Obesity, insulin resistance, metabolic syndrome and type 2 diabetes have reached epidemic proportions. There’s not a person reading this article who isn’t affected by these conditions, either directly or indirectly. Yet as common as these conditions are, few people understand how closely they’re related to one another.
It is now clear that not only do these conditions share the same underlying causes – and thus require the same treatment – they are 100% preventable and, in many cases, entirely reversible.
Because of these similarities, Dr. Francine Kaufman coined the term diabesity (diabesity + obesity) to describe them. Diabesity can be defined as a metabolic dysfunction that ranges from mild blood sugar imbalances to full-fledged type 2 diabetes. Diabesity is a constellation of signs that includes:
- abdominal obesity (i.e. “spare tire” syndrome);
- dyslipidemia (low HDL, high LDL and high triglycerides);
- high blood pressure;
- high blood sugar (fasting above 100 mg/dL, Hb1Ac above 5.5);
- systemic inflammation; and,
- a tendency to form blood clots.
The subjective symptoms of diabesity include (but aren’t limited to):
- sugar cravings, especially after meals;
- eating sweets does not relieve cravings for sugar;
- fatigue after meals;
- frequent urination;
- increased thirst and appetite;
- difficulty losing weight;
- slowed stomach emptying;
- sexual dysfunction;
- visual problems; and,
- numbness and tingling in the extremities.
The term diabesity is misleading in one respect: it suggests one must be obese to experience the metabolic problems I just described above. That’s not true. Thin people can suffer from the entire spectrum of blood sugar imbalances, all the way up to full-fledged type 2 diabetes. The term sometimes used for someone who is thin, yet has insulin resistance, dysglycemia and dyslipidemia is “metabolically obese”. Their metabolism behaves as if they’re obese, even when they’re not.
It’s almost impossible to overstate how serious and far-reaching a problem diabesity is. It affects more than one billion people worldwide (1), including 100 million Americans and 50% of Americans over 65.
More than half of Americans are overweight, and a full one-third are clinically obese. 24 million Americans have type 2 diabetes, with one in three unaware that they have it. (2)
Diabesity is the leading cause of modern, chronic disease. The “diabese” have increased risk of heart disease, stroke, dementia, cancer, kidney failure and blindness – to name only a few.
In the U.S. today, every ten seconds someone dies from diabetes-related causes. (3) Diabetes and cardiovascular disease have now outpaced infectious disease as the primary cause of morbidity and mortality worldwide. In Dr. Bernstein’s Diabetes Solution, Dr. B claims that diabetes is now the 3rd leading cause of death. But death certificates don’t list diabetes or hyperglycemia as the underlying cause of heart attacks, strokes or fatal infections. Nor do they consider the role of obesity, insulin resistance and inflammation in these conditions. If they did, it’s quite possible that diabesity is not only the leading cause of disease, but also the leading cause of death.
Diabesity is literally bankrupting our health care system. The direct and indirect costs of type 2 diabetes were $174 billion in 2007. The cost of obesity in that same year was $113 billion. So the total cost of diabesity to society can be conservatively estimated at nearly $300 billion per year. (4) To put that in perspective, diabesity has cost the U.S. $3 trillion over the past decade. That’s three times the estimated cost of fixing our entire health care system. And it’s only going to get worse. the projected cost of diabetes alone is expected to rise to more than $330 billion by 2034. (5)
With numbers like this, you’d expect a state of emergency to be declared. You’d think we’d be doing everything in our power to figure out the cause of these conditions and how to treat them successfully.
But the reality is that the conventional treatment of diabesity has been a dismal failure. This is reflected in the shocking growth of the conditions that fall under the diabesity umbrella over the past two decades, and the equally alarming projections for the future.
Recent reports suggest that one-third of people born in 2010 will develop diabetes at some point in their lives. (6) What is particularly horrifying about this statistic is that many of those who develop diabetes will be kids. Type 2 diabetes used to be a disease of the middle-aged and elderly. No longer. A recent Yale study indicated that nearly one in four kids between the ages of 4 and 18 have pre-diabetes (glucose intolerance). Some regional studies show type 2 diabetes in kids has jumped from less than 5% before 1994 to 50% in 2004. (7)
Each year, kids are getting fatter. Among American children 2-5 years of age, more than 10% are now obese. (8) Even more alarming is the rise of obesity in infants under 2 years of age. Research from Harvard shows infant obesity has risen more than 70% since 1980. (8) And this isn’t because babies are eating more donuts and cheese doodles while cutting back on their Stairmaster workouts, either. Clearly there’s more to the diabesity story than eating junk food and not exercising enough. But I digress. We’ll be covering causes in future articles.
From 1993 to 2008, the number of people in the world with diabetes increased seven-fold from 35 million to 240 million, and is expected to rise to 380 million by 2030. This is ten times the number of people affected by HIV/AIDS worldwide. In the U.S., the incidence of diabetes is projected to increase to 44 million in the year 2034. (9)
What accounts for such an explosion of new cases? One reason is that the standard treatment for diabesity is not only ineffective, it’s contributing to the problem. Once they have developed, diabetes and obesity are characterized by insulin resistance, which in turn results in carbohydrate intolerance. Yet prominent organizations such as the American Diabetes Association have been recommending a low-fat, high-carbohydrate diet as a treatment for diabetes for decades. It didn’t work in 1985, and it still doesn’t work. Einstein once said that insanity is doing the same thing over and over, and expecting a different result. Clearly the conventional approach to treating diabesity is insane.
In this series, we’re going to get the bottom of the diabesity epidemic. We’ll leave the conventional model of understanding diabesity – which is now about 40 years old – in the dust and replace it with an updated 2010 model that reflects the current scientific literature. We’re going to uncover the real causes of of diabesity, and we’re going to find out exactly how it can be prevented and even reversed in the majority of cases.
As we go along we’ll be busting a number of conventional and alternative myths about diabesity. We’ll learn that:
- Obesity isn’t as simple as eating too much and not exercising enough.
- Diabetes isn’t always progressive, and can be reversed in many people.
- Diabetes isn’t caused by eating too many carbohydrates.
- A fasting blood sugar of 95 mg/dL and Hb1Ac of 5.5% isn’t “normal”.
- Thin people can get type 2 diabetes.
- And more…
As we begin, I’d love to hear from you. Do you have any specific questions about diabesity? Anything you’ve always wondered about but haven’t found the answer to? Leave a comment, and I’ll do my best to address it at some point in the series.
According to the American Association of Clinical Endocrinologists, 27 million Americans suffer from thyroid dysfunction – half of whom go undiagnosed. Subclinical hypothyroidism, a condition in which TSH is elevated but free T4 is normal, may affect an additional 24 million Americans. Taken together, more than 50 million Americans are affected by some form of thyroid disorder.
