The article is trying so hard not to say that obesity is the cause. I call it the obesity pipeline: You start off young and obese and you don't have diabetes and it's all fine. Stay obese long enough and you get diabetes -> metformin. Stay in a diabetic state long enough and you get heart disease -> statins. These are obesity comorbidities.
Unfortunately, since Ozempic treats diabetes with or without obesity, and it also treats obesity without diabetes, it won't help us figure out if obseisty is a cause or a side effect of diabetes. But there really is little reason to pretend it's clear either way.
I find it exceptionally hard to believe populations at scale went from relatively “normal” weights to obese as the majority due to an emerging novel metabolic disorder. All within 1 to 2 generations.
Much simpler explanation is that diets and lifestyles changed leading towards obesity. Whether or not a metabolic disorder happened somewhere in the middle there seems irrelevant to me. It’s very clear to me that obesity causes the issues and not the other way around.
I’m open to thinking differently about it, I just find the evidence uncompelling as someone who was obese the majority of my adult life. Given the unique circumstances of how I grew up and then later experienced life, I’m quite confident obesity is primarily caused by lifestyle. Put simply - put yourself in a situation where obesity becomes easy to achieve and the majority of people will become obese.
Humans being what they are will of course have myriad of outliers to refute the point, but outliers are uninteresting to discuss in this context.
This is just my unqualified opinion to be clear
When an article starts like this, I instantly close it and wait for proper sources. Anyway, the phrase "metabolic syndrome" has been gaining currency for the last few years. For those who don't want to read journal papers and meta-analyses, there are plenty of doctors and fitness coaches (on YouTube) who have made videos on how to get metabolic syndrome under control or even reverse it. And many of the doctors do a good job of filtering and summarizing the research.
The actual science is unimaginably boring. Do not be overweight on the BMI scale and do some moderate exercise for around 2 hours every week. This will drastically improve the health 1000x more than say the insane stuff that Brian Johnson is touting.
I hate modern fitness influencers and health wellness people in general. My head near about exploded when I saw a Tiktok from Jeff Nippard claiming that eggs increase your testosterone on a study with a sample size of FIVE PEOPLE.
Don't be depressed is also excellent advice for people with depression: if they can manage that, it improves their mood tremendously. Not catching colds also greatly reduces your chances of cold-like symptoms.
By which I mean, what you're saying is a truism, not medical advice. Keeping your BMI under control is a natural no-effort thing for some people, and a grueling lifelong struggle for others. Telling fat people to stop being fat is not "advice", it is exactly as helpful as telling sick people to stop being sick.
That doesn't detach from the reality of the objectives, getting there is difficult for people and there is more research to be done.
FYI: None of my posts are medical advice and I am not a doctor
https://www.ahajournals.org/doi/10.1161/01.atv.0000111245.75...
Why? You don't believe in car crashes or what?
This seems needlessly cynical. Someone can have multiple objectives in writing, to tell you facts and also to capture your attention or to convey an emotion and motivate you to action. Very little writing is done with a single purpose in mind. We don’t expect academics drafting research papers to eschew concerns about the impact the writing will have on their career for example.
Starting a story with an anecdote that humanizes the information is simply acknowledging the reality that people want more than just facts. If the latter was all they wanted, most of us would only read encyclopedias and textbooks.
Seems absolutely unnecessary, forced, immeasurably trite, off-puttingly boring, overused, so brazenly cliché that there has to be some kind of counter-intuitive selection going on, like with the email scammers that target those who are not immediately noticing the fraudulent intent.
... or simply our arrogance is showing, after all average minds discuss people, right?
This logic error is easy to make, and the headlines all too often imply it, but it isn't always true (sometimes it is).
Though, to be play devil's advocate for a second, it does seem that diabetes is typically where the symptoms start, and we do understand that diabetes is fundamentally metabolic and/or functional dysfunction in 1 or more of 7-ish different areas.
I think it's the level of perspective zoom + timing we take that makes the article's assertion either useful or not.
If we zoom out, while catching disease early on, and we address the metabolic conditions via lifestyle and/or certain drugs like GLP1, then we prevent the need to intervene on the kidney and cardiac front.
But if we zoom in to a specific issue, after disease has progressed a profound amount, a GLP1 intervention may be too little, too late.
Hopefully though, this may help the messaging to folks that if they are contending with metabolic disease that presents as diabetes, introducing lifestyle and pharma interventions early may be helpful on the larger epidemiological front.
The main marker of kidney function, eGFR, was added with the AHA/ACC's PREVENT equations in 2023.
I wrote a bit about the science behind heart risk calculators, and their various inputs like cholesterol, blood pressure, A1c, eGFR, and so on here: https://www.empirical.health/blog/heart-attack-risk-calculat...
If they find the drug of immortality, I am sure they will name every disease "partial death".
Seems like this is mostly an extension of the previously existing label of metabolic syndrome, now including kidney. Ozempic is mentioned and I take that to mean obesity is the cause. But are some of these ailments like diabetes reversible?
tl;dr it's everything you expect - home-cooked healthy meals, avoid sugary stuff, moderate exercise five days per week, etc