Many years ago, I mentioned to a doctor friendￂﾠthat a woman I knew --ￂﾠa Seventh Day Adventist who never drinks alcohol -- had been toldￂﾠshe was at risk forￂﾠcirrhosis of the liver due toￂﾠher poor diet and excess weight. ￂﾠMy doctor friend looked at me skeptically and said I must have misunderstood the diagnosisￂﾠ-- one could not develop cirrhosisￂﾠthat way, she said --ￂﾠand since I'm no medical expert, I assumed I'd been misinformed.
But while "nonalcoholic fatty liver" was so rare 30 years ago there was no medical name for it, theￂﾠNew York Timesￂﾠreportsￂﾠit now affects one in 10 American children, with the rate among children and teens more than doublingￂﾠin the last two decades. ￂﾠOf those afflicted, 10 to 20 percent will eventually develop the liver scarring that can lead to cirrhosis, liver cancer and liver failure, requiring a transplant for survival. ￂﾠThe condition is also aￂﾠrisk factor for developing heart disease and Type 2 diabetes.
The cure for nonalcoholic fatty liver is quite straightforward: improving one'sￂﾠdiet by cutting out fast and processed foods and sugary beverages. ￂﾠBut despite incredibly powerful motivators ￂﾠ-- ￂﾠ"crippling" abdominal pain (one patient referred to it as "being stabbed in your stomach with a knife")ￂﾠand theￂﾠpossibility of needing a liverￂﾠtransplant (or, far worse, needing a transplant and andￂﾠbeing unable obtain one, as demand outstrips the number of organs available)ￂﾠ-- many patients still find this "treatment" just too difficult:
Yubelkis Matias, 19 ...ￂﾠwas told she has NASH several years ago. She is reminded of the trouble brewing in her liver by the sharp abdominal pains that come and go ... [S]he has been told by her doctors that diet and exercise may be her only shot at reversing the disease. But at 5-foot-5 and 200 pounds, she finds every day a struggle
"I'm on a roller coaster," she said. "I eat healthy, then not healthy -- pizza, McDonalds, the usual. My doctor told me I have to quit all of that. But it's cheap, and it's always there."
[...] "A lot of times when I see a patient with fatty liver," [Dr. Shahid M. Malik of the Center for Liver Diseases at the University of Pittsburgh Medical Center] said, "the first thing out of their mouth is, 'Well, is there a pill for this?' And there's not. There just isn't. You have to make lifestyle changes, and that's a much more difficult pill for people to swallow."
One could attributeￂﾠthese patients' inability to improve their diets to aￂﾠlackￂﾠof individual willpower, but this conclusionￂﾠignores a whole host of societal factors that make eating healthfullyￂﾠon a regular basis extremely difficult for many people. ￂﾠAs Dr. Thomas Friedan, director of the Centers for Disease Control andￂﾠPrevention, once memorablyￂﾠsaid:
... if you go with the flow in America today, you will end up overweight or obese.ￂﾠ That is not a reflection of individual personal failing.ￂﾠ It's a reflection of the structure of our society ... [T]he popularity of weight loss programs is a reflection of both the intense desire of many people to lose weight as well as the great difficulty of doing so. ￂﾠ[Emphasis mine]
Meanwhile, when you have a condition like fatty liver disease that's growing ever more prevalent, and patients clamoring for "a pill" instead of weaning themselves off their unhealthful diets, it's predictable that drug companies would see the potential forￂﾠhuge profits. ￂﾠThe Times reports that at least two companies are now scrambling to develop drugs which will help treat the disease, and one of those companies saw its stock price "soar" when its first clinical trial showed promise.
There's nothing new about any of this, of course. ￂﾠFood companiesￂﾠprofit from our dependence on their productsￂﾠwhile drug companies reap the profits on the other sideￂﾠof the equation. ￂﾠBut somehow the prospect of kids doubled over with liver pain and facing potential liver failure, entirely due to Big Food's grip on our palates and our lifestyles, got to me on a visceral level.
What does it say about our society if we wouldￂﾠrather send children to such mutilating procedures but yet lack the political willￂﾠto properly fund school nutrition and ban junk foodￂﾠadvertising to children? It reflects a systematicￂﾠpolitical failure. We're the richest society in theￂﾠworld. We've failed because we've placed privateￂﾠprofit and special interests ahead of public health.
Dr. Ludwig was referring to a morbidly-obese teen undergoingￂﾠgastric bypass surgery, but he could just as well have been referring to an overweight child needing a liver transplant. ￂﾠAnd, indeed, we are clearly in the midst of a "systematic political failure," because just as we already knowￂﾠthe "cure" for fatty liver disease, we also alreadyￂﾠknowￂﾠthe the "societal cures" for all obesity-related illnesses:
- Restructuring the agricultural subsidies thatￂﾠmakeￂﾠfast food and processed food unnaturallyￂﾠcheap, while inadequately supportingￂﾠfarmers growing fruits and vegetables;
- Banning the advertising of junk food to children;
- Taxing and/or placing healthￂﾠwarning labels on non-nutritive, sugar-sweetened beverages;
- Investing more money in federal school meal reimbursement, so schools can afford to buy healthier food and pay for the increased labor needed to prepare it;
- Investing in school infrastructure, both to build school kitchens in whichￂﾠscratch-cooked meals can be prepared, as well as home economics classrooms where children can acquire basic cookingￂﾠliteracy and skills; and
- Requiring and funding meaningful nutrition education curricula, including home economics, throughout the K-12 school years.
And yet, like a fatty liver patient addicted to fast food, our elected leaders are currently too addicted toￂﾠBig Food's and Big Soda's lobbying dollars, and/or too afraid of "nanny state" rhetoric from the right, to muster the political courage to fulfill thatￂﾠRx.
For four years now, I've been saying on my blog that some day the costs of obesity, both financial and personal, will be just too high for our legislators to continue to ignore. ￂﾠBut when you read aboutￂﾠone in 10 kidsￂﾠfacing the possibility of a liver transplant due solely to the unhealthful American diet, you really do have to wonder: Where on earth is the tipping point?