South Africans are getting heavier and sicker. Obesity has become a modern day global pandemic that is contributing to deaths from non-communicable diseases (NCD) such as high blood pressure, diabetes, heart disease, cancer, non-alcoholic fatty liver disease and dementia at a faster rate than ever before. It is predicted that by 2030 deaths from NCDs will be five times higher than deaths from communicable diseases and this includes HIV/Aids and Tuberculosis.
If we’re going to slow down this modern plague, we need to stop blaming and shaming. It’s time to remove the stigma attached to obesity. This is the view of Dr Peter Hill, from Met-S Care and a specialist in Metabolic Syndrome.
Research is in fact increasingly indicating that people with weight issues, particularly central obesity, are fat, not because of laziness, lack of discipline or greed but rather because the majority of them have a metabolic dysfunction called insulin resistance. This means that they have sustained high levels of insulin preventing the efficient burning of fat.
“Approximately 80% of obese adults have Metabolic Syndrome. The syndrome is so important that the United Nations (UN) held a summit in 2011 with the specific purpose of formulating a worldwide strategy to address the growing pandemic. The UN issued the following statement: “Non-communicable diseases – or NCDs – like heart attacks and strokes, cancers, diabetes and chronic respiratory disease account for over 63% of deaths in the world today. Every year, NCDs kill nine million people under 60. The socio-economic impact is staggering.”
“There is no doubt that Metabolic Syndrome has assumed pandemic status. We can’t afford to ignore this reality. We are fatter and sicker than ever. And our children are also not immune from this modern plague,” says Hill.
So what is the solution? “When it comes to losing weight, metabolic dysfunction is often an invisible hurdle for many obese and overweight people who are in fact insulin resistant.”
Obesity and insulin resistance go hand in hand. “Insulin resistance means that cells have lost some of their sensitivity to the hormone insulin. Insulin is secreted by the pancreas in response to blood sugar (glucose) which is mainly derived from carbohydrates.”
Hill says starch and sugar are refined carbohydrates and because they are easily converted into blood glucose they drive insulin levels upwards. “Bread, pasta, biscuits, cakes, breakfast cereals, sweets and chocolate, sugar sweetened beverages, fruit juice as well as some fruits and vegetables are just some of products that drive our insulin levels,” he says.
Extended and high levels of insulin make the body really good at storing fat and not very good at burning it. “When fat production and storage exceeds the breakdown and burning of fat as fuel for energy, weight gain and retention is inevitable. The result is a constant hunger and lack of energy, which are all physiological responses to insulin resistance. It’s NOT simply a psychological problem: eat too much and don’t exercise, as we have been led to believe. High levels of blood glucose and thus insulin mean three important things: Fat storage, hunger and inflammation,” explains Hill.
As insulin is the primary regulator of fat storage and utilisation, it follows that re-establishing an insulin balance is key in terms of both obesity prevention and reversal or therapy. Bringing insulin levels back to normal can be achieved by cutting out sugar and other refined carbs because insulin secretion is mostly controlled by blood glucose levels, largely affected by carbohydrates and, to a lesser extent, protein in the diet. Other factors that exacerbate Metabolic Syndrome are sedentary lifestyle, advancing age, endocrine dysfunction and genetic predisposition.
How do we overcome this vicious cycle? “This can only be changed by whole-body lifestyle modification with people thinking of food as medicine, understanding the importance of exercise, psycho-social support and lastly, medicines and supplements.”
“To put it simply, improved self-care is essential. While medical care remains important, patients need to be educated and empowered to be able to take charge of their own health. On the correct programme, patients will be in a position to identify disease-related needs, set health-related goals, discuss and agree on a treatment strategy, implement the interventions and monitor the outcome,” explains Dr Hill.
It’s time to look at obesity and its associated conditions for what they are. Obesity is a chronic condition just like high blood pressure and heart disease, yet society still attaches a stigma to it. We can no longer ignore the evidence that obesity is largely about physiology (insulin dysfunction) and not psychology (lack of will power).
If you are living with any of the chronic conditions associated with Metabolic Syndrome and would like help to modify your lifestyle and improve your self-care, visit a Dis-Chem pharmacy and get help. Met-S Care works with Dis-Chem Pharmacies to empower people living with Metabolic Syndrome to take control of their condition. Read more at www.metscare.com.