Tuesday, August 16, 2011

Some Obesity Explanations Don't Work. Why?

Some Obesity Explanations Don't Work. Why?
The dissenter is every human being at those moments of his life when he
resigns momentarily from the herd and thinks for himself.
-
 [Caution: the following article is long by usual standards. Read it when you have time to digest is content. It will cause you to think. Obesity is a worldwide problem. Real solutions are scarce.]

When something close to us goes terribly wrong, we don't understand it and we don't like it, human nature dictates that we look for someone to blame. The blame, all too often, goes to the person or group who exhibits behaviours we disapprove of.
A child dies mysteriously, many want to blame the mother. Some even want her executed for murder. Not long ago, after many mothers had been charged and some imprisoned for murdering their infants in what was called crib death, SIDS (Sudden Infant Death Syndrome) was discovered and proven by science. Nature, not bad parenting, took its toll.
In centuries past, Americans in New England were troubled in 1692 by terrible events they couldn't explain. Many women in Salem, Massachusetts, were tied to stakes and burned to death as "witches." Despite the fact that today's witches have not been proven to practice harmful curses, witch costumes remain one of the most popular on Halloween. Wiccans find themselves excluded from the mainstream of society in most communities. The "curse" the Salem witches supposedly had cast was a disease that was not known or understood in their time. Think of influenza scares in recent years and the near panic effects they had.
In ancient times, bad weather was often blamed on bad behaviour by humans in a community that suffered crop damage from hail, drought or floods. Family deaths from disease were often attributed to bad behaviour by current or former members of a family. Humans, it was said, had displeased the gods. Someone was always fingered for blame, no matter if any evidence to convict even existed.
So it is today with obesity. Societies around the world commonly and readily accept that overweight and obese people got that way by overeating. Some graciously add lack of exercise. Too heavy? Convicted, without further investigation or explanation.
Obesity is hardly only the curse of overfed people in rich countries. It exists in virtually every country and almost every culture in the world. It exists in primitive tribes hidden away in the rain forests of the Amazon, in the Innuit (a.k.a. Eskimo) people of the far north, among hard working members of active militaries, among truck drivers, mail carriers and former Olympic athletes who still work out vigorously but not as much as when they were competing.
Overeating and lack of exercise may work as explanations for many people, but not all by any means. Some condition exists today that was rare or non-existent in the past. Laziness and gorging alone do not explain this pandemic.
Most of us know of people who eat far more food than their bodies need and get virtually no exercise. I will never forget the image of three obese women in a restaurant where my wife and I had gone for pizza. Without much to look at around us, we glanced over several times to see the women devouring their food. We noted how much more they had ordered than we had, and commented to each other about the fact. As we finished our pizza, we looked at their table to find it had been cleared of the previous plates and their main course had been delivered. What we saw had only been their appetizers. Before we left, fully satiated with one shared pizza, they had ordered desserts.
I also know a few people who eat far less than I do, exercise more, but tip the scales about 50% heavier than I do. That doesn't make sense.
Much about obesity and persisting explanations for it don't make sense. When we don't understand something mysterious, we tend to blame human behaviour. That is, with the blunt statement: they eat too much, exercise too little. For many obese people, they exercise very little because their weight prevents them from doing more.
Science has identified the protein leptin as the hormone that controls appetite and metabolism. Leptin tells us when we are full, when the meal is over. Or should be over. People with Cushing syndrome lack the gene that controls leptin production on chromosome 7, or they lack receptors for the leptin their bodies produce. The more researchers look, the more people they find with leptin problems. Most obese people have Cushing.
Wikipedia identifies Cushing as being "caused by high levels of cortisol in the blood." Well, now it seems we should be getting somewhere. The adrenal glands produce cortisol as our means of controlling stress in flight-or-fight situations. In other words, in moments of high stress. So, stay calm, right?
Not so fast. Science doesn't have a clear idea about how these chemicals react with each other and how they interact in each individual body. We're still waiting for the pill. That should straighten everything out.
Ah, but many of us today, especially those who live in large cities, whose employment situation is dubious or whose marriage (or primary relationship) is rocky live with constant stress. Constant stress means constant production of cortisol, which means constant depression of leptin. Such people have no way of knowing when to stop eating, when they are full. That is very important. Nature failed these people because another part of nature overrode natural signals.
A PBS documentary I watched recently showed a 500 pound man who went through gastric bypass surgery. It said that this 40-something man could have reached this giant size by overeating (more energy than his body burned) as little as one apple every three days over his whole lifetime. One extra apple every three days could have caused his obesity.
Science also knows that virtually everything that happens within the body takes place as a result of hormones, triggered by endocrine glands, with messages sent to body organs with protein messengers. What affects these hormones?
Governments in several countries have banned bisphenol-A because it can affect the brains of fetuses, babies and young children. Bisphenol-A, used to make polycarbonate plastics and epoxy resins, appears in many plastic products we use daily. World production of bisphenol-A in the 1980s was around one million tonnes. By 2009 that number had rocketed to 2.2 million tonnes. How does that fit with your memory of when obesity became a world pandemic? How might this chemical hidden in so many plastic products have affected you? Have you heard of any studies about how bisphenol-A affects adults or adolescents?
Industries chuff over half a million kinds of chemicals into the air we breathe and more than half that many chemicals into the water we drink. Our governments ignore possible health affects of these chemicals because the industries provide jobs. Jobs for voters.
At least we can eat organically produced foods, can't we? A recent study examined eggs produced on a Canadian farm that strictly followed guidelines for organic products. Everything the hens consumed from the time they were hatched from eggs was organically "clean." The study found five superbugs, antibiotic resistant microbes for which medical science has no cure, in the farm's organically produced eggs. How? The farmer could only speculate that the original eggs from which his hens had hatched were from non-organic farms. Those superbugs were likely passed from one generation of chickens to the next genetically.
At least the drugs our doctors prescribe are safe. They have been tested for safety and approved by our governments. Well, not quite. Most governments depend on the manufacturers of these drugs to do their own testing and to report their results honestly. Hmmm, honest pharmaceutical companies?
But our governments set the rules for these tests and the tests can be supervised by government representatives. Yes, but few are. Cutbacks. And the test periods that determine how safe chemicals are for us that our medical professionals prescribe? Three years for the most rigorous tests. One year for the majority of new products. Products prescribed by doctors, products that supposedly improve your health.
What you do in your 20s can severely impact your health in your 40s, even in your 60s. You could literally die at age 45 as a result of something that happened to you or that you did in your teens or your 20s. Our bodies take that long to react to stressors in some cases. But prescribed drugs are tested for only one year in most cases.
Returning to our original discussion point of obesity, we have no clue about what causes it, or what might cause it, or what might influence obesity in some people but not in others. As for our tradition of blaming people for their own health condition, maybe we should restrain ourselves on that. For all we know, it could be "something in the air or water." Or something their doctors prescribed to clear up a simple skin problem. Or an antibiotic prescribed to clear up a childhood infection.
Of two things we can be certain. One, we alone bear responsibility for our own health. No one else, certainly not our governments, will be there with us all the way. We need to be knowledgeable and vigilant about what we eat and drink.
Two, we need to prompt our elected representatives to act more on our behalf than on the behalf of corporations that provide jobs but little health protection as they rake in fortunes and become Big Something-or-others.
We need to help ourselves. We need to help each other. Finally, and perhaps most importantly, we need to teach these lessons to our children whose lives could otherwise be destroyed by predator corporations whose sole objective is profits.
Addenda to the original article (random thoughts on obesity):
(1) Historically all societies have had obesity rates around three percent, with about six to ten percent of the population overweight. Worldwide, the numbers are now up to ten times what they were. In some families, every member is obese, in others everyone is relatively thin. Lifestyles and amount of food consumed may be similar.
(2) Humans, like all species of animals, have never been lazy or slothful. A species could never survive that way. Laziness is not in our nature. Maybe many of us get less exercise than our ancestors because our lifestyle is restricted by work commitments that tie us to one place and position for too long each day.
(3) No society in human history has been forced to consume water that is filled with hundreds of chemicals that have never undergone long term studies for their effects on human health. Nor has any society been forced to eat food from chemically produced containers as we have. We inhale up to half a million chemicals that are foreign to our bodies with each breath we take.
(4) "Fresh" produce we find in markets, advocated my many health authorities as the best food we can eat, is polluted with chemical pesticides, fertilizes and growth stimulants. "Organic" food products are not free of them. They grow in the same air and with the same water.
(5) Food preservatives that allow us to shop for food once a week rather than once a day do exactly the opposite in our bodies of what we want, which is for the food to break down into raw components we can digest.
(6) No one wants to be fat or obese. Neither exercise nor diets (including permanent changes in eating habits) have proven to be successful in keeping weight off. Most promote yo-yo weight losses and gains that are much harder on our bodies than excess fat. We don't know how our extra weight goes on, we don't know how to get it off. Nothing works over a longer term.
(7) Dramatic increases in longevity over the past two generations may have changed more than just the health of gene strings in our DNA chromosomes. What is causing many of us to be fat may also be causing us to live longer. We just don't know.
(8) Every health authority advises us to avoid gaining weight. Not one says how to do so safely. Some people eat "like birds" but gain weight rapidly. They would starve if they ate less by depriving their bodies of essential nutrients.
(9) I, personally, could not eat the quantities of food recommended by my government's health authority. My stomach is not large enough. If I were to stretch my stomach by eating more of what it recommends, the government has no evidence to support the claim that I would be healthier or that I would not gain weight. It's "ideal" diet could actually prove to be unhealthy because it would cause me to consume chemicals in fresh produce that my body is not prepared to deal with.
(10) Our governments need to start finding real solutions. We are all tired of hearing about the problem.
(11) Eating treats and overeating are the most dependable strategies to tweak the reward centres of the brain without having a downside in the near future (such as a hangover after drinking alcohol heavily). Do we have too few ways to reward ourselves in a non-harmful way or too few support mechanisms so that we need rewards to make our lives seem worthwhile?
(12) There is no such thing as a true expert on consumption of healthy foods or exercise. In time they are all proven wrong.
(13) The best we can do is to eat in as healthy a manner as we believe is right. Worry and stress, including obsessing over weight, causes us to gain weight. So far there are no right answers about healthy weight, only scary media stories put forward by charlatans who make money by telling us how fat we are becoming. These cause us stress, which cause weight gain.
Known reasons for rapid weight gain:
- hypothyroidism (low thyroid hormone), in some people body metabolism changes with age mean that even a high average TSH (thyroid stimulating hormone) score on a blood test could mean a slower metabolism resulting in weight gain
- PCOs (polycystic ovary syndrome), associated with cysts or fluid sacs in the ovaries
- Cushing syndrome (see article above), too much cortisol, often the result of taking medication for other conditions, such as asthma, or the existence of a noncancerous tumour
- oral contraceptives, some weight gain is associated with taking "the pill"
- steroids (not anabolic steroids as used by weight lifters and athletes), often taken to counter painful conditions such as arthritis or inflammation, possibly even from topical application for a skin condition
- type 2 diabetes, possibly caused by weight gain, possibly a result of having it (either is possible)
- antidepressants, especially selective serotonin reuptake inhibitors, though Prozac seems to cause less weight gain
- estrogen therapy (controversial), as metabolism slows in women after menopause naturally
Finally, a quote from Canadian broadcaster CTV's news web site:
"Obese people who eat well and exercise live just as long as their slimmer counterparts and are less likely to die from heart disease, results from a new study suggest.
Researchers used a new rating scale, the Edmonton Obesity Staging System (EOSS), which gauges the progression and severity of the disease.
They found that obese people who scored lower on the scale, meaning they could metabolize fats well and had no other physical or psychological problems, were less likely than the thin group to die from cardiovascular or heart disease.
"Our findings challenge the idea that all obese individuals need to lose weight," lead author Jennifer Kuk said in a statement.

Bill Allin is the author of Turning It Around: Causes and Cures for Today's Epidemic Social Problems, a guidebook for teachers, parents and grandparents who want to grow healthy, self-supporting and self-sustaining children.
Learn more at http://billallin.com/
Archibald MacLeish, American poet and librarian (1892-1982)