Imagine you have a leaky roof. The roofer comes over, puts down some buckets, hands you a hefty bill and leaves without fixing the roof.
You'd never tolerate that, right?
Yet something similar happens in medicine all the time, and patients rarely complain.
Excessive weight is the underlying repairable cause of most chronic illnesses treated today. But instead of tackling the weight problem (the leaky roof) patients are often given medications (buckets) for the illnesses caused by their weight problem.
Is your diabetes or heart disease cured by the medications you take? Or are they simply being managed?
I find it astonishing how little reaction I get from my patients when I tell them that their weight is a threat to their health. People who would demand immediate action if I told them they had cancer do little more than shrug their shoulders over obesity.
It's easy to become numb to the familiar. Plenty of us can enjoy our dinners while watching the evening news with its parade of accidents, murders and war. We have become almost immune to violence, because it is so prevalent.
I believe we are dulled to the consequences of obesity because we see it everywhere. Think how many people you know who have high blood pressure, diabetes, high cholesterol, or have suffered a heart attack. How many of them weigh too much for good health?
But maybe these weight-related conditions don't get much respect because they tend to come on slowly. What you may not realize is that being obese can be as serious as having cancer — and may play a major role in cancer occurrence.
Fact is, once you're obese (that's a body mass index of BMI of 30 or greater — for instance, being 5 foot 5 and more than 180 pounds), your abdominal fat doesn't just stand in the way of your jeans buttoning.
It begins to produce hormones and toxins, it steals nutrients to support its existence, and it often results — directly or indirectly — in death.
• Substances secreted by fat tissue make the body less sensitive to insulin, aggravating diabetes. Those same factors also increase inflammation in the body, which may play a role in many autoimmune diseases as well as heart disease
• A protein made by fat cells inhibits your blood from fighting clotting of the arteries, promoting plaque and arterial disease.
• Another protein released by fat makes the liver produce more glucose. So a diabetic who is overweight has yet another source of sugar to worry about.
• Overweight men and women produce elevated levels of the female hormone estrogen. This means overweight women have a higher risk of breast cancer.
• Another group of hormones produced by excess fat belongs to the androgen family, and in obese men, too much of this inhibits testosterone production. Between the high estrogen and the low testosterone, impotence and breast growth often occur in men. Excess androgen in women contributes to infertility, hair growth where you don't want it (face and chest) and hair loss where you do want it (scalp).
• Fat is living tissue that needs nutrition and will compete with the rest of your body for it. The most common vitamin and mineral deficiencies found in overweight individuals are Vitamin D and calcium.
Put it all together, and you can see why I believe a diagnosis of obesity must be taken as seriously as the diagnosis of any potentially fatal condition.
Obesity is caused by many factors, and they aren't all the fault of the overweight person. Weight loss is difficult, and it's not something that even the most caring and informed physician can achieve for a patient.
But understanding that fat is a serious medical condition may help motivate us to make major, lifelong changes and choices towards health. As a society we need to prevent obesity in children and aggressively address weight in adults.
We need to become a healthy, thriving, vibrant society, not an overmedicated, sluggish, tired society. It's time to patch up that leaky roof for good, and throw away those buckets.
Dr. Katarzyna "Kasia'' Ostrzenska is medical director of Bay Medical Center in St. Petersburg and is board certified in internal medicine. She can be reached at baymedical.com, and you can visit Dr. Kasia on Facebook.