Experts argue that obesity is a chronic, relapsing, progressive disease : LC Research/Media Forum : Active Low-Carber Forums

#1 ^

Sat, May-13-17, 09:18

doreen T doreen T is offline

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Experts argue that obesity is a chronic, relapsing, progressive disease

https://www.sciencedaily.com/releas...70510115222.htm

Date: May 10, 2017
Source: Wiley
Summary: Experts consider the argument for obesity as a chronic relapsing disease process. They note that obesity fits the epidemiological model of a disease process except that the toxic or pathological agent is food rather than a microbe.

Quote:

Experts argue that obesity is a chronic, relapsing, progressive disease

In a new article, World Obesity Federation experts consider the argument for obesity as a chronic relapsing disease process. They note that obesity fits the epidemiological model of a disease process except that the toxic or pathological agent is food rather than a microbe.

The question of whether obesity should be called a 'disease' has sparked controversy for most of the last century. In their Obesity Reviews position statement, Dr. George Bray and his colleagues examine how an abundance of food, low physical activity, and several other environmental factors interact with genetic susceptibility. They draw parallels to chronic diseases, noting that the magnitude of obesity and its adverse effects in individuals may relate to the virulence or toxicity of the environment and its interaction with the host.

"Accepting the concept that obesity is a chronic disease process is important for several reasons," said Dr. Bray. "First, it removes the feeling that patients alone are responsible for their excess weight. It also focuses attention on the ways in which this disease process can be tackled. And finally, it shows that if we can successfully treat obesity, many of its associated diseases will be eliminated."

In an accompanying letter to the editor, experts agree that declaring obesity to be a disease could benefit those people who are suffering with obesity and wish to have access to medical advice and support, "whilst also strengthening the call for dealing with the social determinants, obesogenic environments and systemic causes of individual weight gain." They also note that recognizing obesity as a disease may reduce individuals' internalized stigma, change the public discourse about blame for the condition, and have benefits in countries where health service costs are funded from insurance schemes that limit payments for non-disease conditions or risk factors.

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#2 ^

Sat, May-13-17, 09:18

doreen T doreen T is offline

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The full position paper is here .. http://onlinelibrary.wiley.com/doi/.../obr.12551/full

Quote:

Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation

Authors: G.A. Bray, K.K. Kim, J.P.H. Wilding

First published: 10 May 2017

Summary

This paper considers the argument for obesity as a chronic relapsing disease process. Obesity is viewed from an epidemiological model, with an agent affecting the host and producing disease. Food is the primary agent, particularly foods that are high in energy density such as fat, or in sugar-sweetened beverages. An abundance of food, low physical activity and several other environmental factors interact with the genetic susceptibility of the host to produce positive energy balance. The majority of this excess energy is stored as fat in enlarged, and often more numerous fat cells, but some lipid may infiltrate other organs such as the liver (ectopic fat). The enlarged fat cells and ectopic fat produce and secrete a variety of metabolic, hormonal and inflammatory products that produce damage in organs such as the arteries, heart, liver, muscle and pancreas. The magnitude of the obesity and its adverse effects in individuals may relate to the virulence or toxicity of the environment and its interaction with the host. Thus, obesity fits the epidemiological model of a disease process except that the toxic or pathological agent is food rather than a microbe. Reversing obesity will prevent most of its detrimental effects.

#3 ^

Sat, May-13-17, 09:51

teaser

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Experts argue that the standard of care treatment of obesity results in a chronic, relapsing, progressive disease.

#4 ^

Sat, May-13-17, 12:32

WereBear

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Quote:

Originally Posted by teaser

Experts argue that the standard of care treatment of obesity results in a chronic, relapsing, progressive disease.

My thoughts, too. When eating the Standard American Diet it IS.

#5 ^

Fri, May-19-17, 22:33

M Levac

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OK, this is a position paper by one guy who cites himself at least 10 times in references. The premise is what Taubes described as the toxic environment hypothesis, i.e. abundance of food, fast food joints, lack of activity, etc. The premise is also CICO.

The word sugar appears 3 times, only once in the text proper. The word fat appears 49 times, 39 in the text proper. The word insulin appears 8 times, 6 in the text proper, and always in the context of an effect of obesity, not a cause. The word calorie does not appear, but the word energy does in the context of CICO.

The word Taubes does not appear, nor does Bray's review of Taubes' book GCBC appear as a reference (which is basically a position paper in itself), but it should cuz it's 13 pages long, but then if it did, Taubes would be given credit and Bray's new paper would suffer for it just like his previous review did back then.

Hm, this is not a position paper on the idea of obesity as a chronic disease, but on the mechanism by which obesity is created. I think we can still remember Bray's review of Taubes book GCBC and Taubes' response to that review, but here's the links so we have a good reference:

Bray
Taubes

Anyways, Bray's review made a big impact just because it was such a lengthy review, but basically amounted to "you're fat cuz you're a glutton". Well, considering the actual content of this new position paper, Bray didn't change his mind one bit which means that the paper itself cannot reasonably demonstrate that obesity is a chronic disease.

Good job, Bray. Now I'm just waiting for Taubes to respond in typical style, but maybe this time with the help of genuine experts to back him up (not that there's anybody on this planet with more expertise on the subject, but you guys know what I mean - Eades, Davis, Eenfeldt, et al). I'm sure Taubes and pretty much everybody else can see through the sham too.

#6 ^

Fri, May-19-17, 22:59

M Levac

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Can't help myself pointing this out:

Quote:

We will argue that obesity is a disease process in the same sense that hypertension or hypercholesterolemia is a disease. Weight, like blood pressure and cholesterol are continuous variables

First off, it's not yet determined by anybody if either hypertension and hypercholesterolemia are diseases. If anything, they are accepted widely as risk factors for other diseases such as heart disease, both of them for that in this case. So, if they're risk factors, then Bray can only reasonably argue that obesity is a risk factor in the same "sense" as those two. Doesn't sound good for his position, ya know, shooting himself in the foot and all that.

But then, is Bray really saying that if obesity is a disease, then these other two risk factors should now be defined as diseases as well? That would certainly please the statinators and the antihypertension drug makers, for sure.

I'm getting the feeling that Bray is trying to make some people happy so he gets a cake or something.

#7 ^

Fri, May-19-17, 23:23

M Levac

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I really can't help myself:

Quote:

The intrauterine environment provides a mechanism that predisposes some people with obesity to develop diabetes later in life. Individuals who were malnourished while in utero may be more prone to weight gain, insulin resistance, beta-cell failure and hence diabetes than those who are well nourished, a hypothesis known as the ‘Developmental Origin of Disease’ or the ‘Barker Hypothesis’ [77]. Maternal undernutrition forces the fetus to adapt during its intrauterine development and drives a reprogramming of its endocrine–metabolic state to produce permanent changes in the structure and the physiology of key organ systems [77, 78]. These changes in low-birth-weight infants (normal range, 3,000–4,000 g) contribute factors to chronic diseases such as type 2 diabetes, coronary heart disease, stroke and hypertension in adult life [79].

The idea is that a mother who starves herself, therefore who is emaciated, will produce an offspring who becomes obese. But that's exactly not what we see, and in fact not how it works. Instead, we see fat mothers give birth to fat babies who grow up into yet fatter adults, who then give birth to even fatter babies who grow up into even fatter adults, and so forth.

Bray calls this epigenetics, but in fact it's called generational epigenetics (I had to correct myself on this point, too). In this phenomenon, each generation manifests the same disorder (because it's the same cause), not opposite disorders. The disorder worsens with each subsequent generation exposed to the same cause.

#8 ^

Fri, May-19-17, 23:37

M Levac

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But seriously:

Quote:

Obesity predicts the development of some forms of cancer, particularly in women [80]. Oestrogen production by adipose tissue and the associated risk of endometrial and breast cancer is well known. In post-menopausal women, adipose tissue is the major source of oestrogenic compounds because the ovaries no longer produce oestrogens (Fig. 5). In addition, the growth factors produced by adipose tissue such as fibroblast growth factor-21, nerve growth factor, transforming growth factor-β and vascular endothelial growth factor, as well as insulin, may also participate in the growth of cells that eventually become malignant contributing another component to the risk for diverse forms of cancer in the individual who is obese

I mean, here Bray invokes insulin as a growth agent for cancer, but just can't seem to do the same for obesity. It's growth too. Ngh, ngh (I'm mimicking a guy pushing a giant rock, see?), poor Bray, too weak to push that big fat rock, or maybe he doesn't want to crush his glass house.