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Mark Hyman, MD

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The Diabesity Epidemic Part I: How Diabetes And Obesity Are Ravaging America Today

Posted: 12/10/09 09:20 AM ET

Do you fear for your health or feel exhausted all the time? Are you overweight? Or do you just have too much belly fat? Do you suffer from diabetes, monitor your blood sugar all the time, have serious blood sugar and insulin imbalances, or have elevated cholesterol, blood pressure, and triglyceride levels? If so, you may find this remarkable story of one my patient's very interesting.

One evening, after a lecture in New York, a man approached me about becoming my patient. He was rotund, with a round, ruddy face, a booming voice, and a gentle manner. Everything about him was large--his appetite, his belly, and his heart.

Sam was nearly 60 years old, and his love of everything big was waning as he felt the encroachment of death. As we talked, he described years of feeding his fat, drinking a pint of heavy whipping cream every night before bed to keep his weight up.

In the end, the big presence that Sam's 300-plus pound corpus gave him was not worth the infirmities he suffered. He was diabetic. His insulin was over 200, normal is less than 20. He also had dangerous cholesterol levels, angina, sleep apnea, a sluggish thyroid, and was doggedly fatigued, short of breath at nearly every step, had nasal congestion, swollen legs, dry skin, and yeast grew all over his body.

Sam may sound like a hopeless case, but the truth is that everything Sam had done to his body he did himself and could undo. I told him that if he did everything I suggested he would lose weight, feel better, and all his symptoms would go away.

Enthusiastic, though somewhat skeptical, he left my office determined. Three months later when I spoke to him again, he lost 30 pounds, had more energy, his nasal congestion was gone, his fluid-filled, swollen legs were better, and all of his cravings were gone--he never felt hungry, and he found the program I prescribed to him easy to follow.

Fourteen months later I saw him again and repeated his blood tests. I was shocked when he weighed in. He had lost 110 pounds without being on a strict deprivation diet. He simply changed his eating and his lifestyle. His diabetes was CURED. His blood sugar dropped from 130 to 74 (greater than 126 fasting denotes diabetes). His HDL and LDL cholesterol and triglycerides were normal without any medication. And he was exercising vigorously three to four times a week.

After a lifetime of uncontrollable appetites, Sam finally found balance and health without suffering. Yes, he changed his diet and lifestyle, but he was able to continue taking pleasure in food. Most importantly, he looked and felt twenty years younger.

Now, I know Sam's story is an extreme one. You may or may not be suffering from problems as severe as those he faced. Even so, I'm sure you can relate to some of what Sam experienced if you are overweight, have high blood pressure, elevated cholesterol, have problems with your blood sugar, or have been diagnosed with type 2 diabetes ...

You may feel twenty years older than you are, and, deep down, you may even be terrified by the possibility of additional health complications like heart disease, stroke, dementia, nerve damage, blindness, and amputation or even cancer. Like so many others that suffer with this condition, you just want to live a normal life and get back some of your energy and vitality; you want to turn back the clock and reverse your diabetes ...

You can do that. I know most people are skeptical when a doctor tells them they can reverse diabetes, but over the course of this three-part series of blogs I'm going to show you how. You can have the same experience Sam did, and you don't have to suffer or starve to make that happen.

Later in this blog series, I will tell you how you can do that. Today, I want to explain what I mean by the term "diabesity". If you have diabetes you have it. But you don't have to have diabetes or even have symptoms to be suffering from diabesity. In fact most people who have it don't know they are suffering from a deadly condition that is 100% reversible.

Many Names, One Disease--Defining Diabesity

You may be one among millions of people who are suffering from a health problem that is now epidemic in our country. Your doctor might have diagnosed you with one of many seemingly different diseases. He may have said you have:

• Insulin resistance

• Pre-diabetes

• Metabolic syndrome

• Obesity

• Syndrome X

• Adult onset diabetes

• Type 2 diabetes

What he likely didn't tell you is that ALL of these conditions are basically the same thing--just with varying degrees of severity. The underlying causes of ALL of these conditions are the same. And because they are all the same condition, the treatment for all of them is also the same.

That is why I have set aside these conventional diagnoses in place of a new name that more accurately defines the health problems you may suffer from. That term is diabesity. (i) Diabesity is the condition of metabolic imbalance and disease that ranges all the way from mild blood sugar imbalance to full blow diabetes.

Whether you are suffering from a little extra weight around the middle or you have been diagnosed with insulin resistance or even type 2 diabetes, the fundamental underlying biological causes of ALL of these conditions are the same. This is what I've discovered in over 20 years seeing thousands of patients.

Diabesity, in its various forms, affects over 1 billion people worldwide. It is a massive global problem, and our current approach to prevention and treatment is obviously not working because millions more are affected every year in a dramatic increase of a condition that was once very rare.

Diabesity is also the leading cause of most chronic disease in the 21st century. (ii) Those with diabesity are at an increased risk of heart disease (iii),(iv) , stroke, dementia (v), cancer (vi), high blood pressure, blindness, and kidney failure. Nervous system damage also affects 60 to 70 percent of people with diabetes and can lead to a loss of sensation in the hands and feet, slow digestion of food in the stomach, carpal tunnel syndrome, sexual dysfunction, and other nerve problems.

So this is VERY real and VERY serious for those who suffer from the condition. Given all of this, one would think the questions on everyone's mind would be: Why is this happening? What has caused this diabesity epidemic? Why are our current approaches to treating the problem failing so miserably? And what new approaches could we take that would more effectively treat the problem?

Few in medicine today are asking these questions, yet their answers are disarmingly simple.

The Problems with Diabesity Treatment--Symptoms, Not Causes

The reason our current approach to treating diabesity fails is because it focuses on treating the symptoms or risk factors of the disease rather than the causes. All of our attention is on treatments that:

• Lower blood sugar (diabetes drugs and insulin)

• Lower high blood pressure (anti-hypertensive drugs)

• Lower cholesterol (statins)

• Thin the blood (aspirin)

But we never ever ask the most important question: Why is your blood sugar, blood pressure, or blood cholesterol too high and why is your blood too sticky and likely to clot? Put another way: What are the root causes of diabesity?

Answering that question must be the focus of our diagnosis and treatment of this disease if we are going to solve this global epidemic.

In truth, diabetes, elevated blood sugar, blood pressure, and cholesterol are simply downstream symptoms that result from problems with our diet, lifestyle, and environmental toxins interacting with our unique genetic susceptibilities. These are the real causes of diabesity. Unfortunately, few are taking the time to treat them.

Using medication or surgery to treat symptoms like imbalanced blood sugar, high cholesterol, high blood pressure, and the other complications of diabetes is like mopping up the floor while the sink overflows.

In medicine today we have a choice. We can continue to mop up this overflow, or we can deal with the source of the problem and turn off the faucet--that is, treat the root problems that are causing your illness. In this three-part blog series, I am going to show you how to turn off the faucet so you can heal from your diabesity and achieve optimal health.

The real solution for diabesity is a comprehensive diet and lifestyle program. And in this series of three blogs I am going to teach you how you can integrate such an approach into your life to heal from your symptoms. I will show you why conventional treatments typically fail, what you can really do to treat diabesity, and explain how healing the 7 key underlying systems in your body is the real solution to the problem.

By following this system you may see many of your lifelong health symptoms evaporate in a matter of weeks or even days in some cases, and you may--for the first time--achieve vibrant health.

Now I'd like to hear from you ...

Do you believe you can be healed from diabesity?

Have you tried conventional medical treatments? How have they worked for you?

Are you ready to try a radically new approach that may help you heal once and for all?

Let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, MD

References

(i) This term was first coined by Shape Up America, former Surgeon General C. Everett Coop's foundation.

(ii) http://apps.nccd.cdc.gov/DDTSTRS/FactSheet.aspx (National Diabetes Fact Sheet 2007)

(iii) http://www.cdc.gov/diabetes/statistics/cvd/fig5.htm

(iv) Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002 Dec 4;288(21):2709-16.

(v) Ott A, Stolk RP, van Harskamp F, Pols HA, Hofman A, Breteler MM. Diabetes mellitus and the risk of dementia: The Rotterdam Study. Neurology. 1999 Dec 10;53(9):1937-42.

(vi) Key TJ, Spencer EA, Reeves GK. Symposium 1: Overnutrition: consequences and solutions Obesity and cancer risk. Proc Nutr Soc. 2009 Dec 3:1-5.

Mark Hyman, M.D. practicing physician and founder of The UltraWellness Center is a pioneer in functional medicine. Dr. Hyman is now sharing the 7 ways to tap into your body's natural ability to heal itself. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on Youtube and become a fan on Facebook.

 
 
 

Follow Mark Hyman, MD on Twitter: www.twitter.com/markhymanmd

Do you fear for your health or feel exhausted all the time? Are you overweight? Or do you just have too much belly fat? Do you suffer from diabetes, monitor your blood sugar all the time, have seriou...
Do you fear for your health or feel exhausted all the time? Are you overweight? Or do you just have too much belly fat? Do you suffer from diabetes, monitor your blood sugar all the time, have seriou...
 
 
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04:57 PM on 01/11/2010
I look forward to reading the second part of Dr. Hyman's post on diabesity and to leaning his views on diabetes and how other approaching to caring for the body may help people who have diabetes.

In my dental practice I work with many people who have diabetes and have seen, first hand, the dramatic difference good oral health care can make in their lives. On my blog at www.dentistryfordiabetics.com/blog, I write extensively about the connections between oral health care and diabetes.

Dr. Charles Martin
-- Founder, Dentistry for Diabetics
12:39 AM on 12/20/2009
Wow.
Just frikin WOW. I read a while back that conventional drug therapy for Diabetes was only 13 percent effective. That means for 87 percent, it was a slowing of the death. My partner is an EMT and has transported dialysis (spelling?) patients for years, I cannot handle the idea of a fistula in my arm someday. I am so afraid of insulin use as it is permanent and I also know an RN who is so casual about his diet and 'just use a little more insulin' approach that I know it cannot be the route to a lasting solution. (He also takes neuropathy medication that could stun an ox).
I got walking and diet changes as I knew I needed to do something that attacked my weight, my metabolism and would decrease my high blood pressure as well as change my trigliceride levels (once over 6000). The diet and exercise work. I am still inconsistent with regimen but know I can and have done it.
Here is the sad thing about 8 years ago; I asked my doctor to write me a prescription for exercise; one that said to buy a home gym or better to get a gym membership so I could deduct some of the cost from taxes to help afford this. He poo poo'd me and never wrote one.
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msoverall
I think, therefore I'm not a Republican!
09:29 AM on 12/15/2009
I hope I'm not offending anyone here, I truly don't want to but, how can you stress weight loss when so many people now believe it's ok for them to be heavy as long as they're happy with what they look like?
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KEATSnSKYESMOM
My life is way too complicated to put in this tiny
11:53 AM on 12/24/2009
People that are overweight know that losing weight is the best thing but it is very difficult to do. There are those people that are bigger than the norm but exercise and eat healthy. Acceptance comes from a different place - overweight people are discriminated against on a regular basis. We must be happy with who we are flaws and all before we can move on to really embrace any sort of meaningful change.
11:59 AM on 12/13/2009
Look forward to the series, Dr. Hyman.
02:54 AM on 12/13/2009
Excellent post Doctor... I learned a lot... Thanks for the enlightenment...

http://www.top3acaiberry.org
06:18 PM on 12/12/2009
I was diagnosed with type 2 diabetes about 2 months ago. I am very interested in how to solve the problem with my diabetes. Only 2 months & i'm already tired of having to shoot my insulin from 3 to 5 times a day, test my sugar level at least twice a day, & so on. So i'm ready for the first lesson!
09:36 PM on 12/12/2009
It's been a long time, Dr. Hyman... Thank goodness you're back. I read all of your postings here with great interest, and they have been amazing.
It is unusual to find an MD in the public eye that has more than a rudimentary understanding of alternative healing. i was astounded at how perceptive you are, and feel that your patients are lucky indeed.
Keep up the good work. And please don't stop posting. The world needs to hear exactly what you are saying, and especially in the thorough, scientific, and brave style that you are using.
Warm regards
07:23 PM on 12/11/2009
I would like more information on how to heal diabesity. I have type 2 diabetes I am 47 yrs old,4'11" and weigh 198 lbs. I also have high blood pressure and high cholesterol.
12:00 PM on 12/13/2009
A great start is to cut out added sugar and high-density carbohydrates and exercise.
12:08 PM on 12/13/2009
My first response was poorly written. I'll try again:

A great start is to cut out added sugar and high-density carbohydrates and to start exercising.
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DrP
07:20 PM on 12/13/2009
Actually, all carbohydrates metabolize as sugar, so eliminate all carbs except non-starchy green vegetables. It's worked for me for 10 years.
02:54 PM on 12/11/2009
What I don't see mentioned is the genetic aspect and the aging aspect. I am in my 60's and weigh about 135. I exercise 5 days a week and eat very healthy, low carb, and seldom eat processed foods. I seldom eat out either. But here I am, with metabolic syndrome. I am on all the drugs mentioned and would probably be dead soon without these drugs. I don't like it but that is what I was given genetically and with my aging body. So to be fair, plenty of people work hard to stay fit and healthy, but still have problems. A few decades ago people didn't live as long. So there is more time for people to fall into the pre diabetes or insulin resistance. Its not all that simple as putting the fork down as mentioned.
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Horus45
Liberal Activist, anti-Fascist
10:54 AM on 12/11/2009
I was almost exactly like Sam, except my weight was 360 lbs.
A few years ago I finally found the secret to losing weight and keeping it off, completely eliminate High Fructose Corn Syrup(HFCS) from your diet!
After I eliminated that poison from my diet I found dieting easy.
I lost a total of 170 lbs.
It is not easy to eliminate HFCS from your diet, it is in almost ALL prepared food, you will have to read all labels of everything you buy from now on.
I was able to make the connection between my weight gain and when the use of HFCS became widespread in the US in the 1980s.
Americans did not have such a huge Obesity problem until manufacturers switched from using cane sugar to HFCS, nor was there such a huge problem with Type 2 Diabetes in this country.
Since the use of HFCS became widespread in the US the incidence of Type 2 Diabetes has Quadrupled and Obesity has increased nearly ten fold.
This poison is killing our nation.
You can also blame HFCS for the high costs of Medical Care in this country as well.
The US is the ONLY country that uses HFCS as the main sweetener in it's food supply, the incidence of Obesity and Diabetes has NOT increased in other countries like it has here.
Your body will thank you with weight loss once you stop eating that poison!
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KIMBER
Reality has a pronounced liberal bias.
03:04 PM on 12/11/2009
There is a mad rush on by agribiz in this country to get every living thing to consume massive amounts of corn - preferably genetically modified corn. Corn is a number one ingredient in pet foods - neither dogs or cats would naturally consume corn, but they get it, and look how fat they are becoming. Cows aren't made to eat corn either, but they are fed corn precisely because it makes them fat very quickly, in order to make the insanely high quantity of beef people eat. High fructose corn syrup is hidden away in almost all processed foods. Why is there such an agenda to get every living animal consuming vast amounts of corn? It's subsidized, and most of it is genetically altered to withstand even more toxic chemicals, which you ingest along with whatever genetic modification it has undergone. That's big money for the people doing the genetic modification and the manufacture of the specialized chemicals. Unless you buy it organic at the farmer's market, stay the heck away from corn, in its multitude of processed forms. Soilent Green isn't people - it's corn.
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TazoWolf
Med student, Colorado
07:05 PM on 12/11/2009
I agree with you. I've done far better since eliminating HFCS and much processed corn from my diet. My pets don't eat it either. My 2 cats have been far healthier since I switched them to grain free diets a couple of years ago.

We're lucky here. Sunflower Market is a year round organic farmer's market. We also have grocers like Vitamin Cottage. Locally owned stores selling locally grown fresh produce and organics.
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Horus45
Liberal Activist, anti-Fascist
08:18 AM on 12/12/2009
That is exactly why I cook my dogs food.
She was doing poorly on commercial dog food, she always had a weird skin rash and other unexplainable illnesses.
Once I started cooking her food everything weird went away, plus she lost weight.
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Ziona Etzion
Humanist, activist and creator
10:03 AM on 12/11/2009
How much exercise is enough excercise to make an imprint in our lifestlyle
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walteradamson
Cloud, social, mobile things.
01:52 AM on 12/13/2009
I'm no expert, but I am diabetic Type 2 and studied your question for my own health, here's an answer I wrote on my own blog: How Fast Must You Walk for Fitness? http://dawnweslept.com/forum/topics/how-fast-must-you-walk-for

"You need to achieve a goal of "moderate exercise" each time you walk, and in addition to do this for at least 30 minutes, and 5 times per week.

If you do this you will become physically fit, as measured by a high level of cardiorespiratory fitness (CRF), and will be less likely to develop heart disease and less likely to die from any cause. Studies have proven this fact."

After that you get into call sorts of claims about cardio versus strength training etc etc but if you do the walking as described in my post you will become fitter i.e. it will make an imprint. Importantly, it tells you that although many people say "just go for a walk" while that is a nice lifestyle thing it will not make you fit or "make an imprint". My post explains why, from the research.
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Ziona Etzion
Humanist, activist and creator
04:12 AM on 12/13/2009
Thank you walteradamson

You answer is appreciated...and yes I have been walking for between and hour and an hour and a half for the last year and a half.

Both flat and hilly and sometimes flights of steps...

I had visitors from overseas and we were walking in the old city and at the end of the visit...one of the visitors gave a stinging comment...which most probably motivated me to take up a daily regime! She told my brother that I was unfit and the body is meant to move. She is right!

People do not realise that once they start to exercise the body demands it...

So now the diet part...
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DrP
07:23 PM on 12/13/2009
I personally feel that walking 30 minutes/5 times a week is not enough if you are insulin-resistant. You need to work up a sweat and get your heart rate up - my goal is a minimum of 30 minutes every day and strive for a couple of hour-long workouts a week. In the summer when I don't work everyday (yeah, I'm one of those darn college professors) I work out as much as 3 hours a day - jogging, biking, etc.
I'm almost 57 and have major family history of "diabetes."
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Ziona Etzion
Humanist, activist and creator
09:59 AM on 12/11/2009
Heard that there is corn syrup to bolster foodstuffs and people do not even know the additives
that the manufactures are plying our bodies with.
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HUFFPOST SUPER USER
simplify
09:55 AM on 12/11/2009
Fat, salt and sugar is the standard daily diet .High frutose corn syrup, growth hormones, corn complex processed carbs in almost everyfood sold in our grocery stores.

An uneducated public eats its way to an early grave. The food industry is killing us.
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Horus45
Liberal Activist, anti-Fascist
08:22 AM on 12/12/2009
Some food manufacturers are seeing the light.
I started a letter writing campaign to Oroweat a few years ago and as a result of that they stopped using High Fructose Corn Syrup in all their breads.
Now they print it right on the label, "Contains No High Fructose Corn Syrup".
10:21 AM on 12/12/2009
That's awesome! Good for you, and thank you!
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Konnie
Really South Carolina??
06:40 PM on 12/12/2009
to confirm that our food industry is killing us, just take a look at what america food items cannot legally be imported into other countries. and yet we scratch our heads that the citizens in other countries can eat so well, hardly ever exercize and are in better health...............
09:10 AM on 12/11/2009
I am anxious to hear more about this I have most of the symptoms that you describe and have been working with an endocrinologist for 4 years on blood sugar and diet issues. The blood sugar is under control but the weight is not. Interested in hearing your ideas on this matter.
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TazoWolf
Med student, Colorado
08:26 AM on 12/11/2009
Dr. Hyman,
I don't have diabetes or hypertension, but I have a parent who does. Until 10 years ago, I had been an athlete. Then I developed a weird autoimmune bone marrow disease, accompanied by collapsing glomerulopathy, a severe kidney disease in which recovery is not normally seen, even with transplant. I recovered. But in my recovery, my energy levels never returned (I was also hypothyroid), and high dose prednisone led me to put on quite a few pounds (which while I didn't further increase these, nor did I lose all of them).

In August I decided to do something about it. I rebuilt my 23 year old racing bicycle and decided to train for a bicycle race called the Triple Bypass- 120 miles across the Colorado Rockies... in one day. I've kept with it, and while I've not lost a lot of weight (although I'm not considered obese), I've gained a LOT of strength, endurance, and energy.

I've dedicated my training and ride to raising awareness about renal disease, especially since most is the result of lifestyle and dietary issues (diabetes and hypertension) and can be prevented. I'd love it if you could help me in my effort in some way (my training blog is on Lance Armstrong's health related website, http://www.livestrong.com/).

Riding for Renal in 2010 http://www.livestrong.com/profile/circarigel
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TazoWolf
Med student, Colorado
08:41 AM on 12/11/2009
Also, when I visit my family over the holidays, I plan to fix up my dad's old bike... diet has started to reverse his diabetes... I want to encourage more, get him to take it all the way, controlling blood pressure as well, hopefully getting off the meds.
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MrBadExample
Friends call me ‘exampleicious’
06:45 AM on 12/11/2009
Dr. Hyman--
I hear you. five years and 60 pounds ago, I was testing positive for diabetes. My first experiences with glucophage drugs were horrible, so I made a deal with my doctor to try it my way first. Twelve months in a gym program (five days a week) plus a bicycling regimen put my a1c (hemoglobin) numbers at 5.5. I also gave up my local pizza place and started eating vegan two days a week.

That said, the 'put down the fork' school of thought doesn't help most obese people. You need the exercise program to get your body to a place where you can function. The sleep apnea is a particularly pernicious problem, because until you can actually get restful sleep, you can't do exercise and your metabolic rate won't match consumption. The other benefit of exercise (as opposed to calorie counting) is I could no longer eat high-calorie junk food like takeout Chinese--my body didn't tolerate junk very well.

The medical crisis facing the US is only partly about obesity and diabetes. Sedentary people (even if they are of 'normal' weight) face a huge number of medical problems. Fit people are less susceptible to disease and recover from injury far faster. The US crisis is a fitness crisis, and our sedentary, car-dependent lifestyle is a huge contributor.