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War on Obesity II

Stanley Feld M.D.,FACP,MACE

I received a comment from Karen Madrono. You can read her complete comment in the “War on Obesity” post.

The point Karen makes below is critical to the understanding of how change must occur.

“Battling against obesity seems easy but I’m telling you, it takes courage and faith in yourself.
One must be conscious about every food that they put in their mouth. It could either make the person healthy or sick. It’s not the teacher’s obligation, though they should teach children the right food to eat but it is still up to person himself not to the doctor.

I am not blaming anybody, all I’m saying is we should be responsible in everything we do with our body. It’s our body and it is irreplaceable so we should learn to take care of it. I’m doing it now so can you.”


Our health is our most precious possession. We inherit our genetic predispositions. For example, twenty percent or more of us have a disposition for Type 2 Diabetes Mellitus. However, the Diabetes declares itself in only 5% of the Caucasian population. In America the percentage of Caucasians with Type 2 Diabetes Mellitus is rising. The incidence is much higher in Hispanics and Blacks. In fact, Clinical Type 2 Diabetes Mellitus is now appearing at a younger and younger age as the epidemic of obesity in America is spreading. Our Super-sized Fast Food portions are contributing to the epidemic.

The rising incidence of Type 2 Diabetes Mellitus is directly related to the increase in Obesity in this country. Obesity represents an environmental abuse to our genetically predisposition. Increasing weight results in insulin resistance. Insulin resistance leads to increasing blood sugars. Type 2 Diabetes Mellitus can be thought of as a disease that results from our inability to overcome the increasing insulin resistance resulting from increasing weight gain. The insulin resistance results in hypertension and a rising cholesterol. The end result is Coronary Artery Disease. The combination of diseases is currently called Metabolic Syndrome. Metabolic Syndrome is the major cause of heart disease in this country. It takes 8 years from the time of onset of Metabolic Syndrome to the time of discovery of Type 2 Diabetes Mellitus. Many times the diagnosis of Diabetes Mellitus is made at the time the patient has a heart attack.
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The entire Metabolic Syndrome can be reversed by weight loss. Weight loss can be achieved by decreasing food intake and increasing caloric output. Weight gain is the environmental abuse to our genetic predisposition. Weight loss is difficult to accomplish. It requires a consistent and long lasting change in life style activities. Many “tricks” have been tried. None of the “tricks” seem to work long term. Industries have been built around these “tricks” because we are a nation of instant gratification.

In the long term, it remains the patient’s responsibility to fix the problem by changing his lifestyle. Systems of Care can help the patient develop a lifestyle change. Government campaigns could provide educational tools. However, it is up to us to be responsible for ourselves.
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Karen has made the point abundantly clear. Thank you Karen.

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