety occurs, and lead to "effortless" weight reduction. It was banned for reasons that elude me. A related compound (fenfluramine) was found to correlate with a heart condition so all isomers of the drug were dropped. There was no evidence made public that either established causation or the effect of the dex isomer. Could it be that it worked so well that it threatened too many drugs and too much medical trade? And the entire diet and agricultural industry and their lobby groups.
The "food pyramid" is a good example of dietary advise that has nothing to do with what's a proper diet and everything with what foods need to be pushed to satisfy political goals. As farm subsidies shift to other sectors of the agricultural sector, the "food pyramid" is adjusted to favour the products of that sector. That's why we ended up with the "standard diet" which is filled to the brim with processed carbohydrates. All that came about when the production of grain was massively subsidised and those subsidies are still there. If grain consumption were to go down to healthy levels, there'd be such a massive excess of grain and grain products that prices would collapse. Some countries have gone so far as to set in law minimum grain prices (and thus minimum prices for bread, pasta, rice, etc.) to part offset that! The EU used to massively subsidise milk as well, and milk and milk products had a very prominent place on European "food pyramids" (which always differed from American ones...). When those subsidies were greatly reduced, suddenly milk became the boogeyman and was pushed to a very low percentage "healthy for consumption", all the government initiated "milk is good for you, drink 2 liters a day" campaigns disappeared overnight as well. And they're still at it. Meat is the new boogeyman, to the point there are discreet plans to leverage an excessively high tax on it in order to stop people eating meat. This time it's all "for the environment" of course. And suddenly meat has all but disappeared from the "food pyramid", going from 25% or more "recommended for a proper diet" to something like 5%. The moral of your story is don't concern oneself with government "food pyramids" because they are manipulated to reflect current political policies.
Once again I have to defend Trump, a man I do not like and am also voting for.
I don't think Trump is fat for a 70 year old man. His neck is fat, but that's probably genetic and also comes with age. The original piece is incoherent, as commonly is this subject in this place. Sadly, there's nothing such thinking can be led to, whether statistically, medically, or logically, that's penetrated its internal myths or corrected the double think. I've tried.
"A third of Americans are obese"? Really? I don't think so but I do not see very many obese people in my life. Whether X ratio of Americans are obese isn't the point. The point is that some percentage of Standard Diet-eaters in the west are obese and they are historically atypical and profoundly unhealthy, and that that dietary problem then extends to disease. Separating the symptoms as if they were distinct is no more rational than separating their causes. Like diabetes, cancer, and heart disease - all at higher levels than in the past or elsewhere in the world where diets are not the standard western diet and had already been connected by research to vastly different medical cohorts and ratios - are both symptomatic of and the cause of underlying and preventable problems. Finding those problems has already been done and the research is absolutely rife. That data does not make the terminal logical mistake of also separating diet from obesity, and hence from disease. I could think that a third might be fat, though, aka "overweight." Being overweight is a bad idea because it slows you down, damages your joints, and plays a role in some diseases such as breast cancer and heart disease. Ergo, at the least obesity causes serious disease but, somehow, the cause of obesity is undiscussed and undisclosed. I do not view being overweight or obese as a disease. But you view it as causative of disease. They are physical "conditions." Disease is also a physical condition and if obesity uniquely causes it, then it becomes a symptom of obesity. Obesity is then a pathology. All behavior has physiological consequences and correlates, which does not make them diseases. We over-pathologize things these days in an effort to let people off the hook for their behavior or, sometimes, in search of an insurance code. Here starts the double think: Obesity causes disease but obesity is merely the extension of a cultural affect, goes the thinking, notwithstanding the pathology of its resultant diseases. We "over-pathologize" what becomes the pathology of disease-by-obesity but obesity is abstract and arbitrary and looking "to let people off the hook" about it somehow interrupts that relationship. In my view, if you do not mind being fat, that's fine. Your choice as long as you accept the consequences. Fair enough. But in sum, this all says that the obesity-disease correlate is a choice we shouldn't pathologize as the pathology it becomes, and while it can kill you by its effects - by the diseases obesity causes that somehow exonerate it itself as a disease - those shared roots shall go beyond the scope of such an analysis. There's a weak cause-and-effect without a cause. Since we've diagnosed obesity as a cultural affectation without known cause - except overeating and in a moment, evil King Carbs - disease admitted as stemming from it does not itself condemn it although it does roundly implicate carbs. In other words, lifestyle is exempt except when it's not exempt. Consciousness of obesity cannot invoke the cause of obesity save for an undefined cultural effect and presumably, a limited, narrow, and undeveloped personal choice. And this is not "letting people off the hook"? I'll briefly discuss two physiological correlates of overweight and obesity. First, satiety. A sense of satiety is managed by chemical signals from the gut to the brain. The signals are slow to inform you that "That's sufficient." Thus fast eaters do not get the memo in time to stop. Furthermore, some people have weak signaling, or just learn to ignore the signals. Heavy-duty eaters also have expanded stomachs which are less-readily satisfied and always seem to have room for more. Recreational eating is what I call that. This "physiologically-correlated" salad simply avoids the connection between any of the areas related to health vis a vis obesity, and therefore to disease. In fact, "heavy eaters" in this odd matrix are spontaneous creations, who, like "slow signalers", may/can have no discernable relationship to weight, obesity, and ultimately the diseases Bliss has already tied to them. Somehow, there is a physical relationship between diet and weight and therefore disease that may establish no (known, discussed, causative) relationship between diet and disease, whether via weight or not. Here choice is blurred together with the most peripheral take on obesity, or therefore to the serious disease said to stem from it, but never let it be said that, with one undeveloped exception, there is some underlying connection - despite mountains of evidence - (unless presumably it's the "genetics" canard. Genetics, of course, that may never be tied to culture or diet either, despite these elements of society all being implicitly tied together over all time. In fact, see the Adkins/Taubes obsession and fad that implicitly and for all time ties all of them together.) This particular double think applies accidental, uncorrelated, assumed, and/or spontaneous conditions but logically disconnects this implied "impulse control" quasi-pathology from the previous human choice-centered tacit lifestyle "physical condition" that ultimately causes the obesity said to cause disease, even if both are symptomatic of poor health rooted elsewhere, in a taboo subject that, ironically, actually is about choice, that being diet. I think many people seem to ignore or misinterpret all sorts of physiologic signs and signals. Also, hedonism is, by definition, fun. And I agree that many people actually do ignore or misinterpret all sorts of physiologic signs and signals, as well as causes and symptoms; pathologies and diseases. Because lifestyle is, by definition, also confirmation bias. My second physiologic correlate for today concerns insulin. An excess of carbs (more than you need to stay alive that day) gradually causes "insulin resistance." That is not diabetes, but just an adaptation to the amount of carbs a person consumes. And again, by the copious data on nutrition and the body, this is just flat wrong, and by the omissive bias that impairs this whole opinion. |