Diabetes Self-Management Blog

Medical and public health experts are starting to call diabetes an “epidemic.” They are saying the same thing about “obesity” and calling for national action. But what is causing these “epidemics?” Is some germ infecting us? What is this germ, and how can we stop it?

I called Type 2 diabetes a social disease in my book Diabetes: Sugar-Coated Crisis. I also called it an epidemic, which I now sort of regret, even if I was ahead of my time. I probably should have used the term “environmental illness,” because the causes of Type 2 are almost entirely environmental. Certain individuals will get the symptoms, because of their social situation and/or genetic makeup. But society itself has the disease — a culture of inactivity, inequality, isolation, stress, and unhealthful food.

A new study in the journal Health Affairs calculates that the U.S. spent $147 billion in excess medical costs due to “obesity.” I put obesity in quotation marks because I hate that term. It’s from the Latin word for “overeating.” Eating is one factor in weight, but stress and physical inactivity are probably more important.

I question the study’s conclusions, though. Heavy people do spend more on medical care, but the Health Affairs authors don’t consider that the same environmental causes of “obesity” may also be contributing to the diseases that heavy people tend to get.

First among these causes is stress, as I’ve written about here and here. Stress increases insulin resistance and promotes abdominal fat. It also changes behaviors, causing people to eat more “comfort foods” to reduce the stress.

The healthiest way to deal with stress is through physical activity, like a zebra does when it sniffs a lion. The zebra runs away, and the running promotes insulin sensitivity. But in this society, we don’t run away from threats and stresses. We just sit there and worry about them. So stress and physical inactivity are a lethal combination, and a very common one in most people’s lives.

The biggest causes of stress are social, especially social inequality. People are hierarchical creatures, like chimpanzees. When we feel always outranked, outgunned, and insecure, we will have more stress. If we are constantly worried about finances, that can also stress us out, and over time, it makes us sick.

What can we do?
The real epidemics are inactivity, inequality, and stress. “Obesity” and Type 2 diabetes are just symptoms. But what can we do about such huge problems?

I wrote about ways of reducing stress in this blog entry and about coping with stress in this entry. We need to find ways to avoid stressful situations and change stressful thoughts. We need to keep physically active. Eating healthful food definitely also helps.

To make any real impact on these “epidemics,” though, we’ll need to change the social environment. People need more social support and more economic security. We need environments that promote physical activity instead of preventing it. To make any of this happen, we would need to become politically active and effective. To be honest, I don’t know a way to do that.

But we could help each other when we get the chance. If done voluntarily, helping others can reduce stress for both the helper and the helped.


  1. Dear David

    Yesterday on our local TV news there was a blurb about some university researchers finding another cause for insulin resistance. They said it was an autoimmune problem with the t cells going wrong and causing obesity first and then diabetes. Can’t find anything on the news channel web site.

    Still stress is probably the prime causus that triggers all these problems. Just like when we believed that stress caused ulcers(which is does) what was really helpful was the discovery by a biologist of the pilori bacteria as the agent which permited a very efective treatment of antibiotics, gaviscon and an anti-acid. It would be helpful if the agents causing insulin resistance be found possibly effective treatments could be found for some people.

    At present there is nothing. Using insulin to fight diabetes caused by insulin resistance is like using gasoline to extinguish a fire.

    Until something better all we have is exercise.

    Posted by CalgaryDiabetic |
  2. Dear David

    There is very much stress that we cannot do anything about.

    Posted by CalgaryDiabetic |
  3. Calgary, check this, see if this was what your news station was referring to:

    Posted by Israel |
  4. Dear Israel

    What I saw was the July 27 episode of Healthbeat on this web site.


    sounds like a similar finding to your post but by a Research group at the Hospital for sick children. This is a good sign is different researchers are finding similar things that might be the first showing of the truth. Hopefully something good comes from this.

    Posted by CalgaryDiabetic |

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