Diabesity: A Reversible Epidemic

By Mark Hyman, MD Chairman, Institute for Functional Medicine Founder and Medical Director, The UltraWellness Center Author of The Blood Sugar Solution

Posted on | By Dr. Mark Hyman

What life-threatening, life-sapping, energy-robbing condition affects 1 in every 2 Americans (that is every other person), including 80% of those overweight and up to 40% of normal weight people? What condition is responsible for more deaths from heart disease, cancer, high blood pressure, diabetes and dementia than anything else? What condition also causes acne, infertility, sexual dysfunction and depression?

What condition accounts for more then 70% of our $2.4 trillion annual health-care bill and will account for most of the $47 trillion we will spend globally over the next 20 years to deal with chronic disease? What is responsible for nearly twice as many deaths every year as infectious disease, even in the developing world?

And what condition is not even diagnosed in over 90% of those who suffer from it?

What condition are doctors not trained or reimbursed to diagnose, treat or prevent, yet makes up the majority of health-care visits and costs?

And what condition is nearly 100% preventable, treatable and reversible? 

Diabesity.

It is the single biggest health challenge facing us individually, as a nation and as a global community. 

Diabesity is the continuum of metabolic disturbances from mild blood sugar and insulin imbalances to pre-diabetes to full blown type 2 diabetes. It occurs in about 40% of people of normal weight – these are the skinny fat people who look thin but are metabolically fat and have all the same risk factors for disease and death as those who are overweight. And it occurs in 80% of overweight people. 

Since it affects every other American, watch this video to see if you have it.

The solution is not coming from our health care system or doctors, not from our government, or from most corporations.  There are too many people vested in maintaining the status quo or worse profiting from making us fat and sick.  We need a solution.

That is why I wrote The Blood Sugar Solution. It has a bold central goal: to address and begin to reverse a global epidemic. It is a personal guide and plan, as well as a program for helping people get healthy together, based on functional medicine, and it is a blueprint for us to take back our health as a society.

Obesity, pre-diabetes and diabetes, or what I call diabesity, which now affects 1 in 2 Americans arises out of existing social, economic and political conditions. In fact, obesity and diabetes are social diseases and need a social cure and collective action on many levels to reverse the tide. 

Over 10 years, these conditions will cost America over $3.5 trillion in direct costs, not including lost productivity and the costs in quality of life. From 1983 to 2008, worldwide diabetes rates increased sevenfold from 35 million to 240 million. In just 3 years from 2008 to 2011, the roll call for diabetes increased another 110 million.

Children less than 10 years old now get type 2 (or adult onset) diabetes, and have strokes and heart attacks by age 15 or 20. One in three children born today will have diabetes unless we do something differently.

I wrote The Blood Sugar Solution to tackle this problem head on.  

It is a personal plan that breaks through myths about obesity and diabetes that keep us sick and fat. And lays out the seven key steps to preventing, treating and reversing diabesity by dealing with the underlying causes. It is an 8-week plan that takes you through step-by-step how to reboot your metabolism, lose weight, and reverse type 2 diabetes.

It is a plan for us to be more successful by working together to get healthy. We do twice as well and lose twice as much weight when we get support from others in our community. We are better together. 

We recently did a “beta test” of this program with about 150 people. Their results were astounding:

  • The group lost a total of 1536 pounds in just 8 weeks. That’s an average weight loss of over 10 pounds per person!
  • More than half the group lost more than 10 pounds. Some lost as much as 28 pounds.
  • Average waist size decreased by 1.5 inches, and some people lost so much of their waist that they had to go out and buy new clothes. One woman lost 8 inches from her waist. Imagine, 8 inches in 8 weeks. No medication can help you do that.

But The Blood Sugar Solution is about far more than weight loss; it’s about taking back your health and your life. People who completed the program reported an average reduction of 14 points on their systolic blood pressure; their fatigue evaporated and they had more energy than they had felt in years; their joint and muscle pain vanished; the program improved their mood and sleep, eliminated their brain fog, and a provided a deep sense of well-being. The Blood Sugar Solution gave these people a new lease on life.

The Blood Sugar Solution is a plan for each of us to take back our health as a society. Our health has been hijacked from us, taken from us slowly, quietly, over the past century. Our current food, social, family, school, work, faith-based, and community environments, health-care institutions, and government policies make it hard for us to make healthy choices. We are presented with choices that foster bad habits. But together, getting and staying healthy is possible given the right information, tools, support, and collective action to take back our health.

Navigating the Terrain of Disease: Getting to the Root of the Problem

To effectively treat diabesity, we must shift our focus away from the symptoms or risk factors of the disease and begin taking a hard look at the causes. All of our attention is on treatments that lower blood sugar (diabetes drugs and insulin), lower high blood pressure (anti-hypertensive drugs), improve cholesterol (statins), and 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 the disease if we are going to solve this global epidemic.

The good news is that the answer is shockingly simple.

The Real Causes of Diabesity

The entire spectrum of diabesity including all of its complications – diabetes, elevated blood sugar, blood pressure and cholesterol – are simply downstream symptoms that result from problems with diet, lifestyle and environmental toxins interacting with our unique genetic susceptibilities.

 

Those are the real causes of diabesity.

And the reason these dietary and lifestyle factors lead to diabesity is because they create a condition known as insulin resistance. Contrary to what most people think, type 2 diabetes is a disease of too much, not too little, insulin. Insulin is the real driver of problems with diabesity.

When your diet is full of empty calories and an abundance of quickly absorbed sugars, liquid calories,[i] and carbohydrates (like bread, pasta, rice, and potatoes), your cells slowly become resistant to the effects of insulin and need more and more to do the same job of keeping your blood sugar even. Thus you develop insulin resistance. A high insulin level is the first sign of a problem. The higher your insulin levels are, the worse your insulin resistance. Your body starts to age and deteriorate. In fact, insulin resistance is the single most important phenomenon that leads to rapid and premature aging and all its resultant diseases, including heart disease, stroke, dementia and cancer.[ii],[iii]

As your insulin levels increase, it leads to an appetite that is out of control, increasing weight gain around the belly, more inflammation and oxidative stress, and myriad downstream effects including high blood pressure; high cholesterol; low HDL, high triglycerides;[iv] weight gain around the middle; thickening of the blood; and increased risk of cancer, Alzheimer’s, and depression. These are all a result of insulin resistance and too much insulin. Elevated blood sugar is not the source of the problem.

And because insulin resistance (and diabesity) are a direct outcome of diet and lifestyle, the condition is 100% reversible in the vast majority of cases. Most people just need to eliminate the things that are sending their biology out of balance and include what’s needed to help the body rebalance itself. For most, the interventions required are extremely simple and extraordinarily effective.

8 Steps to Reversing Diabesity

In my new book, The Blood Sugar Solution, I outline a comprehensive 8-week plan for overcoming diabesity in all its forms. Here is a sneak preview of the steps outlined in the book:

  1. Get the right tests. Most doctors focus on fasting blood sugar. This is actually a poor indicator of diabesity. The best test to tease out the condition is an insulin response test where insulin levels are measured fasting and then 1 and 2 hours after a glucose drink. Demand this test from your doctor.
  2. Get smart about nutrition. Despite the media hype and the seeming confusion amongst doctors, the basics of nutrition are extremely simple. Eliminate sugar and processed carbohydrates, include whole real foods, like lean protein (chicken or fish), veggies, nuts, seeds, beans and whole grains.
  3. Get the right supplements. There has recently been a frenzy of negative reports about supplements. Most of them are unfounded. Supplements are an essential part of treating diabesity. A good multivitamin, vitamin D, fish oil, and special blood sugar-balancing nutrients like alpha lipoic acid, chromium polynicotinate, biotin, cinnamon, green tea catechins, and PGX (a super fiber) should also be included.
  4. Get relaxed. Stress is a major unrecognized contributor to insulin resistance and blood sugar imbalance. Push your pause button every day with deep breathing, visualization, yoga, and other relaxation techniques.
  5. Get moving. Aside from changing your diet, exercise is probably the single best medication for diabesity. Walk for at least 30 minutes every day. For some, 30-60 minutes of more vigorous aerobic exercise 4-6 times a week may be necessary.
  6. Get clean and green. Environmental toxins also contribute to diabesity. Filter your water, look for green cleaning products, and avoid plastics when you can.
  7. Get personal. While the aforementioned steps will address 80% of the problems with diabesity, some may need to take additional steps to optimize key areas of their biology. Remember, the medicine of the future is personal medicine. Seek out your own biological imbalances and look for ways to address them.
  8. Get connected. Research is beginning to show that we get better more effectively when we get together. Invite your friends, families and neighbors to change their diets and lifestyle along with you. Together we can all take back our health.

I hope that my book The Blood Sugar Solution will be the beginning of a larger transformation – for individuals, communities and for society.


[i] Chen L, Appel LJ, Loria C, Lin PH, Champagne CM, Elmer PJ, Ard JD, Mitchell D, Batch BC, 
Svetkey LP, Caballero B. Reduction in consumption of sugar-sweetened  beverages is associated 
with weight loss: the PREMIER trial. Am J Clin Nutr. 2009 May;89(5):1299-306.
[ii] Bhashyam S, Parikh P, Bolukoglu H, Shannon AH, Porter JH, Shen YT, Shannon RP. Aging
is associated with myocardial insulin resistance and mitochondrial dysfunction.
Am J Physiol Heart Circ Physiol. 2007 Nov;293(5):H3063-71.
[iii] Ryan AS. Insulin resistance with aging: effects of diet and exercise. 
Sports Med. 2000 Nov;30(5):327-46. Review.

[iv] Gaziano JM, Hennekens CH, O’Donnell CJ, Breslow JL, Buring JE.

Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction.

Circulation. 1997 Oct 21;96(8):2520-5.

Article written by Dr. Mark Hyman
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