Obesity
Obesity is a largely preventable disease that affects a third of the world’s population today. The excess weight can lead to diabetes, cardiac diseases, liver conditions, and Alzheimer’s - incidentally, Alzheimer’s disease is often referred to as Diabetes III these days. It starts early as insulin resistance and metabolic syndrome, progresses past Diabetes II and Atherosclerosis and goes on to being Diabetes III. Alzheimer’s disease actually starts twenty or thirty years before the symptoms of dementia appear. Some studies project that 85% of all Americans will be overweight or obese by the year 2030. Culture, childhood conditioning and diets, religion and traditions, geo-politics, and even poverty are all factors that individually or as a group have some role to play in this increasingly alarming condition.
There is a history of obesity on my father’s side of the family. I have seen my dad and almost all my aunts and uncles (five in all) succumb to Nonalcoholic Steato Hepatitis (NASH) also known as fatty liver cirrhosis. The disease is now affecting my generation of the family; cousins who never watched how they ate or lived until it was too late.
I saw the first manifestation of this disease in 1987, when my dad, 47 years old at the time, after an entire day of movie watching and sight-seeing with us, suddenly vomited copious amounts of dark blood at 2 AM in the morning. I summoned the neighborhood doctor who recommended an immediate transition to the emergency care in the local hospital. At that time we were told he suffered from “portal hypertension”. I recall traveling from pillar to post in those pre-Google days trying to understand what this was. I questioned my friend’s father, a cardiologist, who explained that the vein that connects the liver to the stomach gets so compromised that other minute secondary veins and capillaries emerge in order for the body to bypass this stress. These tiny veins can then burst. He said this was probably what had happened to my father. It was frustrating to get an explanation of the symptom but there were no insights about the underlying cause. No one called his disease Cirrhosis then because people always associate liver cirrhosis with drinking. My dad was a lifelong teetotaler. No one could comprehend cirrhosis in a non-drinker.
People attribute certain diseases and conditions to genetics, often forgetting that while genes may be a loaded gun, every gun has a trigger (paraphrasing Dr Caldwell Esselstyn). My dad discovered he had Type II Diabetes when he was a twenty-six year old doctoral student at the University of Hawaii. He was upwards of 200 lbs on a 5’7” frame at that time. As children we were regaled with stories where his weight had got him into some hilarious jams. The tallest monument in New Delhi is a tower called the Qutub Minar. It has five levels and the fifth and final level is really narrow at the top. My dad used to tell us that when he visited this monument he got stuck at the top with another man who was equally large. They did not know how to get themselves out of the jam and kept urging each other to establish a rhythmic inhalation-exhalation pattern so that they could inch their way out of there. Every time he told this story we doubled up with laughter. But at 26, when they told him he had diabetes my mom put him on a cabbage soup diet and he became unrecognizably lean in the eyes of everyone who saw him. His health improved, his energy levels improved. He was like a new person. He never really gained back all of that weight and I remember him being very careful how he ate for the rest of his life. This is probably why he made it to the age of 74 and his other siblings could not. He was a big believer in moderation, except for the times when he was not. He was very fond of all the sugary-milky deliciousness that is the Indian dessert, delicacies like gulab-jamuns or jalebis were irresistible to him.. He tried dessert abstention and moderation but every now and then would say, “Just a tiny little bite, please, it won’t hurt!”
My dad bounced back from this illness and all of its insidious symptoms several times until they finally told him that his liver had been reduced to the size of a golf ball and that a transplant was the only way out. He got a liver transplant in 2004 and a kidney transplant in 2006. Modern technology kept him with us till 2015. I think people don’t leave their bodies until they have accomplished all their earthly tasks. We were deprived of his physical presence in 2015.
My other aunts, uncles, and cousins were not as lucky. Before them my grandparents had left my dad orphaned at a young age - all victims of obesity, diabetes, and ultimately liver disease.
Obesity or hyperlipidemia is a disease that has reached the status of a global pandemic but is entirely reversible and when addressed it can reverse many other chronic conditions.. I urge you to take control of your health and to be your own health advocate. We are on the cusp of change as more doctors start developing a nutritional orientation but until such change is complete and universal you will find yourself going to doctors who never took a nutrition course during their years in medical school and who run a blood glucose, blood sugar, blood composition, and liver function test at the most at your annual check up. If your numbers are borderline high or low they tell you to try and lose some weight and exercise and if your numbers have crossed the borderline thresholds they are happy to write you a prescription for blood pressure medicine, diabetes medicine or statins with a message that many of these conditions are tied to your genes or are a normal consequence of aging. In their minds our health conditions are a linear progression toward pill dependence and senescence . Do not accept this. Most chronic illnesses are reversible and the key to this reversibility lies in lifestyle and diet changes that lead to weight loss, healthy BMIs and a complete reset of your arteries, veins, immune systems, heart, brain, neuromodulation and gut microbiome.
