Well readers, you’re in for a more serious Sunday here. I promise to keep it short. Frankly I’m most interested in what everyone thinks. My copy of “Wired” showed up Saturday. The cover story is about a drug for obesity and how big pharma turned fat into a disease and then invented the cure. So what do you think? Is obesity a lifestyle issue or a disease?

The new diagnosis is “metabolic syndrome,” which includes five factors: high blood sugar, high triglycerides, low HDL and obesity. I’m not in the medical profession, but these sound to me like several problems that currently have treatments: diabetes, high cholesterol and obesity. There seems to be an effort to explain the rising obesity all over the world, not just in the U.S. For some I know, their weight is a serious problem that just never responded very well to diet and exercise. Others find that diet and exercise work quite well. It’s funny that this article never mentions the possibility of thyroid problems, which causes either weight loss or weight gain depending on the thyroid problem. Perhaps that is the issue.

I’ve always wondered if it isn’t the chemicals in our food. We put pesticides on our produce. Over many years this stuff builds up in the body. Then there are the preservatives in processed foods. Perhaps the new obesity epidemic is due to convenience foods and stress. Many of the theories seem to make sense, but the doctors and pharma are looking for a one-size-fits-all answer. I don’t think there is one.

I read a book a few years ago called “The Obesity Myth.” Its thesis is quite interesting. I know what you’re thinking: “I see so many fat people that it can’t possibly be a myth.” Well this book looks at the new definitions of obesity, which have been lowered for years by doctors and insurance companies. It looks at how BMI (body mass index) is a poor indicator of obesity. The data is quite convincing though. The line between just overweight and obesity gets lowered every few years, which means that more and more people are considered obese—when just 10 years ago they weren’t. The author looked at mortality rates due to being overweight and found that overweight people often lived longer than their thinner counterparts. He also found that what mattered was exercise, not weight. So a thin couch potato has the same mortality rate as an obese couch potato, but the thin couch potato has a lower life expectancy that an overweight person who exercises three times a week.

So there are several questions and arguments supporting and disagreeing all of them. I am concerned about the pharmaceutical companies pushing a diagnosis that looks bogus on the surface so they can sell new drugs. This is called “developing new disease markets.” Do we really want pharmaceutical companies creating new markets? Do we want them writing the guidelines for diagnosis? Can all our problems be cured with a pill?

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