Our current obesity epidemic started rolling along over the past 50-75 years. Prior to that, and certainly throughout antiquity, obesity was rather rare. In today’s world obesity has become the norm rather than the exception. To understand this dramatic change, we first need to address a few definitions.
Get the Definition Right
Let’s start with the term obesity. From a scientific standpoint there is universal acceptance that obesity is defined as “excessive body fat”. It’s a body composition issue, meaning there is too much fat relative to other body elements such as muscle, bones, organs, and other tissues. Healthy humans have a certain amount of body fat that falls within a “normal” range. Up until recently this percent body fat was determined by Mother Nature and evolution. If you exceeded this normal amount, you were classified as obese. In bygone eras, obesity was as rare as hen’s teeth.
BMI Throws Science Out the Window
This is where it gets a bit messy. In the late 1990’s, Walter Willet and colleagues were considered to be prominent obesity experts, and they published “Guidelines for a Health Weight” in the prestigious New England Journal of Medicine. They were informing us dummies in primary care how to define and diagnose obesity. They admitted that measuring body composition would be the ideal way to diagnose obesity, but they considered it to be too expensive and difficult to perform on a large scale. Thus, they recommended using Body Mass Index (BMI), which is essentially a size measure. BMI and measured body composition do correlate somewhat in large populations, but what about individuals? After all, you are an individual, not a population. What does BMI tell you about the amount of fat in your body? The answer is zero, zilch, nada, zippo, nothing! BMI clearly does not measure fat, the parameter that defines obesity. Does this seem like scientific reasoning to you?
There are a lot of large people with a high BMI who have low levels of body fat–think professional football players. Other large folks have excessive body fat—think sumo wrestlers. There are also many thin people with excessive body fat, and they are referred to as “skinny fat”. As of 1999, I had already measured over 10,000 body composition readings in my primary care practice. I sent a letter to the editor to the NEJM challenging Willet’s views, and it was published. My wisdom failed to penetrate the medical and scientific communities, because today almost a quarter century later, they are still waddling along in Willet’s footsteps.
Measure the Parameter the Defines the Illness
After measuring the body composition of every patient at every visit, I discovered that obesity is much more common than public health experts have estimated. That’s because many people with a low or normal BMI have excessive body fat. If you combine these folks with big people with excessive body fat and a high BMI, most people in developed societies now have obesity. We are living in an era where fatness and obesity are the norm rather than the exception.
An Immerging Epidemic
Humans have lived on this earth for over 200,000 years, yet up until the last few decades obesity was extremely rare, even when plenty of food was available. Many experts believe that virtually all obesity is driven by excessive calories and lack of exercise. In other words, they believe it’s an energy imbalance issue—too many calories consumed and not enough calories burned. I agree this is the case for a few individuals. For example, sumo wrestlers become obese by purposely overeating huge amounts of relatively healthy food, but for most people with obesity, there is no “energy imbalance”. People in our modern world who are obese are often eating normal or low amounts of food.
With Obesity, the Brain is Driving the Bus
I came up with my own somewhat unique view of what’s driving modern obesity when I was taking all those body composition readings. I also had an interest in neuroscience and brain disorders, and over time I noticed a strong correlation between certain common brain dysfunction symptoms and obesity. The symptoms always seem to lead changes in body composition, suggesting that when it comes to fat storage, the brain is calling the shots. This makes a lot of sense from an evolutionary standpoint. A normal brain knows how to maintain appropriate amounts of fat regardless of caloric intake and activity level. These parameters seem to fit the pattern of a disease that I term Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. This extremely common disease is defined by two parameters:
- Patients have excessive body fat regardless of size, BMI, or weight, and regardless of caloric intake or level of physical activity.
- Patients have up to 22 brain dysfunction symptoms that overlap with many traditional brain disorders, creating a great deal of diagnostic and therapeutic confusion. These symptoms degrade a person’s ability to function.
It soon became obvious to me that people with CARB syndrome will develop excessive body fat at virtually any caloric intake, because their obesity is driven by brain dysfunction rather than calories. Excessive calories will certainly cause more fat storage, but they are not necessary to create the excessive fat in the first place. Because the medical and scientific communities completely missed CARB syndrome, we now have a huge diagnostic and therapeutic mess, both for obesity itself and for the brain dysfunction symptoms that overlap with many traditional brain disorders.
The Diet-Brain Connection
For example, true bipolar disorder has been around since the dawn of mankind. It’s defined by manic psychosis alternating with depression. Over the past 50-75 years, we started seeing a lot of people with hypomania but no psychosis, and mood swings. The folks at DSM recognized that these folks sort of looked like bipolar disorder, but not completely. They decided to call the classic disease bipolar disorder I and this new form bipolar disorder II. I have news for you. Bipolar disorder II is CARB syndrome, and it has absolutely nothing to do with classic bipolar. If you treat these folks with antipsychotics and mood stabilizers that are effective for managing bipolar I, over time they get worse and develop more obesity and metabolic problems like insulin resistance and type 2 diabetes. You would end up with a massive mess, exactly like we are witnessing in modern medicine today.
Believe Your Own Eyes
Visual obesity is excessive body fat that anyone can see with their own eyes. It consists of people who are usually but not always large, and they have obvious flabbiness without obvious muscle definition. You probably agree with me that visual obesity is rapidly becoming the norm in our society. Yesterday I watched a video with my eight-year-old daughter titled “Barbie and the twelve dancing princesses”. It was released in 2006 and has hundreds of animated adults, all of whom appear to be thin and fit. There wasn’t one visually obese person to be found. Back in the early part of this century, being visually fit and thin was the norm. If this video came out today, people would immediately recognize that the people in the video don’t fit today’s norm. That’s also the reason that popular media and advertisements in today’s world virtually always include some or many people who are visually obese.
Those Lying Eyes
The main problem with this situation is that when something is recognized as the norm, it no longer appears to be a health threat. Because virtually all obesity today is driven by CARB syndrome rather than just excessive calories, even the medical and scientific communities fail to recognize this threat to our collective health. That’s because they are hung up on the size and BMI definition of obesity, which misses many folks who have a normal size, weight, or BMI, yet clearly have excessive body fat. They are also missing the brain dysfunction that is associated with most cases of obesity. That my friend is not where we want to be.
First Things First
The first step in dealing with this dire situation is to understand the CARB syndrome disease model. You can’t diagnose and treat a problem that nobody recognizes or understands. At the present time you can’t go to your healthcare provider to get diagnosed with CARB syndrome. The solution is to read my book “Brain Drain”, where I teach people to diagnose and arrange for treatment of their CARB syndrome using readily available, inexpensive, and safe treatment modalities. If you have any degree of CARB syndrome (and it’s likely that you do), effectively treating your disease will dramatically improve your brain function, overall health, and quality of life. To me that seems like an obvious solution to the major healthcare disaster looming over today’s world.
It’s your choice whether to follow my easy to implement recommendations. You are in the driver’s seat when it comes to CARB syndrome, the most common debilitating disease in modern society. As I tell my kids, if you don’t comply, don’t complain!
