Over at PJMedia, physician Theodore Dalrymple asks a question that German immigrant and pediatrician Hilde Bruch posed and answered over the course of her career starting in 1935, when she founded a clinic for obese children at Columbia University’s College of Physicians and Surgeons.* The question is, “What are we to make of the fact that an affliction of the rich is now predominantly a problem of the poor?”
However, the main question Dr. Dalrymple asks in his headline is, “Is Obesity a Disease or a Moral Failing?”
Dr. Dalrymple comes down on the side of moral failing.
I disagree. The research explained in the books I cite below suggests that the obesity epidemic has its foundation in bad advice from the medical profession based on ignorance of the endocrine system, sleep, exercise and what actually makes people fat. I think people will take personal responsibility just fine when they have better advice that is certain to get them the result they want.
Dr. Dalrymple also is dismissive of the idea that there are institutional causes of obesity. I disagree for the following reasons:
- The low-fat diet the medical profession has touted for weight loss and heart health is high-carb and makes you fat. This model must be discarded and replaced with the correct understanding of the roles that consuming carbs, exercise and sleep deprivation have on the endocrine system. People do take personal responsibility but the medical profession has to provide them with solutions that actually work.
- High carb foods dominate the offerings practically everywhere food is served: restaurants, shopping malls, you name it. The free market should fix this — supply will chase demand when people want healthier food.
- Exercise is not built into our daily activities as much as it used to be. You often have to work to find the place, equipment and time to exercise. Government will be involved in this solution because planning things like sidewalks, bike lanes and parks are part of the government’s job.
Here’s what I wrote as a comment:
Dr. Dalrymple, as other commenters have noted, you would benefit from reading Gary Taubes’ book, Why We Get Fat and What To Do About It. Taubes explains research showing the effect of eating sugar and simple carbohydrates on the endocrine system. Research shows that people who eat a lot of carbs can be starving while getting ever fatter simply because their insulin production is sending the food they eat straight to the fat cells instead of making it available for energy. They are caught in a vicious cycle. Worse, the low-fat/high-carb diets currently recommended for heart health exacerbate the problem. The more the public is educated about how the carb/insulin cycle affects them, the more motivated people will be to get out of it.
Unfortunately, as a solution Taubes recommends the Atkins diet, which can cause kidney failure, kidney stones, gout and osteoporosis.
Other diet and fitness experts educating the public about the role of the endocrine system in weight loss with more thorough explanations than Taubes provides and healthier diet recommendations include Jillian Michaels in her book, “Master Your Metabolism,” and Dr. Michael Aziz in his book, “The Perfect 10 Diet.”
By the way, one of Taubes’ major contributions to the field in “Why We Get Fat” is his history of which experts in charge of telling the rest of us how to live blew it so badly that they effectively are the creators of the obesity epidemic. This puts an entirely different light on the belief that the obese have failed in their own personal responsibility when you consider that the advice they were following to get or stay slim was instead absolutely guaranteed to make them fat and sick.
*Gary Taubes opens his book, Why We Get Fat and What to Do About It, with this information. I first started reading Dr. Bruch in the 1980’s when I was researching anorexia as I was trying to heal from having an anorexic lover when I was in college. I highly recommend her work.
“Unfortunately, as a solution Taubes recommends the Atkins diet, which can cause kidney failure, kidney stones, gout and osteoporosis.”
Wow. This is spoken with such conviction that one would assume that there was some kind of science to back it up. As far as I know there are very few scientific studies that have looked at the Atkins diet (it just isn’t very popular with establishment grant providers, don’t ya know), but I don’t think any of the few that have been conducted have even suggested a correlation between LCHF diets (which is what the Atkins diet is) and kidney failure, kidney stones, gout, and/or osteoporsis.
Perhaps you could provide some references. Or, failing that, could propose a mechanism that would make a claim that LCHF diets “can cause” these problem seem plausible.
I found plenty of sources and thought I’d linked one, but I see I didn’t. Here is a succinct summary from WebMD.com:
“What Are the Risks Linked to High Protein, Low-Carb Diets High protein, low-carb diets can cause a number of health problems, including:
“Kidney failure. Consuming too much protein puts a strain on the kidneys, which can make a person susceptible to kidney disease.
“High cholesterol. It is well known that high-protein diets (consisting of red meat, whole dairy products, and other high fat foods) are linked to high cholesterol. Studies have linked high cholesterol levels to an increased risk of developing heart disease, stroke, and cancer.
“Osteoporosis and kidney stones. High-protein diets have also been shown to cause people to excrete a large amount of calcium in their urine. Over a prolonged period of time, this can increase a person’s risk of osteoporosis and kidney stones. A diet that increases protein at the expense of a very restrictive intake of plant carbohydrates may be bad for bones, but not necessarily a high-protein intake alone.
“Cancer. One of the reasons high-protein diets increase the risks of certain health problems is because of the avoidance of carbohydrate-containing foods and the vitamins, minerals, fiber, and antioxidants they contain. It is therefore important to obtain your protein from a diet rich in whole grains, fruits, and vegetables. Not only are your needs for protein being met, but you are also helping to reduce your risk of developing cancer.
“Unhealthy metabolic state (ketosis). Low-carb diets can cause your body to go into a dangerous metabolic state called ketosis since your body burns fat instead of glucose for energy. During ketosis, the body forms substances known as ketones, which can cause organs to fail and result in gout, kidney stones, or kidney failure. Ketones can also dull a person’s appetite, cause nausea and bad breath. Ketosis can be prevented by eating at least 100 grams of carbohydrates a day.”
I also recommend reading “Atkins Diet Alert” from the Physicians’ Committee for Responsible Medicine. Be sure to scroll down for the information about kidneys, gout and osteoporosis. They point out that the Atkins diet may only harm the kidneys of people who already have impaired kidney function, but that is a huge percentage of the population and most of them don’t know their kidney function is impaired. They also note the Atkins diet did not excel at helping people keep weight off.
There’s also plenty of information about the Atkins diet at Livestrong.com.