The Truth about “Diabesity”

An ABC news online report today lead with the line “Half of all American adults are destined to develop diabetes or pre-diabetes by 2020 if they don’t slim down….” It goes on to talk about the “diabesity epidemic”

While I applaud the portmanteau, I have to come down against horrible, irresponsible, unprofessional reporting.

Being overweight doesn’t cause diabetes. I know that because the American Diabetes Association says on their website:

Myth: If you are overweight or obese, you will eventually develop type 2 diabetes.

Fact:  Being overweight is a risk factor for developing this disease, but other risk factors such as family history, ethnicity and age also play a role. Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes.  Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight. [emphasis is mine]

Obesity is not a disease.  It’s not a diagnosis.  Obesity as we currently define it is simply a ratio of weight and height.  By this definition almost the entire NFL is headed toward diabetes. The only thing that you can tell based on a ratio of someone’s weight and height is the ratio of someone’s weight and height. Obesity has no consistent behavior.  There are healthy fat people, there are unhealthy thin people.

Their “cure” doesn’t exist.  “Slimming down” as suggested by ABC news is problematic at best.  Nobody can prove that any method of weight loss works.  95% of people who attempt weight loss fail.  We blame them and stop there.  That’s like if Viagara only worked 5% of the time and doctors kept prescribing it and them blamed the rest of the guys for just not trying hard enough.  In medicine, if a prescription doesn’t work 95% of the time, we work to develop a new solution.

Correlation is not causation. The fact that two things happen at the same time doesn’t mean that they cause each other.  It’s quite possible that both things are caused by a third factor, or that they are unrelated.  For example studies are starting to show that, in countries where there is no stigma on obesity, there aren’t negative health outcomes of obesity.  More studies are needed to determine if the constant shame, stigma and guilt faced by obese people in the other cultures causes the health issues, or if it’s something else, or if causality can actually be linked to weight.

I’m a fan of health.  I’m for people getting access to affordable, healthy foods.  I’m for people having access to movement options that they enjoy.  Why is that not enough?  Why can’t we be for health?  Why do we have to create a culture of guilt, shame and blame.   If weight loss fails 95% of the time then why not be honest that even if it would solve these health problems (and we don’t know if it would) we don’t know how to get it done.

Then we could start spending all of this omigoddeathfatiscomingforus money creating access to foods that are nutritious and delicious, and movement options that people enjoy. We could pull our health out of the wallets of the diet industry, and put the 60 billion dollars that we pay to them every year into something that actually works.  Imagine what kind of health we could have if we actually focused on health!

Published in: on November 25, 2010 at 4:26 pm  Comments (19)  

19 CommentsLeave a comment

  1. Imagine a $60B subsidy for sustainable organic urban farms, for grass fed beef and for ethically treated feed animals, how about a variety of movement programs in schools and not just sports. I think we could do a lot with 60 billion dollars.

  2. “…countries where there is no stigma on obesity…”
    Where are these countries? Can I move there? Do they have WiFi and a decent shoe store that carries narrow widths?* ;)

    Thanks for another great post, and happy Thanksgiving!

    * Yes, you read that correctly. I’m “obese” according to BMI (5’4″, 185ish lbs.), and I have narrow feet. Anything in a medium/B width falls off.

  3. As someone who is a size acceptance and fat activist as a result of poor health due to a society that made me think it was ok to hate my body because almost everyone did and do the self destructive things I did to get thin.
    A population of people you will see mark my words, already exists but isn’t talked about is those who are post operative gastric bypass patients. Those who claim they have the surgery for health, are trading in the potential for the “so called comorbidities of obesity” of diabetes and hypertension for reactive hypoglycemia and hypotension and the complications that are resulting from this not only are destroying qualities of life (RH and hypotension are the only 2 I am listing because they correlate with the diabetes obesity scare) but are causing millions of dollars in healthcare to manage people who are inflicted with this. If I was a taxpayer (I am no longer as I am too disabled from my complications to work any longer and am on SSDI) and I would find out what I already know about how much wls is costing health care, not just from the surgery itself but its complications, would maybe help people take a different approach and regard to weight. Kind of like what you have to say. Ragen Chastain For President(or maybe Ragen can knock some sense into Michelle Obama’s fat fear perpetuating ass)

    • I’m sorry that this happened to you. Thanks for sharing this story – I think it’s really important for people to hear. I agree that there is going to be some serious backlash from WLS for which we are not prepared.

    • I’m so sorry you’ve had to go through that. Thank you for your willingness to share your story with others. That definitely broadened my understanding of the issues surrounding that procedure.

  4. The number 20.3 million includes undiagnosed diabetes, by definition people that have had one positive fasting glucose test. The number of diagnosed cases is 14.6 million. To have diagnosed to have diabetes, you have to two tests on different days.

    I was scheduled for a fasting test and ate and forgot that I had eaten until after the test. I think I had pancakes and syrup. My normal fasting blood sugar runs about 80, nowhere near the 126 cutoff.

    The CDC uses the higher number, a false number, as the number of diabetics. People lie with statistics.

  5. If I find a way to slim down and still eat copious amounts of sugar everyday, am I in the clear for getting diabetes or just diabesity (diabesites?)? Surely, according to ABC News, you could answer the question just based on that scanty amount of information. Right?

    Everybody knows how easy it is to solve “simple” metabolic disorders! Why don’t they have a pill for diabesity yet??? I’ll bet there’s one on the way….

    (Sorry, I guess I should have hung out my SARCASM sign first.)

  6. Today my mom emailed me the link to that abc article because omgdeathfat is upon me (or some such nonsense) and in-turn I emailed her the link to this blog post. She responded with “well obviously this girl read the ada site wrong and is just tired of being picked on for being fat. If she would just try harder she wouldn’t have that problem.” My head met my desk briefly then I told her to read your “about” section which was met with the usual VFHT and the “fact” that all overweight people are unhealthy. How do you explain to someone so obviously thick-headded that they are wrong?! You must be a better person than me, because I either have to walk away or risk punching them in their mis-informed mouth.

    • I’m sorry that your Mom is being like this. My opinion is that people can think whatever they want. What I control is how I allow myself to be treated. If it were my Mom, I would decide what my boundary is and then let her know, with consequences. It might be that if she isn’t open to rational discussion and the possibility that she might be wrong, that this is a subject that she is no longer allowed to discuss with me. It might be that she is no longer allowed to discuss health and weight with me. Then I would create a consequence that I can actually follow through with and then apply it. As an aside, I must say that I’m highly amused about the idea that I read the ADA site wrong. That’s a special kind of stubborn.

      As far as what to send her, you’ve actually inspired a blog post that will go up in a little bit so you could send her that! Good luck :)

      ~Ragen

      • Thank you for the advice! Living with her makes it doubly hard as we tend to have dinner together, which is offten my biggest meal since I’m up so late. All she sees is that I eat a *tiny* bit more than she does, and I get the “you don’t want to end up with [insert VFHT du jur] do you? Blah blah blah.” I’m going to have a little chitty chat with her tonight.
        Keep up the amazing work you’re doing!

      • This is a recurring issue with my dad, I have tried to set boundaries but he just ignorantly pushes on under the pretense of “I love you dearly, BUT… [lecture]”
        What kind of consequences do you suggest? I have gone through periods of restricting contact but i fear it affects me + our relationship up for the worse. :/

        • Hi Georgia,

          This is a tricky question. The short answer is that you can only set boundaries that you are willing to uphold. I would suggest waiting until a time when the situation is not charged, and then being honest with him. Maybe something like: Even though you know that he feels it’s out of love, the comments are inappropriate and need to stop. Then explain your boundary. I’m not sure if that helps or not. Good luck with this and let me know if there is anything that I can do!

          ~Ragen

  7. I work with the elderly. There are numerous skinny type-2 diabetics that I have encountered. Therefore I would say that weight is not the giant pre-determining factor that the anti-fat brigade would have us believe in development of type 2 diabetes.

    • I thought you might be interested in some fact over fantasy. High levels of triglycerides damage the Beta-cells of the pancreas, these cells perform the endocrine secretion of insulin into the blood. The damage to these cells is mainly due to the oxidative damage caused by these triglycerides. Below I have listed all the publications I could find in 2 minutes that confirm triglyceride involvement in this process.
      I apologise there are only 20, however given 30 minutes I could probably find another 100,000. A further 100,000 could be provided if I had an hour… or millions if continued until I was dead.

      Artac, M., Sari, R., Altunbas, H. & Karayalcin, U. (2002). Asymptomatic acute pancreatitis due to tamoxifen-induced severe hypertriglyceridemia in a patient with diabetes mellitus and breast cancer. J Chemother, 14(3), 309-11.
      Axelsen, M., Smith, U., Eriksson, J. W., Taskinen, M. R. & Jansson, P. A. (1999). Postprandial hypertriglyceridemia and insulin resistance in normoglycemic first-degree relatives of patients with type 2 diabetes. Ann Intern Med. United States.
      Bar-David, J., Mazor, M., Leiberman, J. R., Ielig, I. & Maislos, M. (1996). Gestational diabetes complicated by severe hypertriglyceridemia and acute pancreatitis. Arch Gynecol Obstet, 258(2), 101-4.
      Cabre, A., Lazaro, I., Girona, J., Manzanares, J. M., Marimon, F., Plana, N., Guardiola, M., Heras, M. & Masana, L. (2010). The APOA5-1131 T>C variant enhances the association between RBP4 and hypertriglyceridemia in diabetes. Nutr Metab Cardiovasc Dis. Germany: 2009 Elsevier B.V.
      De Luis, D. A., Conde, R., Aller, R., Izaola, O., Gonzalez Sagrado, M., Perez Castrillon, J. L., Duenas, A. & Romero, E. (2009). Effect of omega-3 fatty acids on cardiovascular risk factors in patients with type 2 diabetes mellitus and hypertriglyceridemia: an open study. Eur Rev Med Pharmacol Sci, 13(1), 51-5.
      Doi, K. & Ishida, K. (2009). Diabetes and hypertriglyceridemia modify the mode of acetaminophen-induced hepatotoxicity and nephrotoxicity in rats and mice. J Toxicol Sci. Japan.
      Hogue, J. C., Lamarche, B., Deshaies, Y., Tremblay, A. J., Bergeron, J., Gagne, C. & Couture, P. (2008). Differential effect of fenofibrate and atorvastatin on in vivo kinetics of apolipoproteins B-100 and B-48 in subjects with type 2 diabetes mellitus with marked hypertriglyceridemia. Metabolism. United States.
      Kametani, T., Koshida, H., Nagaoka, T. & Miyakoshi, H. (2002). Hypertriglyceridemia is an independent risk factor for development of impaired fasting glucose and diabetes mellitus: a 9-year longitudinal study in Japanese. Intern Med, 41(7), 516-21.
      Kim, D. M., Ahn, C. W., Park, J. S., Cha, B. S., Lim, S. K., Kim, K. R., Lee, H. C. & Huh, K. B. (2004). An implication of hypertriglyceridemia in the progression of diabetic nephropathy in metabolically obese, normal weight patients with type 2 diabetes mellitus in Korea. Diabetes Res Clin Pract. Ireland.
      Kotani, K., Satoh, N. & Yamada, T. (2010). Bezafibrate and serum amyloid A–low-density lipoprotein complex in patients with type 2 diabetes mellitus and hypertriglyceridemia. Eur J Intern Med. Netherlands.
      Kumar, S., Durrington, P. N., O’Rahilly, S., Laing, I., Humphreys, P. J., Olukoga, A. O., Bhatnagar, D., Mackness, M. I., Davis, J. R. & Boulton, A. J. (1996). Severe insulin resistance, diabetes mellitus, hypertriglyceridemia, and pseudoacromegaly. J Clin Endocrinol Metab, 81(10), 3465-8.
      Lampman, R. M. & Schteingart, D. E. (1991). Effects of exercise training on glucose control, lipid metabolism, and insulin sensitivity in hypertriglyceridemia and non-insulin dependent diabetes mellitus. Med Sci Sports Exerc, 23(6), 703-12.
      Lee, S. J., Moye, L. A., Campos, H., Williams, G. H. & Sacks, F. M. (2003). Hypertriglyceridemia but not diabetes status is associated with VLDL containing apolipoprotein CIII in patients with coronary heart disease. Atherosclerosis. Ireland.
      Nayak, K. R. & Daly, R. G. (2004). Images in clinical medicine. Eruptive xanthomas associated with hypertriglyceridemia and new-onset diabetes mellitus. N Engl J Med. United States.
      Rius Riu, F., Pizarro Lozano, E., Reverter Calatayud, J. L., Gener Rexach, J., Bechini, J. & Salinas Vert, I. (1993). [Acute pancreatitis in newly diagnosed type I diabetes mellitus with diabetic ketoacidosis and hypertriglyceridemia]. Med Clin (Barc), 101(16), 622-4.
      Saxena, R., Madhu, S. V., Shukla, R., Prabhu, K. M. & Gambhir, J. K. (2005). Postprandial hypertriglyceridemia and oxidative stress in patients of type 2 diabetes mellitus with macrovascular complications. Clin Chim Acta. Netherlands.
      Teno, S., Uto, Y., Nagashima, H., Endoh, Y., Iwamoto, Y., Omori, Y. & Takizawa, T. (2000). Association of postprandial hypertriglyceridemia and carotid intima-media thickness in patients with type 2 diabetes. Diabetes Care, 23(9), 1401-6.
      Tuncman, G., Erbay, E., Hom, X., De Vivo, I., Campos, H., Rimm, E. B. & Hotamisligil, G. S. (2006). A genetic variant at the fatty acid-binding protein aP2 locus reduces the risk for hypertriglyceridemia, type 2 diabetes, and cardiovascular disease. Proc Natl Acad Sci U S A. United States.
      Valdivielso, P., Sanchez-Chaparro, M. A., Calvo-Bonacho, E., Cabrera-Sierra, M., Sainz-Gutierrez, J. C., Fernandez-Labandera, C., Fernandez-Meseguer, A., Quevedo-Aguado, L., Moraga, M. R., Galvez-Moraleda, A., Gonzalez-Quintela, A. & Roman-Garcia, J. (2009). Association of moderate and severe hypertriglyceridemia with obesity, diabetes mellitus and vascular disease in the Spanish working population: results of the ICARIA study. Atherosclerosis. Ireland.
      Wilson, D. E., Hata, A., Kwong, L. K., Lingam, A., Shuhua, J., Ridinger, D. N., Yeager, C., Kaltenborn, K. C., Iverius, P. H. & Lalouel, J. M. (1993). Mutations in exon 3 of the lipoprotein lipase gene segregating in a family with hypertriglyceridemia, pancreatitis, and non-insulin-dependent diabetes. J Clin Invest, 92(1), 203-11.

      • Couple of things. First, your name is “steralize-the-morons”. Out of curiosity do “the morons” include people who can’t spell? If so, you’ll need to line up for sterilization. Second, while you seem to have a decent skill set of typing search terms into Google and copying and pasting the results, you appear to lack an understanding of the difference between body size and triglyceride levels. I’m not sure if you misread the blog or simply lack the cognition to understand it. This blog doesn’t debate the effects of high triglyceride levels on the body, instead it is based on the fact that you cannot tell someone’s triglyceride level by their weight. Case in point: I’m 5’4, 284 pounds and my triglyceride level is “exceptionally low” according to my doctor. My friend who is 5’4 and 110 pounds has dangerously high triglyceride level. Thank you so much for giving me an opportunity to restate my point.

        ~Ragen

  8. I looked up “diabesity” once, and found out it is a registered trademark of the Shape Up America campaign.

  9. Dear Ragen,
    Every time I read one of your posts, I want to leave a comment but all I can think of to say is “I LOVE YOU.” And since you don’t know me from Adam that sounds a bit creepy. But be assured it’s stated in pure awe and admiration for your putting into words what the world desperately needs to hear.
    Anyway, this time, I have something to add, and that is that “omigoddeathfatiscomingforus money” is such an excellent turn of phrase that I would love to use it too (with proper attribution of course).
    Thank you for all you do. Really.

  10. It’s amazing how fear sells. If they give real statistics, then it is boring and will not looked at. This country thrives on DRAMA!! Without it, ratings are in the dumps.

    Thanks for sharing the truth.

    Kenny

  11. I had Type 2 diabetes when I was dangerously thin. I also had undiagnosed celiac disease. The Type 2 wasn’t diagnosed until I got “fat” after pregnancy. No doctor ever took my blood sugar even when I described all the classic symptoms of diabetes because I was thin. I guess it’s a good thing it wasn’t Type 1, huh? But boy were they quick to tell me I “got” diabetes after I got “fat”.


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