Friday, June 20, 2014

Your Body Thinks Obesity Is A Disease

sharma-obesity-adipose-tissue-macrophageYesterday, the 4th National Obesity Student Summit (#COSM2014) featured a debate on the issue of whether or not obesity should be considered a disease.

Personally, I am not a friend of such “debates”, as the proponents are forced to take rather one-sided positions that may not reflect their own more balanced and nuanced opinions.

Nevertheless, the four participants in this “structured” debate, Drs. Sharon Kirkpatrick and Samantha Meyer on the “con” team and Drs. John Mielke and Russell Tupling on the “pro” team (all from the University of Waterloo) valiantly defended their assigned positions.

While the arguments on the “con” side suggested that “medicalising” obesity would detract attention from a greater focus prevention while cementing the status quo and feeding into the arms of the medical-industrial complex, the “pro” side argued for better access to treatments (which should not hinder efforts at prevention).

But a most interesting view on this was presented by Tupling, who suggested that we only have to look as far as the body’s own response to excess body fat (specifically visceral fat) to determine whether or not obesity is a disease.

As he pointed out, the body’s own immunological pro-inflammatory response to excess body fat, a generic biological response that the body uses to deal with other “diseases” (whether acute or chronic) should establish that the body clearly views this condition as a disease.

Of course, as readers are well aware, this may not always be the case – in fact, the state of “healthy obesity” is characterized by this lack of immunological response both locally within the fat tissue as well as systemically.

Obviously, it will be of interest to figure out why some bodies respond to obesity as a disease and others don’t – but from this perspective, the vast majority of people with excess weight are in a “diseased” state – at least if you asked their bodies.

While this is a very biological argument for the case – it is indeed a very insightful one: it is not the existence of excess body fat that defines the “disease” rather, how the body responds to this “excess” is what makes you sick.

As readers, are well aware, there are several other arguments (including ethical and utilitarian considerations) that favour the growing consensus on viewing obesity as a disease.

Of course,  calling obesity a disease should not detract us from prevention efforts, but, as I often point out, just because be treat diabetes or cancer as diseases, does not mean that we do not make efforts to prevent them.

If calling obesity a disease increases resources towards better dealing with this problem and helps take away some of the shame and blame – so be it.

@DrSharma
Waterloo, Ontario

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4 Responses to “Your Body Thinks Obesity Is A Disease”

  1. David Brown says:

    To understand why some people can be obese and healthy (but most aren’t) while others (both fat and thin) experience metabolic disturbances associated with their food choices, it is important to pay attention to the quality of fat consumed.

    A factor generally ignored by experts is that prior to the industrial revolution, intake of omega-6 linoleic acid was 1 percent or less of total calories. NIH scientists Joseph Hibbeln has been investigating the matter for nearly two decades and recommends a decrease in omega-6 intake. Excerpt from a 2013 interview:

    “… the issue of high fat diets needs to be looked at very carefully. Just as all polyunsaturates are not created equal, all high fat diets are not created equal. A good example of this is an animal study we did where we compared three high fat diets. All with 60% of calories from fat, in mice. We compared high fat diets that resembled the linoleic acid, Omega 6 intakes, comparable to the levels at the beginning of the century, which was about 1 percent of calories, and those high fat diets with 8 percent of calories, more similar to the amount of Omega 6 in the diet simply from soy oil in the U-S diet, today. Moving from 1% to 8% linoleic acid in the mouse diets, not only tripled the levels of arachidonic acids, but also tripled the levels of a critical derivative of arachidonic acids, which is an endogenous cannabinoid, which creates a similar affect to marijuana. So it’s the brains own marijuana like molecules, and we were able to triple the body’s marijuana like hormones, three times higher in the liver and about 20% higher in the brains just by altering the linoleic acid in those two high-fat diets. Normally those high fat diets used for mice in studies are composed of high linoleic acid, found in soybean oil. When we deleted that one single molecule, the Omega 6 fatty acid, we were able to obliterate the ability of a 60% high fat diet to induce obesity in the mice.” Google – “Joseph Hibbeln omega-6″ to access the interview and some videos about the omega-6 hazard.

  2. Suzan Nashashibi RNutr says:

    Debating if obesity is a disease or not in my opinion depends on what health consequences sufferers register as lipid profile irregularities -prediabetes or diabetes existance cardiovascular hypertension and other comorbidities and lets not forget psycholigical negative impact of obesity from shame guilt low self esteem and very negative body image thoughts
    throughout my long practice in obesity management very rarely have i encountered someone free from physioligical or psycholigical comorbidities from that point of view i think obesity is a disease but whether one realises that or denies it is individual .Nevertheless obesity should be trearted but in the best way pissible and should be prevented as well so its a special kind of unique disease that can be prevented yet if existing has to be treated intelligently certainly not comnercially

  3. fredt says:

    The disease, in my opinion, is what ever is driving us to eat foods, not the result, obesity.
    Obesity is the result caused by overeating, but what is causing the overeating? What is causing the appetite, cravings, hunger? That is where the solution lies.

  4. joanne says:

    Hi,
    I am a 53 yer old female RN X 33yr.
    I so interested in this area, and took class at Primary Care Network.
    I was planning to sign up for research study.But was checking out what dr. sharma’s specialty is.
    Now I know…
    I love learning how this area applies to human body(Mine). I see huge amounts of patients day in day out .
    They seldom seem,not to get better and keep coming back by the truck loads.
    Pt. charts get thicker and thicker each visit they make.
    Very few seem to feel any better??? Frustrates me so much and patients are frustrated as well. Prescription after prescription. As RN’s, we are unable and not, to talk about topics to our patients regarding other avenues of help.
    I have experience chronic pain,fatigue,weight gain,menopause and it is a vicious circle why no doctor can get to the root so i can have a better quality of life.Thus share and educate friensds and loved ones who struggle and spench much finance on supplements and physio , massage etc. yet no real results.
    passionately(about research and answers
    and sincerely… joanne m.
    Edmonton ab. Canada

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