8.5: ONE VIEW- Obesity - the most serious health problem of our day!
- Page ID
- 116459
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)This is one side of the obesity debate or controversy -- and it is, by far, the dominant side.
Among the health dangers that the CDC and other health sources emphasize are the increased risk for the following disorders, which have been correlated to overweight and/or obesity:
- Coronary heart disease
- Type 2 diabetes
- Cancers (endometrial, breast, and colon)
- Hypertension (high blood pressure)
- Dyslipidemia (for example, high total cholesterol or high levels of triglycerides)
- Stroke
- Liver and Gallbladder disease
- Sleep apnea and respiratory problems
- Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)
- Gynecological problems (abnormal menses, infertility)
As you can see, this list includes some of the most significant health problems our society faces today. (CDC)
Most public health researchers would go beyond seeing these diseases as correlated to obesity - they see obesity as an actual cause of at least some of these disorders.
- Notably, in Type 2 diabetes the interaction of insulin and fat cells is important, and therefore having more fat may lead to the development of this disease (even though diabetes also appears in thin people).
- There are numerous articles that show the health benefits of weight loss, often seen with even very small amounts of weight (5-10 pounds).
- There are other studies that focus on the health benefits of simply staying at the same weight - not gaining more. Here is one that highlights that latter approach (optional).
New weight loss drugs
Just recently, new weight loss drugs have been discovered-- semaglutide (sold as Ozempic and Wegovy) and other even-newer drugs. These drugs, originally developed for treating diabetes, have been shown to produce more weight loss than previous drugs -- around 15% of a person's body weight. More importantly, they also improve other metabolic markers (like, reducing inflammation and improving how the body handles blood sugar). While they cause some digestive side effects, most people seem to be able to tolerate those. Doctors and some public health workers are excited about these drugs and the impact they could have on obesity-linked disease. This is the first time we've had such a drug available that is shown to work this well.
A couple of caveats:
- For people who are seriously obese (what doctors call "morbidly obese"), even if they lose 15% of their body weight, they will still be obese. These drugs will not eliminate obesity. So, news stories talking about "the end of obesity" are problematic.
- Still, if these drugs eliminate some of the diseases and inflammation associated with obesity, it's still a big medical advance. I'm excited that this will be an option for people who want to pursue it.
- The drugs work only while people are taking them. When people go off the drugs, they regain the weight. So we should expect that, in many cases, people will use these drugs long-term.
- The drugs are very expensive, costing $900-1,500 per month. For some people, this will be covered by insurance.
- Because people who are not obese and who have money have been buying up the drug for aesthetic reasons, it has created shortages of these drugs for diabetics who actually NEED them. I hope this will be resolved with increased production -- but at the moment, the shortages are actually life-threatening for some diabetics. People who don't need these drugs should not be taking them while they are in short supply.