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.


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Weight Loss
Battling Food Cravings? Try These Strategies. (11/21/14)
Is Weight-Loss Surgery for You? Pros and Cons (11/24/14)
Is Weight-Loss Surgery for You? (11/17/14)
Can Grapefruit Juice Prevent Weight Gain, Increase Insulin Sensitivity? (10/16/14)

Type 2 Diabetes
New Metformin Combination Medicine Approved for Type 2 Diabetes (10/30/14)
Discovering I Had Type 2 Diabetes (10/17/14)
Low-Carb Diet Improves Quality of Life in Type 2 Diabetes (10/07/14)
Long Hours at Low-Income Jobs Linked to Increased Diabetes Risk (10/02/14)

Ski and Snowboard Camps for Kids With Diabetes (10/06/14)
BMX Camp for Kids With Type 1 Diabetes (07/31/14)
Exercise or Have Fun? (06/10/14)
"Exercise Snacks" Improve After-Meal Blood Sugar Control (05/16/14)

Emotional Health
Why Me? Diabetes and the Story of Job (12/15/14)
How Helping Others Helps You (12/10/14)
Three Ways to Cope With Stress (12/08/14)
Diabetes Holiday Blues (11/25/14)



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