Fat news: awesome and not-awesome edition.

The awesome

Fucking artificial pancreas, my friends. This is the natural evolution of the insulin pump. I am wondering if eventually they’ll be creating an artifical pancreas that also secretes glucagon. I used to have these conversations with people at work, because do you know how many people we saw suffering from diabetes? And not just the high blood sugar, no no no, but more often, the low blood sugar. Which can kill you right away, at worst, or just make your life fucking miserable at best. Which the artifical pancreas seems to have reduced by half.

The not-awesome

Let’s define more Canadian kids as fat! Based on WHO standards that are not always appropriate for North Americans. And not at all in response to recent stats showing that the “obesity epidemic” among children has probably leveled off, thus causing people with a major financial stake in treating childhood obesity to probably shit themselves during their tortured night sweats. Nope, not at all.

Let’s use surgery to combat social stigma! Because reducing stigma itself wouldn’t actually, you know, make money for anyone. Because that would involve making physical objects more universally accessible and teaching people not to be so fucking cruel to people who don’t look like them. Instead, kids who’ve already survived brain tumours should probably just suck it up and have some more surgery.

Let’s pretend that sugary drinks cause pancreatic cancer! Except the researchers go on to say that the association only existed among people who drank soda pop, and likely because people who drink that amount of soda pop probably have other, not-so-great health things going on. People who drank other sugary drinks (i.e. fruit juice) didn’t have the same risk. Also? The study didn’t control for smoking. In case you hadn’t heard, smoking probably causes cancer. Lots of types of cancer. One of which is pancreatic cancer.

That sound you just heard was me smacking myself in the face and falling off my chair.

Do you think, perhaps, drinking soda pop could be associated with smoking? I don’t know. What I do know is, if I were researching the link between pancreatic cancer and sugary drinks, I’d probably fucking look into it.

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22 Comments

  1. Jessica
    Posted February 8, 2010 at 12:50 pm | Permalink

    Huh, I heard about the WHO standards on the radio this morning, but it didn’t say which countries were used – I just assumed it would have been more European countries, and certainly wouldn’t include the US! And the part about kids having access to medical care, that to me would be a big difference in terms of general health, but again, the WHO standards included American children. Also, “desirable”?!? Why not just admit that the obesity epidemic is a big hoax – if the BMI was an accurate predictor of health, it wouldn’t be “let’s see if we can turn that around a little bit”, it would be: here is what you can expect healthwise given your current size. Wankers, the lot of them!

  2. Daniel M.
    Posted February 8, 2010 at 1:07 pm | Permalink

    Ok so to address all:

    1. Yay awesome!
    http://www.youtube.com/watch?v=BtsQxUYHXbw i love my pancreas!

    2. I LOL’d about the new standard including averages of kids from Oman Ghana and so on who are likely to be underfed and so lighter ….

    3. I actually disagree with both – having 160 kg at such an age sure is not healthy because of the physical burden it places on the person at least.
    I am not for surgery but since the reason was messed up circuitry, could they not give her some appetite suppressants?

    4. LOL again – what do we do next, mention that frequent consumers of alcohol have a tendency to die because of brain damage ? (hint hint concussion)
    Reminds me of death being a major cause of fatalities worldwide…

    • Posted February 8, 2010 at 2:08 pm | Permalink

      Yeah, you know, it sucks she gained all that weight due to a brain tumour, and it might even have a harmful effect on her health. But I don’t think WLS is going to fix that, or even appetite suppressants — because they carry risks that are probably far worse than the weight itself, aside from being pretty unpleasant and potentially QOL-destroying. I think the harm-reduction plan du jour here would be HAES.

      ***OF COURSE I AM NOT HER DOCTOR AND IT’S NONE OF MY BUSINESS TO RECOMMEND HER COURSE OF TREATMENT BLAH BLAH BLAH. JUST MY UNINFORMED OPINION THAT HAES MIGHT BE WORTH LOOKING INTO***

      Besides which, her main complaints about gaining the weight? Not fitting into spaces, and how people treated her. There’s a systemic problem at work there that ain’t gonna be addressed by “fixing” one person’s weight.

      • Daniel M.
        Posted February 8, 2010 at 5:57 pm | Permalink

        Well, WLS definitely is not a good way to go, but apparently she had a hunger control problem as some part of the cycle was disrupted. Therefore i strongly doubt that any non-medical solution would do anything pretty much for the same reason (i just remembered that you written it once) that it is a hard job persuading kidney patients not to “drink excessively”

        Besides i strongly doubt that the condition itself was not QOL decreasing enough – even if the obesity had no other ill effect she basically went on carrying a large bag of concrete all day, which is definitely a great strain on the cardiovascular and so on system, made worse that she gained all of it suddenly so the body did not have much time to adapt.

        I do not know whether you will agree or not but i think that there are limits to how heavy a person can get without it having an important ill effect on health, and from the things she mentioned (sleep apnoea for example) it seems like it is being confirmed.

        • Posted February 8, 2010 at 6:52 pm | Permalink

          I can’t even pretend to begin to know what the best practice treatment is for people with that particular type of brain lesion.

          I do find the claims about carrying around body fat being an unhealthy strain to usually be specious though — people are often encouraged to carry around extra strain for the purpose of strengthening the heart and lungs. It’s called exercise. People who are fat also gain muscle and bone mass and vasculature to help carry that extra fat. You can’t call it exercise if the weights are added externally, and then call it strain just because the weight comes from fat. It doesn’t work both ways.

          Though, I do agree that not having time to adapt to the change in body size would be difficult, in the same way someone who started a pretty intensive weight training regime would find it difficult. The irony being that the latter person would be patted on the back for it, even if they were putting themself at serious risk. (And it’s true that this girl may have been at serious risk in the way that someone doing that would be — but we don’t know that for sure. Only she and her doctors do.)

          I do think there are times when fatness/weight directly impacts health. That level, however, is different for different people, meaning that we can’t simply draw a line in the sand and say “This much and no more,” for everyone. There are plenty of very fat people out there who don’t have the specific conditions that are directly associated with excess body weight (like sleep apnea and certain joint issues.)

          Also, the fact that weight can directly contribute to those conditions does not mean that weight loss is the de facto treatment. Because, on the whole, it is a spectacular failure as a treatment, though it does work for a few lucky individuals. But, since these conditions are marginalized by being associated with icky fat people, I think the motivation to develop better treatments for them doesn’t exist in the same way that it does for diseases that affect primarily young and glamourously thin people do. (Sorry to sound so cynical, but that’s how stigma works. The same can be said for other diseases with the “ick” factor, like certain GI conditions.)

          Anyway, as a side note, the interesting thing about kidney patients drinking “excessively” is that “excessive” is relative to their condition. Their sense of thirst, and the amount they want to drink, is likely pretty darn natural (especially if they have a high level of electrolytes in their blood that isn’t being properly excreted by the kidneys.) So that particular dialysis nurse, or whatever he was, acting as though these people were being willfully “noncompliant” as opposed to trying to meet a completely natural and instinctual need that is hardwired into us in order to, oh I don’t know, prevent death, was being really discompassionate and short-sighted. And that’s why I chose to write about it.

          This girl, from the little tiny bit we know about her (and, on a personal level, I hate to make an example of her, or talk about her like she’s not a real person with very complex circumstances which none of us can understand, but ugh, I don’t know how else to discuss this right now), had nonfunctioning satiety signals — not NORMAL satiety signals that were considered inappropriate because of her condition. In that situation, yes, perhaps some medical treatment is in order. Provided, however — and ONLY provided — that such a medical treatment exists and is effective and not excessively risky. Which I’m not sure is the case. It may be.

          • Daniel M.
            Posted February 8, 2010 at 8:04 pm | Permalink

            Finally something i can more or less agreee with.
            Just a few points.
            With the kidneys i was just pointing out to the similarity that if there is some reason that a basic action goes against the person’s interests, approaches aimed at willful control are not going to ‘cut it’

            With the exercise point – there are some things i must argue with.
            Firstly i would not call lifting and carrying a bag of wheat or so (50-70 kg) exercise – i have done it when needed and from the way one feels i doubt it is healthy… and i am an 18 y/o 105kg male
            Secondly i think that the point of being “fit” is that the body becomes overdimensioned for the daily tasks and therefore experiences little strain due to them. If you have to carry the load all the time, it much diminishes the benefit (although you do get relatively stronger, eg pushing a car with depleted battery to get it start is easier for me than for a fitter, but lean guy)

            Lastly i would doubt the this much and no more line.
            It is something like a std distr. You can say that eg people with BMI over 50 are unlikely to be healthy , just like people under BMI 18
            That does not disprove exceptions but it does suggest that something is not optimal

          • Posted February 8, 2010 at 9:01 pm | Permalink

            Secondly i think that the point of being “fit” is that the body becomes overdimensioned for the daily tasks and therefore experiences little strain due to them. If you have to carry the load all the time, it much diminishes the benefit

            Yeah, I thought of this as well. But then, I also thought — once a person is adapted to their high weight, then their fitness should be no more or less impacted than a “normal weight” person who doesn’t do any extra exertion for the sake of fitness. And there’s no reason why, once a person has adapted to carrying “extra” weight around, they can’t then move on to doing additional exertion (in spurts, as you point out, not as a constant base of activity) in order to extend their fitness further and thus enhance their ability to go about doing their daily tasks.

            In other words, this would be what the “enjoyable exercise & fitness” component of Health at Every Size is all about — adapting to your own size, and then perhaps choosing to do additional exertions in order to “overdimension” yourself for daily tasks, thus making them easier. Theoretically, the process should be the same as it would be for a smaller person — it’s only the scale that is different.

            It is something like a std distr. You can say that eg people with BMI over 50 are unlikely to be healthy , just like people under BMI 18
            That does not disprove exceptions but it does suggest that something is not optimal

            This, also, I can answer. Body weights among the population are actually NOT standardly (normally) distributed. Because, while average-height adults can and do survive at very, very high weights (up past 1,000 lbs for example — and I’m not saying ALL those people have optimal health or QoL, but I am saying that they exist and do live into adulthood, and it is still possible that some of them enjoy good health — you’d have to ask them), *no adults exist at all* past a certain point on the left side of the curve. Because adult, average-height human beings cannot survive past a certain low weight. (Recent epidemiological studies have confirmed this association, since they show that the mortality risk of being underweight is actually greater than the risk of being in the higher classes of obesity.)

            Anyway, that cut-off point on the left side does not perfectly correspond to the apparent cut-off point on the right side of the curve. Thus, the curve isn’t symmetrical. In addition, its peak is also shifted to the right, because the majority of the population in North America, at least, tend to be of higher weight (which raises the question of how so many people appear to exist — which is to say *survive*– at weights that are supposedly so dangerous. My thought is that it’s because we’re not seeing a “more-people-becoming-fat-epidemic” [increased incidence] so much as a “more-fat-people-surviving” [increased prevalence] epidemic. Which is not actually an epidemic, by definition. And should actually be good news, no? But that’s a whole other conversation.)

            That’s the reason I propose that there is no blanket “this much and no more” line that applies to everyone — unless you’re talking about high weights at which people simply do not exist. And even if you were, that line would have to be moved upward should another statisical outlier be born and live into adulthood at a record-breaking weight.

            Shouldn’t you be studying or something? :)

          • Daniel M.
            Posted February 9, 2010 at 7:56 am | Permalink

            Anothere round of addressing:

            You do have a point i have not well considered. Only thing i am unsure about is whether everything scales well, for example resistance of arteries to blood pressure (although i have heard of a man who nearly gave the doctor a heart attack as he was absolutely fine and had systolic 220)

            Second thing – my stupid – it indeed is not really a standard distribution although its right half pretty much is, and therefore you can treat it with such a way- there are cutoff points beyond which huge most will be unhealthy and optimal regions..

            Thirdly i think it is a combination – at least in my country the amount of overweight and obese kids i see now, compared to when i was at school ….
            But also because medicine is better most survive longer.

            Lastly , well i was taking a break from work – in this timezone it was well after midnight which is when i actually do stuff … I was writing a lab report for a practical in materials (influence of temperature on elastic and plastic behavior)

          • Posted February 9, 2010 at 7:58 am | Permalink

            One time, I wrote a lab report on gluten balls. And I wrote that they shattered my faith.

            The grading assistant was not impressed.

            Anyway — there’s an interesting question about blood pressure in fat people. Because fat people tend to be bigger, they have more vasculature. And, as you probably know, the more blood vessels you have, the more pressure is required to send blood through the system. So it’s possible that fat people might tend to have higher BP than average, solely due to increased body mass. However, what’s not clear is whether this represents the same risk as a smaller person having that same BP. I *believe* there’s some research available on this, but I really need to go look it up.

            What I also don’t understand is why the distribution itself demands that there’s an “optimal” cut-off point. Take nutrient requirements, for example. They are supposedly normally distributed for the population. There are some people who, for instance, require some huuuge amount of vitamin X compared to the average — they are a statistical outlier. But does this automatically mean that those people are inherently at increased risk? (I mean, other than the fact that the RDA is set 2 SD above the mean, so if they strictly followed those guidelines they might be deficient.) Why does being a statistical outlier = increased risk? I’m not sure I understand. Especially since several possible mechanisms have been proposed that could be the cause of higher mortality risk for fat people, and many of them have nothing to do with fat mass or size.

            I could see there being an association between poorer health and very high body weights if there’s a genetic disorder at play. But then, the genetic disorder (or whatever underlying condition that may cause the extreme weight gain) is the culprit, not necessarily the weight itself. It complicates things. And it still doesn’t mean that those people can or should try to lose weight (and especially not using any of the shoddy methods we’ve so far developed.)

            But also because medicine is better most survive longer.

            I agree. But I think this is a good thing, on the whole. Some of that better medicine might help ameliorate the fact that fat people get poorer quality healthcare to begin with — not necessarily the fact that fat people are inherently unhealthy because of their size or behaviours.

  3. Posted February 8, 2010 at 3:03 pm | Permalink

    HOLY FUCK! AN ARTIFICIAL PANCREAS?????

    I know it’s only meant for Type I diabetes so far, but perhaps eventually one can be developed for Type II as well. I know I would want that for Mr. Twistie and all the other people dealing with diabetes (no matter which kind) out there.

    As for the weight loss surgeries for kids who’ve had brain tumors and gained a lot of weight as a consequence…surgically changing the kids seems to me on par with the days when left-handed kids were ‘retrained’ to be right-handed rather than given desks and scissors that were built for us. I speak as the person who was directly responsible for getting left-handed scissors in every classroom at her elementary school.

    I have a good friend whose grandmother was left-handed as a girl. As a woman, the grandmother was right-handed. The reason? She tried so hard to use her left hand for tasks like writing, etc. that the teacher tied her left arm to the back of her chair. The tie was too tight. Her left arm was utterly useless for the rest of her life. A nine-year-old child was mutilated for the sake of conformity.

    These kids who have already survived brain tumors are having their digestive systems rearranged and mutilated when a few larger desks in each school and the refusal to teach our children to fear fat could ease these children’s lives so much more.

    • jaed
      Posted February 9, 2010 at 1:06 pm | Permalink

      surgically changing the kids seems to me on par with the days when left-handed kids were ‘retrained’ to be right-handed

      The example I think of is prefrontal lobotomy, actually. Because it’s an extremely dangerous surgical procedure with lifelong consequences. Even if it’s not botched, and even in those cases where it improved the condition it was done for, the person is never the same. And also in the way that lobotomy became a fad – the latest in technology to improve people!

      Medicine has several times in its history taken to deliberately damaging or destroying a healthy body system in order to improve health – bleeding patients, lobotomy, WLS, prophylactic removal of tonsils, etc. I cannot offhand think of an example where this attitude hasn’t turned out to be a serious mistake. Unfortunately, this is usually figured out after a lot of people have died or been damaged.

      (Forcibly dieting children seems more analogous to what used to be done to left-handers to me. The intent, at least, is not to cause mutilation, though the side effects of the forcible change of behavior can cause lifelong problems. Not to mention the senselessness of it. Complicated and cruel non-solutions to trivial non-problems: “Oh my God, this healthy and active child has a non-conforming body shape!”)

  4. Posted February 8, 2010 at 3:20 pm | Permalink

    The pancreatic cancer article is particularly egregious. Pancreatic cancer is horrible, and they don’t mention that drinking ALCOHOL is a known risk factor. How about tackling binge drinking, or at least mentioning it? I just hate the agenda these researchers all seem to have. Malpractice as far as I’m concerned.

  5. Posted February 8, 2010 at 6:49 pm | Permalink

    It’s good news to see work done on bettering Type 1 Diabetes treatment, as someone who suffers from the condition it seems we’re neglected all the time in favour of beating up the T2D and omgbesity link on the news.

    My uncle is dying from pancreatic and liver cancer and he is (was) a fit, clean living cop. It’s so chronically underfunded in Australia, I get so bitter about how shitty the research is.

    • Posted February 8, 2010 at 6:57 pm | Permalink

      Oh, I hear you. After working in the diabetes clinic, I get so annoyed with how the two conditions are so disparately treated.

      And, yes, given your family experience, it’s always good to add: though there may be an association between pancreatic cancer and certain risky health behaviours, it should be remembered that not everyone who develops pancreatic cancer is somehow at fault. Plenty of people who do all the “right” things and follow all the going health recommendations get sick and die far too young. And it seems like, as a culture, we don’t appreciate this in the way we should.

      • Elizabeth
        Posted February 8, 2010 at 11:42 pm | Permalink

        Some of the “risk factors” for pancreatic cancer aren’t exactly what we usually think of as health risks, either. My uncle died of it. He was a smoker, which is undoubtedly associated with it, but he was also a kerosene salesman and a volunteer firefighter. It turns out than one of the other big risk factors is exposure to hydrocarbon fumes. But that doesn’t carry the moral weight that smoking does, so people dismiss it, even though it may have been a bigger factor than smoking in his death.

        • Posted February 9, 2010 at 7:53 am | Permalink

          Very good point. I think this holds true for lots of other cancers, as well. We haven’t yet identified all the potential environmental factors that contribute to cancer risk.

          • Ladidah
            Posted February 9, 2010 at 2:36 pm | Permalink

            I really wish we could do away with the “morality” and “virtue” based approach to sickness and health. It has so much to do with why HIV/AIDS was so horribly ignored and people with HIV/AIDS maltreated for so many years, and we’re witnessing it again with cancer and diabetes. It’s very sad.

          • Posted February 9, 2010 at 2:50 pm | Permalink

            Yes to everything you just said.

  6. Anita
    Posted February 9, 2010 at 10:07 am | Permalink

    Hallelujah for pancreases! Pancreai? The article mentions that it kept levels in the “normal” range 60% of the time, which seems low, but I guess for folks in the hospital, things are a little more iffy. Such a marked improvement in keeping blood sugar high enough is totally awesome, though.

    2 or more “sugary” drinks a week isn’t very much, and the sample seems pretty small. Also, does insulin respond differently to fruit juice and soda? The sources I looked at said a soda has about 29800 mg vs about 26000mg in apple/grape juice. That’s different, but not that different.

    It totally enrages me that people publish really shoddy research and apparently NO ONE reporting on it has ever bothered to take a statistics class, much less research methods. If you’re a science reporter, shouldn’t you make some attempt to, you know, understand the science so you can explain it to people? And if it sucks, say something about the potential suckiness of it? I don’t have time to go read every single scientific study that I’m interested in, but I can’t trust summaries anymore – either those released by the company/university or those put out by the press. (And, let’s face it, I can use some assistance spotting the fatal flaws in studies anyway, because I haven’t taken a research methods class.)

    • Posted February 9, 2010 at 2:55 pm | Permalink

      Yeah, people who are ill tend to have higher blood sugars that are harder to keep under control. And I very much doubt insulin responds differently to the sugars in soda vs. juice, but I’d have to look at some research to make absolutely sure. As far as I know, though, fructose and glucose is pretty much just…fructose and glucose, no matter what.

      Totally, totally agree with your frustrations about science journalism. In fact, I should have clarified that that’s where most of my frustration where this study comes from, because I haven’t read the source study itself — but whether it really was a good study or not, the reporting seemed kind of breathlessly stupid. And honestly? Science is not that hard. It only requires logic, a talent with which most humans are pretty well blessed, even if they don’t recognize it or use it. I wish everyone in general could be given better access to good science education because, frankly, we all deserve to have the tools and skills to interpret things and make decisions for ourselves.

  7. deeleigh
    Posted February 9, 2010 at 12:28 pm | Permalink

    I saw that story (about Sick Children’s doing weight loss surgery) in the Globe and Mail. All I could think was “Jesus. Those kids are already traumatized by health problems, and now they’re doing surgery on them that will give them complications for the rest of their lives, if it doesn’t kill them?” It’s clear that surgically induced starvation is not an equal and opposite response to the medical issues that caused the kids’ weight gain. In fact, it’s further harm.

    And then I remember what it was like being a fat teenager – a 200 pound one, incidentally, not 350 pounds – and I understand why they consent to it, and may even demand it. That’s how fucked up our society is.

  8. Elizabeth
    Posted March 23, 2010 at 12:47 am | Permalink

    It honestly makes me sad that we are now creating entire programs to put *children* in *surgery* for no better reason than the shapes of their bodies. That’s just… it reminds me of that part in The Golden Compass, when they’re cutting the children’s souls away from them supposedly for their own good, but really more due to the adults’ fears and messed-up beliefs.

    Tragic. Just tragic.

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  • By SUGARY DRINKS CAUSE CANCER? « Finding Thin on February 8, 2010 at 12:54 pm

    […] SODA, those who drink mostly fruit juices did not have the same risk. But Michelle over at the Fat Nutritionist points out the study didn’t take into account whether these soda drinkers were also smokers. […]

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