Obesity cause and effect: Maybe we have it all backwards
Peter Attia, MD who is a surgeon has a motivational and thought provoking message about obesity and diabetes that suggests we are fighting the wrong war on obesity. In his recent TED talk - Is the ‘obesity crisis’ just a disguise for a deeper problem - Attia suggests there is much more to the obesity epidemic than eating too much and exercising too little. Maybe we have the obesity cause and effect all backwards.
He says it is wrong to punish obese patients. We may be getting the wrong advice on nutrition that challenges conventional wisdom about what we should eat and not eat to stay healthy.
In his own experience, Attia admits to looking at an obese, diabetic patient with a foot ulcer with disdain.He later recognized his lack of empathy and compassion after he was diagnosed with metabolic syndrome despite practicing a healthy lifestyle and following the recommended food pyramid to the letter. He understood obesity and diabetes are not about a lack of caring about one’s own health. Metabolic syndrome does not happen to everyone who is obese..
Attia, who is founder of the Nutritional Science Initiative (NuSI) became resistant to insulin despite following the governments recommended food pyramid to the letter and engaging in regular vigorous exercise. Attia had somehow gained weight.
He immediately started exercising less and says he changed his diet in ways that might be ‘shocking’ to some by eliminating certain foods altogether. He subsequently lost 40 pounds and reversed his insulin resistance.
He decided conventional wisdom about nutrition might be incorrect, saying most researchers believe obesity is the cause of insulin resistance. But then, why are some thin people insulin resistant, he asked himself.
The next conclusion form Attia is that obesity could very well be a ‘symptom’ of a much deeper problem. Perhaps insulin resistance causes obesity, meaning obesity is not a lifestyle choice at all.
If Attia’s thinking is correct, the American Medical Association (AMA), who has just decided to classify obesity as a disease, has completely missed the mark. Once again, clinicians would be treating a symptom versus the root cause.
Attia said he “knows” the notion might sound “crazy”, given the current obesity epidemic, but he wonders if something else is going on inside our body’s cells that is affecting 75 million Americans.
It may be, he says, that obesity, though not benign, may be a symptom of a “far more sinister problem” going on in the cells.
For about 75 million Americans, the appropriate response to insulin resistance may be to store fat, Attia suggests, versus the other way around.
By treating obesity, we may be ignoring the real cause, which does nothing for our health, but does boost profits for the pharmaceutical industry.
He likens it to treating bruises while ignoring the fact that millions of people are banging their shins into coffee tables.
The underlying epidemic causing obesity might be something else, evidenced by the fact that millions of thin people have metabolic syndrome and millions who are obese do not.
Attia hypothesizes our cells are protecting themselves from too much glucose and refined grains and starches; and obesity might not be just a response to overeating and not exercising.
Attia says our current beliefs about obesity should be challenged. He is now working with obesity and diabetes researchers with rival theories about the causes. His team does however agree conventional wisdom about the obesity problem should be challenged and is too important to ignore "because we think we know the answer”.
Attia says in his TED talk that can be viewed here that we cannot keep blaming overweight and diabetic patients any longer for overeating or not exercising. He says people want to do the right thing, but they ”have to know what that is.” Perhaps obesity has nothing to do with eating too much.
He tearfully said he ‘dreams of a day” when we have the courage to throw out ideas that don't seem to be working anymore. His research program is focused on how foods impact our hormones, metabolism and enzymes. He wants to find safe and practical dietary changes people can make to combat obesity, instead of punishing patients who are obese for making the wrong choices when we may not even know the right choices.
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