Healthy, supportive conversations about weight should not be taboo

This week launches a series of columns on the current crisis — not the COVID pandemic, which will eventually come to an end, but rather, the seemingly endless escalation of the type 2 diabetes pandemic. We begin this week with the greatest culprit: obesity. Worrisomely, changing attitudes about weight are making matters worse.

We’ll continue next week with an article on the interplay between diabetes and COVID, followed the subsequent week by a challenge to powerful media houses to do better.

Finally, as we know from your letters that this column helps prevent many from falling victim to avoidable health problems, we’ll do a three-part series on the signs of prediabetes and where you can turn for help.

So, let’s turn to obesity, one of the greatest risk factors for type 2 diabetes. How can we resolve the obesity pandemic that worsens every year?

Recently several well-respected researchers have argued that weight loss is not the solution and obesity is not the problem! Rather, the goal, they say, is “good health.” But is ignoring the major health hazards of obesity an effective way to slow down the tsunami of type 2 diabetes?

In the consultation room, doctors need to be frank with their patients, and it would help if everyone else didn’t contradict the message. Make no mistake, obesity is not good for one’s health.

But “body shaming,” the label applied to the act of humiliating people with critical comments and attitudes about body size or shape, has made any supportive discussions about weight issues taboo. Health promoting support is vastly different from stigmatizing discrimination. A study published in the Journal of Obesity showed that weight discrimination stigma was associated with increased risk of becoming more obese!

So what’s the right approach to take if you are concerned about a family member or friend? Experts recommend discussing ways to improve lifestyle, eating healthier foods, and exercising more.

Is it possible to be healthy and obese? Research shows that 30 minutes of exercises in obese individuals, even if weight loss is not achieved, significantly improves physical health compared to sedentary peers.

Other researchers have studied healthy men comparing their cardiovascular fitness to the amount of belly fat. The results show a relationship between the location of body fat and the risk of heart attack and diabetes. It’s the belly fat — called visceral fat that is stored around important internal organs — that poses the greatest problem. Even being thin does not equate to good health if hidden visceral fat is present in the belly.

Surgeons are well versed on belly fat. It makes operations more technically demanding, with more blood loss, and more anesthesia required for longer operations. Following surgery, incisions are more apt to become infected, and if patients are less active, a fatal pulmonary embolism (blood clot) is more likely.

The key message this week is, don’t let obesity unnecessarily elevate your risk of developing diabetes. If you are struggling with excess weight, don’t struggle alone. Have a healthy conversation with someone who can support you in making a change.

This information is not intended to diagnose, treat, cure or prevent any disease. Dr. Ken Walker (W. Gifford-Jones, M.D.) is a graduate of the University of Toronto and Harvard Medical School. He trained in general surgery at the Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in gynecology at Harvard. He has been a general practitioner, ship’s surgeon and hotel doctor. He is also the author of 10 books. Contact him at contact-us@docgiff.com.