Obesity Epidemic 201
201 funny sounding words to scare you into cleaning up your diet, courtesy of Heymsfield et al featured in this week’s New England Journal of Medicine. It’s quite astounding how much havoc an innocuous fat cell can wield on the human body! Some of these pathways are obvious, such as excess weight and osteoarthritis (right?), but some of this article is truly eye opening, less intuitive, and therefore warrants a 200 level course title.
First is the pro-inflammatory response to fat. Adipose cells are a sack of cytokines that, in effect, create a standing army of immune cells ready to attack something. That something tends to be your own body per emerging literature. This mayhem may even play into overstimulation of your “sympathetic nervous system” which clamps down on blood vessels, offering yet more insight into why obesity correlates to higher resting blood pressure, and either directly or indirectly, higher incidence of heart disease, stroke, and chronic kidney disease. Note also how preferential deposition of fat in the throat lends to sleep problems and consequent cardiopulmonary stress, while central deposition increases abdominal pressure and forces gastric acid up. A concerted New Year’s resolution to tackle the cause of all these problems is surely worth its weight in bitcoin.
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Dr Viglione is a concierge medicine doctor in Santa Barbara, CA