“A conscience which has been bought once will be bought twice.”

Norbert Wiener

photo: Malingering. Yikes…

Disclaimer: as many of you know (or, if you didn’t before, you are hereby notified), that I work in the pharmaceutical industry; in validation, to be exact – a branch of quality control.  So I can take the following cited article in one of two ways – as a public service nightmare, or as, well – a positive indication of continuing job security – for as long as I care to stay in the game.  It’s not in my nature to be self-serving, and so my natural inclination here is deep contempt for those in “power/knowledge” positions, and pity for the masses who listen to them.

So, with “news” like this, out of Amman, Jordan, all indications are that the rest of the world is doing its damnedest to surpass us (“us” here, being the good ol’ USA) in obesity rates.  As if being drubbed math and science weren’t already enough…

According to Kenneth Thorpe, the Robert W. Woodruff Professor and Chair of the Department of Health Policy & Management, in the Rollins School of Public Health of Emory University, Atlanta, Georgia, By 2018, 103 million American adults — or 43 percent of the population — will be considered obese.  I would venture to guess that the numbers for those below the age of 18 are just as gruesome.

Of course, any manner of health care reform will simply implode under the weight of disease management if these numbers hold true.  And “news” like the above-cited Jordan Times story indicate that while the US may lead the way over the cliff, the rest of the world is following, quite lemming-like, right behind.

More to follow…

In health,

Keith

23 COMMENTS

  1. Keith,

    I had another “Terra Orca” shift in the ER last night. No one under 250 pounds, the vast majority over 300 pounds, and one 450 pounder. The were all on the usual pharmocologic cocktail of meds for treating the metabolic syndrome…an anti-hypertensive, oral hypoglycemic, asthma inhalers, steroid inhalers, gout meds, H2 blockers and reflux meds, NSAIDs for arthritis and last but not least…SSRI antidepressants.

    Most were drinking a mountain dew during their visit, and over half asked for dietary to send food before I could get them dispositioned. It is truly amazing how deranged their metabolism is. Treating the acute phases of their illnesses is like treating something that is not even human because their physiology is so deranged.

    Healthcare reform will implode…there are way more people in the cart than there are people pulling the cart, and the ones in the cart all weigh 300 pounds.

    Doug McGuff

  2. I dream of a world where people like Tatyana Kour are charged with criminal negligence and mal-practice, fined, and de-certified. The harm they do cannot, in my opinion, be understated – they are the ones speaking to millions of impressionable readers from the pages of fitness magazines and health columns.

    Since a huge majority of what goes wrong with our bodies can be exarcerbated, mitigated, caused, or prevented by diet, shouldn’t any nutritionist be held to the same standards that Doug or any other physician is with regards to mal-practice and liability?

    • Herein lay an interesting juxtaposition, especially here in the US, with all the heated health care reform rhetoric being tossed about. Who do we trust? The government? The health care “establishment”? Now is an especially lousy time (depending, of course, on your point of view) for the masses to view either entity as having lost credibility. Yet, for policy and “official” recommendations to change, admission of prior grievous errors are a must. It’s not easy to cover up such a blatant misdiagnosis and the resultant wrong-minded treatment as being the result of a slight miscalculation. I see where this is headed, though – acknowledgment of metabolic syndrome as being a crippling impediment to any meaningful health care reform; the proposed fix, though, will come via the pharmaceutical industry, not via substantial changes to the diet, or of “official” dietary recommendations.

      • It such a tragic and impossible situation. The establishment didn’t just “suggest” the lipid hypothesis. Instead, they preached it so fervently, absolutely, and constantly, that now there is no hope of them changing their minds, and recognizing the erro of their ways. There’s just no backing down for them.

        Like Richard points out, people don’t come to resolution, the people who are wrong simply die out.

  3. In addition to the disastrous side affects mentioned in the article I can add a further one which I believe is new to medical science.. Group hallucinations: Since I have been low carb / paleo for 15 months and never eat 3 meals plus 3 snacks a day, I must have passed through the temporary weight loss, stage and piled on many tens of kilograms compared to when I started. Nevertheless to both myself and those around me I look thinner and more muscular than ever. Group hallucination can be the only possible reason 🙂

  4. I have a theory… we’re all just sheeple, victims of the organization/lobby that has the most money to buy the most “experts.”

    In one case, its the farmers of America, lobbying for more of the wheat demand that keeps their coffers filling. Another example: Ethanol from corn. CORN? WTF? Corn has got to be one of the most ineffiecient sources of ethanol on the planet! But I digress.

    The next lobby, quietly backing the farmers, would be the pharmas. “We can sell you a pill, don’t worry about it!”

    I didn’t say my theory was new or unique. 🙂 Sounds like “civilization” is spreading. I can’t wait till the Food Pyramid destroys the health of otherwise healthy countries…

    since I started reading this weekend, I’ve learned a whole lot. Interesting to know that there’s a controversy over cholesteral and heart disease. Apparently most of the studies show a minor correlation and NOT a causality. But we’ll sell you statins! Whoo HOO!

    Am starting to leave the realm of skepticism, and have applied for a visa to the country of Cynicism.

    Suzi,
    Who is on day 3 of low carb and not having the carb cravings so much as the nausea. Suckage. Suggestions?

    • Yes, increase saturated fat input wherever and whenever possible. Extra butter in your scrambled eggs, extra coconut oil in your sauteed veggies, extra heavy cream in your coffee, etc. Even if you don’t tolerate lactose well, like myself, heavy cream might be ok as it has nearly zero lactose/milk proteins. I do quite well with it.

    • Most who experience nausea at the initial SAD (Standard American Diet) to Paleo transition report that, in hindsight, it was most likely brought on by overloading the system – i.e., matching pre-Paleo intake volume to the new, Paleo intake volume. You’ll find that since your food options are much more calorie/nutrient dense (an increase in both protein and fat), that your “Paleo” food volume per meal will decrease substantially. I (sometimes, still), and those around me are baffled at just how “little” I eat – and I’m not a small or inactive guy by any stretch of the imagination. Try cutting back to “snack size” volumes at each meal for a while – even if it means increasing your meal frequency over the short term. In time, you’ll naturally adjust to your new meal-size requirements.

      • I’m actually eating a lot less… so I don’t think its the portion size. I think it might be a fat thing, after checking on some protien eater boards.

        I’m also craving salt like mad. Mad, I tell you. MAD!
        🙂

        • I wonder if the salt craving has anything to do with the initial water loss associated with carb. reduction? Maybe the body’s way of attempting to prevent what it sees as potential dehydration? Not that dehydration is anything that you have to worry about, realistically.

  5. Speaking as a nurse on a cardiac unit, I can relate with Dr. McGuff’s experience of patients asking to pour more poison down their throats while they’re drowning in adipose tissue. Some patients are truly horrific.

    However, I do not agree with Bryce’s assessment that the nutritional establishment is responsible for the state of the patients that Dr. McGuff admits for me. These are not patients who are doing hours of low-intensity cardio and cutting out all the fat in their diets. They are mostly people who are simply from the lowest rungs of society. Low educational attainment, low income, low social status. They have no goals, no hopes, no self-discipline, and their lives consist mostly of finding ways to avoid short-term discomfort through sedentary activity or getting a carb fix. Many aren’t even aware of conventional nutritional advice beyond a vague notion that they should buy things that say “low-fat.” Many do not really understand macronutrients. (I had a girl tell me once that she had gone on a low-carb diet by substituting crackers for bread!)

    What is the point? While I agree that nutritionists are dispensing a lot of bad advice, I do not agree with the view that our obesity rates are explained by bad advice. Correlation is not causation, and I think the causes of the obesity epidemic are very complex. Society has changed in many ways over the same period since the government started recommending low-fat/cardio. And I’m not talking about the fact that kids don’t walk to school anymore. There’s a lot more than that, and not all related to exercise. 400lbs patients primarily have psycho-social problems, in which I would include growing up around other obese people who have nothing going for them.

    Although many people feel that our society is not really meritocratic, in fact it is, and things like “degree creep” and “outsourcing” are making it moreso. The least capable are slowly getting sifted out and stuck and succumbing to cheap supply of food and lack of culture (both physical and mental). How many obese PhDs have I seen on our cardiac unit in five years? Zero. (Their cardiac problems aren’t related to lifestyle.) How many obese investment bankers have been featured on the news since the bailout? When you see CEOs, lawyers, politicians in the news, are there the same percentage of obese as the shoppers in your local Wal-Mart?

    The arguments made by places like TTP are relevant mostly for people on the margins who are capable of clawing their way into good health but need to know how to do it effectively. But I think most of the enormous people and many of the clinically obese can only be helped through coercion (taxes, etc), which is sad and not something I’m really comfortable with.

    • Chris,

      I think I am frustrated with the nutritional community not because they cause obesity, but because they derail the good intentions of so many would-be dieters who want to change themselves, and fail with good advice.

      I think you may be spot on with your last paragraph. Scary.

    • Great insight from the trenches, Chris. Thanks for taking the time to shed some light on this for us. And I whole-heartedly agree with this observation:
      “…many of the clinically obese can only be helped through coercion (taxes, etc), which is sad and not something I’m really comfortable with.”
      I really am of two minds on this. Part of me says that the correct information is out there for all to see – it just takes a little effort & motivation to dig it up – and some moxie, a little more motivation, and yes a small bit of intelligence to interpret the information correctly. That part of me says that if you’re not willing to do at least that minimum amount of work for your own benefit, we’ll just have to leave you behind. For the herd as a whole to survive, they must leave the few lame & intern behind.

      The other part of me says that we’re all in this “human condition” game together – each endowed with specific strengths and weaknesses – with our collective “object”, as it were, being to move humanity forward. Do unto others, in other words…

      • As a borderline libertarian, the taxes thing scares me a bit…

        Mainly because what will they tax? Fat content of our food? Or sugar content??? Because those will create DRASTICALLY different results.

        Taxes are sometimes dished out on the basis of “expert understanding of the situation.” I think we can all agree that the experts pushing whole grain carbs and low fat may not be doing the right thing?

  6. Recent experience of Tom Naughton’s visit to a his primary care physician.

    “Step up on the scale, Mr. Naughton.”

    “Sure, Doctor. I’m looking forward to seeing this myself.”

    “Let’s see … slide this over a bit … hmm, pretty bad. Your weight is up again.”

    “Uh … Doctor, you mind getting your foot off the scale?”

    “Oh, okay.”

    “So … you want to weigh me again now?”

    “Sorry, I’ve already recorded the results. You can step down now.”

    “But–”

    “Just as I predicted. Man-made body enlarging. I told you to stop consuming so much animal fat.”

    “There’s nothing wrong with eating–”

    “If this keeps up, you’ll weigh 650 pounds by the year 2030. It’s a looming disaster.”

    “Doctor, excuse me, but there’s no way I’m gaining weight. Look at me. I had to buy a smaller belt last month.”

    “That’s a temporary anomaly. I’m more interested in the long-term trend.”

    “I’ve been shrinking for two years now. I’ve also been eating more animal fat. So it can’t be making me fatter. Your theory doesn’t hold up.”

    “Do you weigh more than you did 40 years ago?”

    “Yes, I was a skinny runt 40 years ago.”

    “And did your fat consumption go up during the past 40 years?”

    “I was 11 years old 40 years ago! Of course I eat more now.”

    “Aha! So you agree there’s a long-term trend in your body enlargement.”

    “Those are natural forces at work. I’m pretty sure that’s been happening forever.”

    “But the rate of the enlargement has accelerated. Look at your weight chart. See there? All nice and even for two decades, then it shoots up here at the end. It looks like a hockey stick.”

    “That chart is bull@#$%!”

    “It can’t be. I showed it to a bunch of doctors who are friends of mine and they agreed: it looks like a hockey stick. We even wrote a paper about it.”

    “Look, Doctor, I went through period in my thirties when I was fatter than I am today, and I wasn’t eating animal fat because I was a vegetarian. Now I’m experiencing a thinning trend, even though I eat a lot of fat. So obviously, fat isn’t the problem, and that chart is bull.”

    “I see. So you’re a denialist.”

    “What?!”

    “I suppose you don’t believe the Holocaust happened either?”

    “No! I mean, yes, I believe it happened. There’s evidence it happened. But there’s no evidence that I’m gaining weight!”

    “Who’s paying you to say this? The dairy industry? The cattle ranchers?”

    “Nobody’s paying me! Just use your senses! I’m smaller!”

    “This is the worst case of denial I’ve ever seen. I’m afraid we’re going to have to institute a fat-and-trade system. Every time you consume fat, you’ll need to pay me a stiff fine. Or you can buy a fat credit from another tubbo who’s willing to go without butter for a week. It’s the only way to stop you from getting larger.”

    “I AM NOT GETTING LARGER!”

    “Yes, you are. It says so right here in my computer data.”

    “Let me see that.”

    “No. I will not have you second-guessing my data. I don’t have to show you anything.”

    “Yes, you do, Doctor. And if you don’t, I’ll call my lawyer and have him file the papers.”

    “Damn! I was hoping you didn’t know about that law. Now I have to destroy the data.”

    “What?!”

    “Nothing. I didn’t say anything.”

    “Give me that book!”

    “Hey! Give that back!”

    “Back off, Doctor, or I’ll smack you. Let’s see … Hey, what’s with all the emails and notes?”

    “Nothing. Just doctor’s notes.”

    “Nothing, my @##. Look at this: ‘James – I figured out how to apply Mike’s trick of mixing belt-ring data with actual weight measurements to hide Mr. Naughton’s mid-thirties fattening period.’ What the hell is that supposed to mean?”

    “It doesn’t mean anything! ‘Trick’ is a common term in medical research. Give me that back!”

    “And here’s a coding comment from the guy who designed your computer program. What does he mean, he’s having a hard time writing code that produces the results you want?”

    “You know … just programmer lingo. That’s how they talk.”

    “And this one: ‘James – Perhaps we should encourage our colleagues to boycott medical journals that publish articles by doctors who have seen people lose weight on high-fat diets. By the way, please delete this after reading.’ And you printed it out? What are you, an idiot?”

    “Oh, I see. Already reduced to resorting to attacks on my character, huh?”

    “And what’s up with this one: ‘James. That fact is that we cannot account for Mr. Naughton’s failure to gain weight in recent years, and it’s a travesty that we can’t.’”

    “Well, uh …you see, the theory is still correct, because uh … I mean it’s not like we have anything to hide!”

    “Let me get this straight … you wouldn’t give me your data, you threatened to destroy your data so I wouldn’t see it, your programmer was upset because he was having a hard time producing the data you wanted, you applied ‘tricks’ to your data, and in spite of all that, your colleague thinks it’s a travesty that you can’t explain why I’m not actually gaining weight. I’d say you were hiding something, Doctor.”

    “But the theory is still correct! I’m sure of it! To hell with your annoying weight loss.”

    “No, to hell with you, to hell with your theory, and to hell with your fat-and-trade fines. I’m leaving.”

    “Don’t go outside while you’re angry, Mr. Naughton! You’ll get heat exhaustion!”

    “It’s snowing, you moron.”

    • The ol’ “testing to the expected outcome” syndrome. Gives the term “bending the curve” a whole new flavor. 🙂

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