CRIME IS DOWN--- WEIGHT IS UP

Victor Bloom MD

You would think there would be no downside to the healthy economy. Crime is down 10% from a high ten years ago, as predicted by the sociologists. They say as long as people are poor there will be crime, the more poor people the more crime. It only stands to reason, although the relationship of poverty to crime is not so simple. Decreasing crime is the upside to a healthy economy.

But the latest news is that accompanying this steadily improving economy, with more money in people's pockets, is a growing tendency to obesity, and with that an increase in diabetes, now said to be of epidemic proportions. Medical research data show a continuing connection between obesity and diabetes. Diabetes, especially the late onset type 2, undiagnosed and untreated can lead to dire complications. These include arteriosclerosis, which affects the heart, eyes, kidneys and brain, and hypertension, which adds a burden to the heart and compromises blood flow to vital organs. Eventually loss of blood and nerve supplies to the limbs can lead to infection and gangrene, necessitating amputation in extreme cases.

This dire picture is not common, but can result from lack of treatment over time. Diabetes can be controlled by diet and insulin or oral sugar-lowering medicines. People with diabetes need education as to the mechanism of the disease, which foods to avoid or consume only in moderation, and how to test the blood sugar.

The best remedy is prevention, and prevention requires knowledge of the root causes, complex as they may be. What are the causes of obesity? It's a combination of eating too much and exercising too little. That seems simple enough. If you take in more calories than you burn, the excess calories will be stored as fat. Many sedentary individuals gain a pound a year, but after fifty years, that is fifty pounds! Many middle aged and older people are fighting the battle of the bulge, and there are numerous weight-reducing methods and schemes available. The bookstores are full of books, such the Atkins diet and there are such group methods available as Weight Watchers and Take Off Pounds Sensibly (TOPS). Although most of these work in the short run, most dieters eventually revert to their old habits. It is a difficult problem.

It is difficult because food tastes good and food is the great universal comforter. We are raised in a society where food is varied and plentiful and easily accessible. Visiters from other countries are amazed at the sheer abundance of food displayed in our supermarkets. They are also impressed with the sheer number of fast-food outlets and restaurants, the quantity of which seems to grow exponentially. And there is an increasing tendency to consume ever larger amounts of food, for example the double whopper with cheese and bacon and extra fries. Do you want extra fries with your extra fries? And how about a liter of Coke?

Add to the volume, quality and variety of food, the tendency to not exercise. Consider how the automobile has replaced walking. And consider the time spent watching TV and/or sitting in front of the computer, or playing video games. For every person you see walking or jogging, there are ten people sitting, and sitting for many hours per day. This combination of huge intakes of food and minimal exercise accounts for the increase in the nation's obesity and thereby diabetes.

Whatever happened to "you can never be too rich or too thin?" Interesting that at the same time there is an increase in eating disorders which leave some people too thin--- anorexia and bulimia, the rest of the country is tending to overweight. Many cultures celebrate prosperity with a great consumption of food, and our multicultural society is burgeoning from this cultural tendency. You can never get too much of a good thing? A wise patient once gave me a deeper insight--- "you can never get enough of what you don't really want." That is a clue for the insatiable appetite.

People should take heed of this growing trend toward overweight and diabetes and make some lifestyle changes. Everything in moderation--- moderate intake of food and moderate exercise. The government guidelines for diet include lots of whole grains, fruits and vegetables. If you fill up on those, bulk and nourishment is there and calories are down.

Go easy on animal fat and dairy products (steaks, hamburgers, pizza) and substitute fish and fowl whenever possible. Consider more walking and less driving. Limit sedentary activities.

See your doctor. Check your weight, blood pressure, cholesterol and blood sugar. If you have diabetes, get educated and follow a remedial program. Often, simply changing your diet, getting more exercise and losing some weight will solve the problem. Prevention is the best cure.

Dr Bloom is Clinical Associate Professor of Psychiatry, Wayne State University School of Medicine. He is a member of the American Academy of Psychoanalysis and on the editorial board of the Wayne County Medical Society. He welcomes comments at his email address--- vbloom@comcast.net.