The Skinny on Obesity: The Medical View
by Cynthia Lee
In my younger years I was one of those thin people who could easily lose weight with exercise. I tried to be sympathetic with those individuals who didn’t seem to have the same ability. Most of my experience concerning weight loss came through the filter of trying the different recommended strategies and pharmaceutical products available. Then one of the employees of my medical office lost about 100 pounds in a physician supervised weight loss program at a well established multi-specialty clinic. However, he gained it back over the next two years. Subsequently I ran into one of the physicians from the same clinic, Dr. G., a gastroenterologist. Conservatively I estimated Dr. G. weighed at least 300 pounds. By this time, over a decade ago, I was skeptical that physicians really understood why people become fat if a physician specialized in human digestion couldn’t avoid morbid obesity. Then, more recently, when I shot up from a size eight to a size eighteen in eight months, it was time to start burning the midnight oil to get to the bottom of this mystery (although in retrospect, since burning the midnight oil appears to be one of the causes of unwanted weight gain, this was an inefficient strategy). What follows is the information I have gleamed from the evolving scientific literature related to the subject of weight gain over the last five years. I urge the reader to consider the information and begin challenging their beliefs that they have primary control over their body weight.
It is time to consider that all people may not be fat for the same reasons. And, in fact, the reason any one individual is fat may be entirely outside of their control. For example, several years ago Nicki Dhurandar at the University of Wisconsin proved that chickens can be infected with a virus that causes abdominal obesity. This is the dreaded insulin resistant type of obesity that places an individual into the higher risk categories for coronary disease. The virus was studied in a double blind study where half of the chickens were infected while the other half were not. All of the chickens were allowed the same food and the same access to mental health care, exercise, etc. It was found that the infected chickens gained less lean muscular weight and more fat weight than the uninfected chickens. And sure enough, when a group of obese people were examined, 20% were infected with the chicken adenovirus. These individuals also were the most obese of the group. A total of nine different viruses have been shown to cause obesity including a human adenovirus known to cause “pink eye”, a common condition usually considered self-limiting and benign. I suppose counseling for stress management may help an individual more successfully fight off a virus, but who is going to volunteer to be infected in a double blind study to test this hypothesis? Not me.
Viruses are not the only factors unrelated to caloric intake or diet content to be implicated concerning obesity in humans. Sleep medicine physicians have long known that obstructive sleep apnea can be related to sudden major weight gain. Although physicians were originally taught that the obesity was the cause of the sleep apnea condition, faith in that concept was shaken by the late 1990’s when large scale surveys documented that half of the individuals with clinically significant obstructive sleep apnea were not clinically obese. Now, there is evidence that a different factor may be the real culprit. A researcher in Chicago demonstrated that depriving healthy, athletic males aged in their twenties of adequate sleep immediately caused insulin resistance, the most important metabolic issue in pre-diabetic and diabetic conditions. When matched groups of obese patients with sleep apnea were compared to obese patients without sleep apnea, the ones with sleep apnea had more insulin resistance, the condition associated with fat weight, i.e. abdominal obesity. Insulin resistance, according to a widely accepted theory, is when the body is unable to efficiently convert consumed food into energy. Compare this concept to a factory taking orders for a finished product. The finished product stands for your energy needed to walk, breathe, think, etc. The customer orders product (energy). Raw materials go in to the factory but there is a slow down in producing finished product. The head office doesn’t realize there is a delay in producing product. The customer doesn’t get their shipment and reorders product. The raw materials stack up out side the factory. The stacked materials are representative of fat storage in the body. Unless the metabolic problem of insulin resistance is remedied, you may lose weight through dieting, but it may be lean muscular weight and not the stored fat. Basically, how well and how long you sleep can affect your metabolism, which affects your ability to stay at a healthy weight.
Because America’s physicians are being fed a steady diet of pharmaceutical industry sales propaganda recommending the latest and greatest new synthetic for this or that disease, most are unaware of the new progress in defining mitochondrial deficiency/inefficiency as an etiology of chronic disease. Previously, mitochondrial diseases were only significant as very rare genetic diseases that an individual practitioner was unlikely to have to consider but once in a blue moon. That means the research pointing to mitochondrial insufficiency as the usual precursor to Type 2 diabetes, as covered in Science Issue (No. 5708, January 21, 2005), may need to be brought to the attention of your physician. This concept needs to be considered as a major etiology of obesity sooner rather than later to protect the individual. In fact, researchers discovered that the metabolic processes usually associated with obesity were present before the research rats became fat, so it became clear these events were part of the cause and not the effect. After reviewing this published research I note that the authors did not discuss the probability that human mitochondria were being subjected to damaging influences but rather, possibly reflecting their association with major corporations, usually discussed the possibility of developing a drug to treat the mitochondrial insufficiency. That emphasis is also consistent with our government’s bias towards promoting the research that benefits pharmaceutical industry drug development rather than disease prevention strategies. To this end I also bring to your attention some interesting research reviewed in Science News (Vol. 106, July 17. 2004, page 35) examining the possibility those synthetic contaminants can influence the ability to lose weight. In this research, which documented numerous hormone levels as well as levels of common environmental contaminants, the individuals attempting weight loss experienced increasing difficulty in doing so. This difficulty correlated most closely with the rise in levels of these common environmental contaminants. Could it be that contamination consisting of thousands of synthetic compounds negligently unloaded into the world’s environment over the decades of the industrial revolution is driving the obesity epidemic? Perhaps those “lazy fat people” who “won’t work” are just those individuals who have the most significant levels of environmental contaminants? Obesity is also commonly seen in our most indigent populations who are, probably not so coincidentally, exposed to the highest rates of pollution. Obviously, scientists cannot burden a person with synthetic contaminants in order to measure whether they develop insulin resistance.
The issue of damaged mitochondria has been popularized after the research of Professor Bruce Ames of the University of California at Berkeley was covered in Reader’s Digest a couple of years ago. His work, published in the Proceedings of the National Academy of Sciences, demonstrated youthful vigor and improved memory in old rats after ingestion of alpha lipoic acid and acetyl L-Carnitine. While Dr. Ames was able to document in humans the state of health of their mitochondria, the process was too expensive for every day clinical use. That problem may now be solved. Very recently two Oregon entrepreneurs, UO biology professor Rod Capaldi and UO monoclonal lab director Mike Marusich, started a bioscience company, Mitosciences, Inc. to develop a tool that can measure the health of an individual’s mitochondria. Since medications like antipsychotic drugs can damage the mitochondria, this tool can help assess whether an individual’s health problem involves compromised cellular energy so as to serve as a contraindication for specific medications. In certain hard to assess populations, like veterans diagnosed with Gulf War Syndrome, a test that can evaluate their metabolic health can establish both the necessity of not labeling them “psychiatric” but also spur appropriate treatment protocols.
Lots of natural substances are involved in the fat weight/lean weight equation. Some individuals have deficiencies of trace minerals associated with insulin resistance. Chromium is probably the best known. Vitamin deficiencies should also be suspect. In fact, Professor Roger J. Williams (bioinst.cm.utexas.edu/williams/), late of the Clayton Foundation Biochemical Institute of the University of Texas, the discoverer of the B vitamin pantothenic acid, once noted that he was unable to induce his laboratory rats to overeat unless he deprived them of an essential ingredient. The possibility of being deprived of an essential compound is the reason the government of Japan advises their citizens to eat 30 different kinds of food items a day. These deficiencies may also be related to how virulent a virus is. For example, until 1979, selenium deficiency was not believed to be harmful. Then a usually benign virus was implicated in an epidemic of viral cardiomyopathy (heart failure) in China. Researchers discovered that the soils in that province were selenium deficient, which caused foods grown in the soil to be deficient, and that the deficiency had allowed the virus to become virulent.
Over the last several decades since JFK’s initial efforts to get Americans exercising, our government has attempted to demonstrate leadership on the issue of obesity. Their attempts have been unsuccessful. For example, Americans were pushed to eat less fat. They were encouraged to eat more grains. The government promoted the concept of a food pyramid recommending lots of grain carbs. Nonprofits with heavy subsidies from the food industry jumped on the bandwagon and breakfast foods composed mostly of sugar were misrepresented as “heart healthy”. The emphasis on carbohydrates, besides the issue of over processed “empty” calories, has an even darker side to it. Several years ago, the Swiss government had to investigate how to follow humans exposed to acrylamide secondary to a massive construction accident. In this accident, acrylamide leaked into a, downstream from which fish and cows, who drank from the river, died. In monitoring the workers exposed to acrylamide, a comparison was made of blood levels of workers who had not been exposed. The individuals not exposed were found to also have acrylamide in their blood despite no known exposure. Since acrylamide was little studied although known to be a neurotoxic compound, rodent studies were employed. It was found that rodents fed uncooked rat chow did not have measurable acrylamide but those fed rat chow processed at more than 250 degrees F. did. This story was covered in the United States in Science News. This is a very important issue best explored further by readers by accessing the website for the Center for Science in the Public Interest. This nonprofit organization documented that the federal government blocked the State of California’s efforts to achieve control of this compound to protect consumers. Suffice it to say, encouraging humans to eat more fried or baked carbohydrates may have caused more damage than eating large amounts of high fat unprocessed products, like almonds, avocados or even boiled meats.
While most of the information the public is exposed to involves decreasing caloric intake to treat or prevent obesity, there is considerable evidence that other factors are involved. Many of these factors are outside of an individual’s direct control. Especially in childhood, one cannot prevent being exposed to viruses, pollution, or acrylamide-containing foods, yet the accumulated exposures of a lifetime may be at work in damaging the cellular metabolic machinery. Many dietary studies, looking at issues from the aspects of weight control to the incidence of cancer, fail to fully consider the whole experience. The studies will look at carbohydrates versus protein intake but fail to look at circadian rhythm/sleep issues. Since our government has so far failed to exercise leadership, we the public have to develop strategies to spread this information. I suggest asking Oprah and other celebrities fighting fat to publicize the issue.
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The good news! I added lecithin and vitamin D to my usual vitamin regimen of Vit C at least 1000 mg per day divided at least in to two portions and at least a multiple B with at least 50 mg of niacin and I’ve lost probably 40 lbs. My clothes are falling off of me. That’s the BAD news! I look like a homeless waif. Oh No! That’s right! I am a homeless waif.
No seriously, FYI family members, I’m now staying at one of the safest places (so far) I’ve been since this whole stalking thing started. I love you but will not be home unless and until I can get the legal profession to step up to the plate and take a swing at these goons. It is a King Solomon decision. Period. If they (the legal profession) think by being rich and connected that they can actually report to their physician and get scientifically competent and humane medical care, they have another surprise waiting for them. When I, a family physician with as much resources and insurance as I had in 1999, can’t find competent medical care because of the pharmaceutical industry influence on my profession, these rich and powerful attorneys can’t either. Their complacency is biting them in the butt. Google my name and Dicky Scruggs for my take on their vulnerability. The situation has not really improved since the 1990’s either. They are still feeding on the 10% of the iceberg that is the marketing of drugs without adequate testing or safety issues delineated. The 90% of the iceberg is the fostering of missed diagnoses. everything from sleep apnea as depression to high cholesterol as a deficiency of a cholesterol lowering agent.