Obesity: Why Is It So Dangerous?

What Is Obesity?

Obesity is defined as the excessive accumulation of body fat to the point where health is impaired, and is one of the main health issues facing societies today. Rates of obesity have more than doubled since 1980 and continue to increase worldwide, with more than one in ten of the world’s adult population now obese. In the USA more than two thirds of the population are overweight or obese – and the UK is not far behind.

The most commonly used method for assessing whether someone is overweight or obese is the Body Mass Index (BMI), which is defined as a person’s weight in kilograms divided by the square of their height in metres (kg/m²). The World Health Organisation defines ‘overweight’ as a BMI above 25 and ‘obese’ as BMI above 30. This is a useful measure as it is height-independent and easy to calculate, however it does not distinguish between fat and lean tissue or water, nor does it identify whether fat is accumulated in particular sites such as the abdomen, where it has more serious metabolic consequences. For this reason, a more useful measure of risk for obesity-related diseases may be waist circumference. To measure waist circumference, a tape measure should be placed around the abdomen - roughly level with the bellybutton - so that it is flat to the skin but does not compress it, and a measurement taken. For men, a waist circumference of 94cm or above is considered to be indicative of an increased risk and 102cm or above is a substantially increased risk. For women the figures are 80cm and 88cm respectively.

Why Is Obesity So Dangerous?

Obesity is responsible for at least 2.8 million deaths each year. Obesity is a significant contributing factor to five of the ten leading causes of death in the USA: heart disease, stroke, cancer, kidney disease and diabetes. It is the leading preventable cause of death worldwide, with more people now dying from overweight and obesity than from underweight. I will now give an overview of some of the most serious medical consequences of obesity. Much of my data is for the USA as this is where the pandemic is most advanced, however the rest of the world should be aware that they are heading in the same direction. The UK in particular is estimated to reach the levels of obesity currently in the USA in just 10 years.

Type 2 Diabetes

Type 2 diabetes mellitus is a metabolic disorder characterised by high blood glucose due to insulin resistance and relative insulin deficiency. Insulin is the essential hormone produced by the pancreas in response to a rise in blood glucose levels which acts upon body tissues, particularly skeletal muscle, adipose (fat) tissue and the liver, to encourage (among other things) uptake of glucose from the bloodstream. In type 2 diabetes this action is impaired, leading to potentially dangerously high levels of glucose in the blood. In healthy, non-diabetic individuals, fasting blood glucose is usually somewhere between 4 and 5mmol/l. A person is diagnosed as diabetic when their fasting blood glucose level is at 7mmol/l or above. Someone with a fasting blood glucose level between 6 and 7mmol/l is classified as “pre-diabetic” meaning they have impaired glucose tolerance and are likely to develop type 2 diabetes within the next few years unless significant diet and lifestyle changes are made. While the precise mechanisms causing insulin resistance are not yet fully understood, it is clear that there is a strong link with obesity, and particularly with the presence of excess fat in the abdominal region.

Type 2 diabetes is the most significant medical consequence of obesity for a number of reasons. As well as being both difficult and expensive to manage, it is exceedingly and increasingly common, with more than 25 million Americans already diabetic and a further 79 million pre-diabetic. Worse, a child born in the United States in 2000 has a 1 in 3 lifetime chance of developing the disease – and if they are African-American or Latino the risk is 1 in 2. Type 2 diabetes mellitus was once referred to as “adult-onset diabetes” because it occurred exclusively in adults, predominantly the elderly. Now, however, due to the rapid rise in obesity, this disease is being seen in younger and younger patients, and even children.

Most people do not realise how serious diabetes can be. When left untreated, or indeed just poorly managed (as is too often the case) diabetes can lead to heart disease, stroke, blindness, kidney disease, nerve damage and amputations... leading to disability (and therefore reduced quality of life) and premature mortality. On average, having diabetes reduces an individual’s life by 8-10 years, and it is estimated that diabetes may contribute to as many as 40% of deaths in the USA each year.

Cardiovascular Disease

The term cardiovascular disease (CVD) includes heart disease, stroke, and all other diseases of the heart and circulation. The most common of these is coronary heart disease (CHD) which is the number one cause of death worldwide. More than 36% of American adults have cardiovascular disease.

CHD is predominantly caused by atherosclerosis – a narrowing of the arteries caused by a build-up of plaque (fatty deposits, including cholesterol.) Atherosclerosis is progressive and can begin in childhood (the Bogalusa Heart Study in America found that 20% of autopsied children had plaques in their coronary arteries, some as young as five!) Being obese, having high blood pressure, high cholesterol or diabetes and being physically inactive all increase the risk of atherosclerosis, and it typically gets worse as an individual gets older. In time, the arteries can become so narrow that they can no longer deliver enough oxygenated blood to the heart. This can cause angina – pain or discomfort in the chest, usually brought on by exertion or stress. Sometimes a piece of plaque from the artery wall will break off and cause a blood clot which then becomes lodged in the already narrowed artery, completely restricting the flow of blood. If this occurs in the arteries supplying blood to the heart muscle it is known as a myocardial infarction or heart attack and is often fatal. A blockage may also occur in the arteries supplying blood to the brain which is what causes a stroke.

Cancer

Cancer is the second biggest cause of death in the developed world, and it is estimated that 20% of cancer deaths in women and 14% in men can be attributed to overweight and obesity. Obesity is not only a factor in causing numerous types of cancer including breast, colorectal, oesophageal, pancreatic, kidney and thyroid cancer, but is also associated with poorer treatment outcomes and hence increased mortality.

Cancer is primarily a result of damage to the DNA which causes a cell to begin multiplying uncontrollably, forming a tumour. Several possible mechanisms have been suggested to explain the link between obesity and a higher risk of cancer, including excess oestrogen (produced by adipose tissue) which is associated with a higher risk of breast, endometrial and some other types of cancer. Insulin is also an important factor as it is known to promote the growth of tumours. Patients who are obese, and particularly those with insulin resistance, are therefore at greater risk of most types of cancer due to a higher level of circulating insulin.

Other Risks

Being obese is associated with numerous other health problems on top of the ones I have outlined above. For example, an obese individual is 83% more likely to develop kidney disease and 80% more likely to develop dementia. Being overweight or obese increases a child’s risk of developing asthma by 52% and makes the condition more serious once developed. In addition, more than 66% of arthritis sufferers are overweight or obese, and they generally experience greater pain than leaner arthritis sufferers due to their excess weight.

Being obese is clearly a problem for an individual, but it also affects society as a whole, not least because of the increased healthcare costs – at current rates of increase obesity related health-care costs are projected to exceed $300 billion by 2018. But how did so many people get so fat so quickly? And what can be done about it? I will be addressing these questions in my next entry.

Evidence For God (part 2)

Sorry I have not updated this blog for a while... I have been facing some persecution from my mother who literally thinks I am possessed by a demon and am doing the devil’s work by writing this blog... which caused me some discouragement. However I am now ready to wrap up this topic with a final post before moving on to write about world issues without bashing religion (lest I become subject to homelessness, exorcism or worse.)

So now, bravely or foolishly, I shall outline my experiences in looking for evidence for God - and particularly the truth of the Christian faith - once I had established that the simple existence or complexity of the universe was not sufficient reason to believe.

By asking a number of people I discovered that those who are willing to give a reason why they believe in God usually tell of some fortunate coincidence which they attribute to whichever God they believe in. These experiences seem to occur amongst people from various religions and therefore cannot be used as evidence for any particular God. They may or may not be things previously prayed for, but are rarely remarkable enough to convince anyone other than the individual that there must have been supernatural involvement.

Other reasons given include “faith healing” which is an area that certainly warrants investigation. Looking into the subject of faith healing I discovered some shocking facts. Unfortunately this was not that a large number of people have indeed been miraculously healed but rather that belief in supernatural healing has actually caused a great number of deaths! There have been cases where people have not sought actual medical treatment choosing instead to rely on the “power of prayer” and a number of parents have actually been convicted as responsible for their children’s deaths in these cases. Others, including some HIV patients, ceased taking their medications on church advice after being told they had been healed and subsequently died.

Faith healings are usually performed by a charismatic church leader in front of a large crowd of people. These gatherings are characterised by apparent miraculous healings including people in wheelchairs getting up and walking – but things are not always as they appear. An interesting article on the topic can be found here but I would like to highlight one paragraph in particular, simply because it shocked me:

“There are many, many similar reports where follow-up found the patients still just as sick or worse off. Patients who “get up and walk” may not be healed. In one unfortunate case a woman was encouraged to get up out of her wheelchair and discard her braces at church. The faith healer proclaimed her “healed.” Unfortunately her cancer of the spine had weakened her bones, and the activity caused bones in her spine to collapse; she died not long after. The faith healing hastened her death and caused her unnecessary agony. For the faith healer and the witnesses at church and for the patient herself that day, it appeared to be a miraculous healing: they couldn’t have been more wrong! Incidentally, many of the faith healing patients who get up out of a wheelchair and walk had actually walked into church and had been offered wheelchairs they didn’t really need.”

And another, which is almost amusing in a dark way:

”Many years ago the Journal of the American Medical Association used to have a regular feature where there would be a testimonial on one page describing how a patient was cured of cancer. On the opposite page, they would print the patient’s death certificate showing that he had died of that cancer shortly after providing the testimonial.”

Of course there are people who do benefit in some way from these “faith healings” but this can almost always be attributed to the placebo effect. These healings are usually limited to subjectively reported symptoms such as pain. It has frequently been pointed out that no amputee has ever re-grown a limb, and I am yet to find a case of “miraculous healing” which has been confirmed by a doctor. For anyone interested, a brilliant documentary on the subject can be found here.

Another possible line of “evidence” for the existence of “God” or at least the supernatural is the occurrence of NDEs (Near Death Experiences). Although rather surprisingly this is seldom used as an argument for the existence of God, I’m embarrassed to admit that this is the one thing that almost made me change my mind. NDEs usually occur when a patient is clinically dead for a period of time before being resuscitated – although some scientists claim they must actually occur as the patient is dying or as they “wake up,” believing these experiences to be creations of the mind, occurring within the patient’s brain. Although these experiences differ from person to person, there are several common features. These include life reviews (having your life “flash before your eyes”), out-of-body experiences (where one sees one’s body from an outside position – usually above), immense feelings of unconditional love and peace, movement towards a light or going through a tunnel, encountering “beings of light” and/or deceased relatives. I came across a few elaborate stories from people claiming to have had an encounter with God, Jesus or Satan and to have experienced Heaven and/or Hell during their NDE. While these accounts read much like dreams, the fact that they had supposedly been dead at the time had me teetering at “is this sh*t true after all??”

It wasn’t until someone pointed out to me that most of the people giving these accounts were trying to sell their books that it occurred to me that people might lie about such things. It seems that people who have NDEs almost always have experiences which are in line with their expectations or cultural beliefs about the afterlife, making the possibility that they are indeed generated by the brain seem much more likely. In fact, scientists have discovered that they can generate these same experiences by applying electrical stimulation to the temporal lobe of the brain in human subjects – and religious subjects would often have “religious” experiences in this setting. While the subject is still not fully understood, I think it is far from “proving” the existence of a spiritual realm, and even less so the truth of Christian doctrine.

Some people try to claim proof of Christianity comes in the form of fulfilled prophesies in the Bible, particularly concerning Old Testament prophesies fulfilled by Jesus. This claim ignores the fact that the Gospels were written several decades after the death of Jesus, by people who never met him and that they were largely embellished to make it seem as though he had fulfilled the Old Testament prophesies. For example, most historians agree that Jesus was not, in fact, born in Bethlehem. Similarly, when listing so called “prophesies” which Jesus apparently fulfilled, Christians will often list passages of the Old Testament they were not intended to be prophesies at all, for example passages from the book of Psalms. I would actually like to do a whole entry looking at this topic, but... well, maybe one day.

Finally there are people who claim to have been converted to Christianity by a religious experience or vision... interestingly enough, most of these people seems to be ex-drug-addicts...

If anyone has any lines of evidence I have not considered in my search for the truth, please let me know... but for now I remain thoroughly unconvinced.  

Why Do You Believe in God?

This post is really looking for answers from believers. If you are a believer, please comment with your reasons for believing in God. Did you have an experience which proved God’s existence to you? Or is it just something you “know”? Have you always believed in God? I will be extremely grateful for all answers given. Also if anyone can pass this on to other believers I would greatly appreciate it. Thanks everyone!

Evidence For God (part 1)

Now, the last thing I want is to be accused of being “closed-minded” or having made my mind up without looking at the evidence. So I must state that when I first lost my faith in the God of Christianity, I searched – genuinely – to find some kind of “evidence” that would convince me that it was true after all. Needless to say, up until this point I have failed to find any such evidence. However for the purpose of this blog I will outline the possible “evidences” I considered.

One of the most common reasons people cite for believing in God is “the evidence of the world around us” and admittedly, at first glance, this seems to be a pretty compelling argument. However when you start to ask the scientific questions of how things came to be, you will find (at least, I did) that there is nothing about the natural world that cannot be adequately explained by science, and certainly nothing that indicates a perfect and benevolent creator.

The most striking feature of the natural world is the abundance of life on this planet, the sheer complexity and diversity of living organisms. Surely if anything pointed to a creator God it would be this? But, as it turns out, all of this can be satisfyingly explained by evolution - and without any of the philosophical problems of “why” a god would have created certain things.

The evidence that all life on earth evolved from a single common ancestor is overwhelming – so much so that it is no longer seriously contested within the scientific community. This video gives a fairly succinct outline of the evidence:

Having established this fact, many Christians (including myself, at this point in my journey) will say “but of course, God must have started the process! He must have created the first life form for evolution to act upon!” But as I searched, I found that the question of how life first began does not require a supernatural answer either. Here is one particularly useful video on the subject:

At this point I was left only with the fact that anything exists at all – that is, that something exists rather than nothing - in this line of evidence for the existence of some kind of supernatural creator... but as Lawrence Krauss explains in this fascinating talk, even this can be adequately explained by science. It’s a long video, but well worth watching:

This left me, (the world requiring no God for its existence,) with only the possibility of personal experiences, miracles and so on as evidence for the existence of God... I will discuss this in my next entry.

Heaven, Hell and the Immortal Soul

So the traditional Christian view - at least, the one I was brought up with - is that every human has an immortal soul which resides somewhere within their body whilst they are alive, then goes to either Heaven or Hell when they die. I found this view problematic for a number of reasons.

Firstly, the idea of “Hell” as a place of eternal torment is, at best, ridiculous. Supposedly this is the punishment that we all deserve for our “sins,” so “God” who supposedly created us and loves us, will quite rightly send us there to suffer the worst pain imaginable for all eternity after we die (unless, of course, we have devoted our lives to worshipping him in gratitude for the blood sacrifice of his son, without which we couldn’t possibly be forgiven.) Now clearly this idea is abhorrent. I don’t believe that anybody deserves eternal punishment, a conviction I’m even surer of having heard Sam Harris talk about the illusion of “free will.” After all, what is the purpose of “punishment”? Surely it is a means of behaviour modification - anything beyond that is simply “revenge.” And so the idea of “everlasting punishment” is illogical and frankly, just cruel. Any God (or person) willing to inflict such punishment would not, in my opinion, be worthy of worship.

By contrast, “Heaven” is supposed to be this wonderful place where we will be perfectly happy in God’s presence forever. There is no pain, no suffering, indeed, no sin in “Heaven.” It is interesting to note that the people who believe this also believe that the reason those things exist on Earth is because we have “free will.” This of course raises the question of whether we would have “free will” in Heaven. The idea of Heaven itself is quite hard for me to believe in – but fortunately perhaps, as the idea of eternal existence is not entirely welcoming, I’m sure I’d be bored after a few billion years...

The problem with belief in a perfect afterlife is that it has the potential to stop people seeking to improve the one world we know exists. If people think the poor dying in Africa have eternal bliss to look forward to, why would they bother worrying about how to improve their lives on Earth? Perhaps these people will give a small amount to a charity to make them feel they have done something good and “pleased God” but many (admittedly, not all) religious people simply distance themselves from the problems on Earth, believing such things to be a part of “God’s plan.”

Finally, the idea that we each possess (or are) an immaterial soul may seem perfectly logical at first glance. People generally feel that their conscious mind is “who they are” and that this is somehow separate from, but in control of, their material body. This viewpoint of separate immaterial soul and material body is known as “dualism.” The most common criticism of this is the question of how an immaterial soul could affect a material body, but for me there were other, more pressing issues. One of the first problems for me was that Christians usually claimed that humans were the only species to have a soul. This seemed to be at odds with the apparent “proof” that was the conscious mind, as other species of animal were clearly conscious. But then even if I assumed that all conscious animals had some sort of “soul” there was the problem of where to draw the line. Were there different kinds of souls with differing levels of complexity? And if the “soul” was what gave life to an organism, would plants also then necessarily have some kind of soul? And what about cells in a Petri dish?

Going back to the assumption that humans alone possess a soul, there are still many unanswerable questions. At what point does the soul enter the body? Many religious people argue that this happens at the moment of conception – when the sperm fuses with the egg cell. But if this is the case, then what are we to make of identical twins, where a single zygote (fertilised egg) splits into two at some early point in development, and each half develops into a complete person? Has the “soul” present at fertilisation split into two? And what of chimeras, where two (genetically dissimilar) zygotes fuse to create a single person? Have two souls fused together in this person? Even if we assume that the soul does not enter the body until later in development, there are numerous problems. For example, research has shown that each half of the human brain can function independently, so theoretically half of a person’s brain could be transplanted into another body – and that person would continue to live as two separate people. In addition, the fact that drugs, brain damage, tumours, surgery and so on can affect a person’s thoughts, i.e. their conscious mind indicates that the mind is indeed a result of material brain physiology – and so on what grounds is an immortal soul assumed?

Even the Bible is not clear on this issue. For example, Ecclesiastes 9:5 says “For the living know that they will die, but the dead know nothing; they have no further reward, and even the memory of them is forgotten,” which clearly suggests the absence of any kind of afterlife. Indeed this idea seems to appear late in Jewish history, being popular around the time of Jesus – which would explain its importance in Christian tradition today.

The "Goodness" of God

So I grew up believing that God was the epitome of “goodness.” He was perfect in every way, and he loved each and every one of us. However I also believed that God was the creator of all things. At some point (pretty early on, I believe) it occurred to me that these two beliefs were incompatible. “All things” included bad things, disease, death, suffering... how could a good and loving God have created these things? My early questions were met with vague answers involving “Satan” and “the fall.”

At the age of five I became a vegetarian because I could not stand the thought of animals being killed just so that I could eat them. It struck me as odd that other people did not share this concern, and that a supposedly perfect and loving God should have created a world where animals had to devour each other in order to survive. I was often told, in response to my questions, that God had not originally created the world this way; that it was only after “the fall” that death entered the world and people (and animals) began to eat meat. However then it just puzzled me that Christians did not try to live as God “originally intended,” especially as consumption of meat is by no means necessary for humans. But, apparently God had said at some point that killing animals was ok, so that made it alright.

Of course, once I had realised the truth of evolution these answers were even less satisfying. Even if Adam and Eve had existed as the first humans with a “soul,” death must have existed long before they arrived as it was a necessary part of the evolutionary process which had already been going on for millions of years before humans evolved. This left me in an awkward position, trying to make sense of the belief that God had somehow used evolution as a means of creation... but I just could not square this cruel and ruthless process with a loving designer.

The “Problem of Evil” is a well known theological problem. It is basically the question of how to reconcile the existence of evil (or suffering) with that of a God who is omniscient (all-knowing), omnipotent (all-powerful) and omnibenevolent (perfectly good). I once posed this question to a devout Christian, and the reply I got was that it is not a problem because God is not supposed to be omnibenevolent. This just raised more questions in my mind.

Over time, I formed an image of God as cruel and vain dictator who created people only so that they could worship him. Despite giving us the “free will” to choose, this God (claimed by so many to be perfectly loving and good) would condemn any who chose not to worship him to eternal suffering in Hell. This was because he was “just.” Some may argue that it is not the crime of “not worshipping” God for which people are condemned to Hell, but the “sins” of which we are all guilty. They would say it is by “accepting the gift of Jesus’ sacrifice” that we can be spared this punishment. However, one has to wonder what “sin” could possibly warrant such a harsh punishment. (More on this in my next post).

Then I had something of a revelation: what if none of it was true? I looked at the world supposing that there was no God, and suddenly everything made sense.

Genesis vs. Science

One of the first bits of Christian doctrine I abandoned was the literal interpretation of Genesis. This wasn’t too much of a big deal for me, as there are many Christians who view Genesis – particularly the first few chapters – as allegorical. However it cannot be denied that this view, particularly accepting evolution over creation as described in the Bible, somewhat weakens the idea of God, and his perceived control over the universe. I suppose this is why there are still so many Christians who cling to the literal interpretation even though it means they must turn a blind eye to what has been empirically proven by science in order to keep their beliefs. This often leads to creationists making ridiculous arguments such as this, which basically states that unless you believe in biblical creation, you cannot assume that the universe is logical and orderly and that it obeys mathematical laws that are consistent over time and space – and therefore cannot trust the conclusions that scientific methods point to. What this argument doesn’t consider, however, is why the scientific methods which can be trusted due to the uniformity of the “created” universe point to the conclusion of evolution.

Another story in Genesis which I was forced to abandon belief in pretty early on is that of “Noah’s Ark.” The main reasoning for this was simply the lack of evidence that such a thing ever happened (the implausibility of the story was secondary to this). However, once again there are biblical literalists who try desperately to argue for the historical accuracy of this story. One interesting example of this is here, which despite being found on the same site as the previous article (answersingenesis.org) gives a mutually exclusive argument, claiming that “to say that sediments have always accumulated in the past at the rates we observe today is an assumption. It’s an interpretation based on man’s ideas about the past and is not a proven fact.” Another example can be found here, detailing an extremely dubious claim of having located the Ark, not least because of the “discoverers” refusal to say exactly where it is...

All in all, early on in my journey from devout religiosity I realised that the book of Genesis was not a reliable historical account, but a collection of old stories/myths about how the world was created, how the snake lost it's legs and why there are rainbows. While this still allowed me to have some level of “faith,” the ridiculous, desperate and even moronic arguments put forward by some religious people only served to push me further from wishing to identify myself as a “Christian.”