Body weight and Diabetes

It was 1997. I had just finished MBBS. For a short period, I stayed at home. One day I met Raman Menon and family from the house nearby. It was many years since we met. Raman Menon was in his early seventies. He had made his fortune in the Middle East. That was his ticket to affluence.

“Hello, you have become a doctor now, eh?” He greeted me effusively. He laughed happily and his huge abdomen moved up and down rhythmically like a balloon caught in the wind. His wife stood smiling by his side. She was also very fat.

“You are still very thin. Why is that? Don’t you eat anything  while in Medical School?” He asked me. I smiled politely. My BMI was 24. That put me in the upper range of the normal weight. I was not too thin at all.

“You have hardly changed. Other than a few hairs lost, I suppose.” He continued. “Too much cramming and thinking is the reason, I guess?”

“And too much testosterone” I thought. Too many testosterone sensitive hair follicles, to be exact. I didn’t want to explain. It was a painful topic.

“You have put on some weight.” I said.

“Some?” He looked insulted. “I must have gained at least ten kilos since I last saw you” He said proudly.

“I love to eat. Everyone in our family is like that. Otherwise what is the point in being able to afford good food?” He said.

“I have increased blood pressure. Doctor said that I am developing Diabetes also. My parents didn’t have any of these.” He said with satisfaction. “She has both” He indicated his wife.

“My son has diabetes. He is hardly forty.” He said in the same way one would have said he had become a CEO of a big company at that age. 

Obesity is an epidemic. While in 1980, there were about 800 million obese people in the world, a 2014 data shows 2.3 billion (2300 million)- a threefold increase.

The 1980 data on type 2 diabetes shows that there were 100 million patients in 1980.  By 2014, there were 400 million.

Together, they form the most rapidly increasing diseases in the world.

Through most of our history, we were able to eat just enough to survive. After widespread agriculture, complex societies with hierarchies sprang up. Surplus food was available, especially for some people, high in the political and religious hierarchy. Still most of the population did not have the luxury of becoming fat. No wonder that fatness was a thing to be proud of. It still is, in many parts of the world. There are places like Mozambique where there are ‘fatness farms’, there girls are force fed to become fat and attractive. This kind of mindset is present in our country also, in patches. It is stronger among rural, poorer communities..

Obesity is associated with diabetes, hypertension, high cholesterol and high triglyceride levels. These are all risk factors for atherosclerosis and consequent coronary artery disease and stroke. Mortality risks have been studied. Large scale American and European studies have shown that the mortality risk is lowest at a BMI of 20 to 25. A BMI above 32 doubles the mortality rate, as shown in a 16 year study in 1995. BMI is a measure that grades fatness. (BMI= weight in kilograms divided by the square of height in metres. Eg: 80/ 1.6 times 1.6)

Other than the lifestyle diseases mentioned, Obesity increases the risk of certain cancers like breast, non-alcoholic liver disease and osteoarthritis. And the list doesn’t stop there. The most important and direct link is to diabetes, technically called type2 Diabetes Mellitus.

Before the 20th century, obesity was a rare disease. Now, it is an epidemic. It was formally declared as an epidemic by WHO, in 1997. About 10 percent of the world population is estimated to be obese. And it doesn’t include the merely overweight individuals. In the USA, 30 percent are obese. The average BMI of an American is 26. It is in the overweight range. The average BMI in societies that still follow the hunter gatherer lifestyle is between 19 and 21. More than 30 BMI is Obesity, and is classed as a disease.

India is also following the world trend. The National Family Health Survey data- 2007 show that 5 percent of the population is morbidly obese. The proportion of people, who are overweight, ranges from 15 to 30 percent in various states. Surveys among school children put the figure at 20 to 40 percent, showing that this is an increasing trend.

Many studies show that there is a direct link between excess body weight and diabetes. A recent study shows that a weight loss of 10 kg in overweight patients can completely reverse Diabetes in half of these people.

This is no doubt the method by which certain naturopathic practitioners claim complete cure of diabetes by their treatment.(For more – you can read ‘Health and Happiness without Bullshit available in by Jimmy Mathew)

Dr Jimmy

I am a Doctor, Writer and Science Communicator. I am a member of Info- Clinic, and have written a few books. This site features my blog posts and stories. Thank you for visiting. ഞാൻ എഴുതാൻ ഇഷ്ടമുള്ള ഉള്ള ഒരു ഡോക്ടർ ആണ് . നിങ്ങളുടെ താത്പര്യത്തിന് നന്ദി .