Diabesity and Other Diseases: The #1 Cause of Death?

Diabesity: The #1 Cause of Death?


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Obesity, insulin resistance, metabolic syndrome, and type 2 diabetes have reached epidemic proportions. I can confidently assert that every person reading this article is affected by these conditions either directly or indirectly. Yet as ubiquitous as “diabesity” and its related diseases are, few people understand how closely they’re connected with one another.

diabesity and other diseases
Diabesity and related diseases are some of the leading causes of death and disease in the nation. iStock/istanbulimage

It is now clear that not only do these conditions share the same underlying causes—and thus require the same treatment—but they are also 100 percent preventable and, in many cases, entirely reversible.

Diabetes and obesity share the same underlying causes and, in many cases, they’re entirely preventable. Find out how diabesity has grown to the epidemic problem it is today. #healthylifestyle #wellness #chriskresser

What You Should Know about Diabesity

Because of these similarities, many professionals, including Dr. Francine Kaufman, have adopted the term diabesity (diabetes + obesity) to describe them. (1)

Diabesity can be defined as a metabolic dysfunction that ranges from mild blood sugar imbalances to full-fledged type 2 diabetes.

Diabesity is a constellation of signs that includes:

  • Abdominal obesity (i.e., “spare tire” syndrome)
  • Dyslipidemia (low HDL, high LDL, and high triglycerides)
  • High blood pressure
  • High blood sugar (fasting above 100 mg/dL, Hb1Ac above 5.5)
  • Systemic inflammation
  • A tendency to form blood clots

The subjective symptoms of diabesity include (but aren’t limited to):

  • Sugar cravings, especially after meals
  • Eating sweets with no relief from cravings for sugar
  • Fatigue after meals
  • Frequent urination
  • Increased thirst and appetite
  • Difficulty losing weight
  • Slowed stomach emptying
  • Slowed wound healing
  • Sexual dysfunction
  • Visual problems
  • Numbness and tingling in the extremities

The term diabesity is misleading in one respect: it suggests one must be obese to experience the metabolic problems I just described above. That’s not true. Thin people can suffer from the entire spectrum of blood sugar imbalances, all the way up to bona fide type 2 diabetes. The term sometimes used for people who are thin, yet have insulin resistance, hyperglycemia, and dyslipidemia, is “metabolically obese.” In short, their metabolisms behave as though they’re obese, even when physically they’re not.

Is Diabesity the Number One Cause for Deaths in the U.S.?

It’s almost impossible to overstate how serious and far reaching a problem diabesity is:

  • More than 93 million Americans are obese (2)
  • Over 30 million Americans have diabetes (3)
  • Over 84 million American adults have prediabetes, characterized by slightly elevated blood glucose levels (4)
  • Worldwide, diabetes affects 451 million adults, and more than 2.1 billion people are overweight or obese (5, 6)

Diabesity is the leading cause of modern, chronic disease. The “diabese” have increased risk of: (7, 8, 9, 10, 11)

In the United States today, someone dies from a diabetes-related cause every eight seconds. (12) Diabetes and cardiovascular disease have now outpaced infectious disease as the primary cause of morbidity and mortality worldwide.

In Dr. Bernstein’s Diabetes Solution, Dr. Richard Bernstein claims that diabetes is now the third-leading cause of death. But death certificates don’t list diabetes or hyperglycemia as the underlying cause of heart attacks, strokes, or fatal infections. Nor do they consider the role of obesity, insulin resistance, and inflammation in these conditions. If they did, it’s quite possible that diabesity is not only the leading cause of disease, but also the leading cause of death.

The High Costs of Diabesity

Diabesity is literally bankrupting the American health care system. The direct and indirect costs of type 2 diabetes were $327 billion in 2017, up from $174 billion just 10 years prior. (13) The yearly cost of obesity surpasses $340 billion. (14) So the total cost of diabesity to society can be conservatively estimated at $650 billion per year. To put that into perspective, the health care costs of the United States in 2018 totaled $3.6 trillion. (15) We spend more per person on healthcare than any other developed nation, yet our health continues to decline.

With numbers like these, you’d expect a state of emergency to be declared. You’d think we’d be doing everything in our power to figure out the cause of these conditions and how to treat them successfully.

But the reality is that the conventional treatment of diabesity has been a dismal failure. This is reflected in the shocking growth of the conditions that fall under the diabesity umbrella over the past three decades, not to mention the equally alarming projections for the future.

Kids Are Impacted by the Diabesity Epidemic Too

Reports suggest that more than one-third of Americans born in the year 2000 will develop diabetes within their lifetimes. (15) What is particularly horrifying about this statistic is that many of those who develop diabetes will be kids. Type 2 diabetes used to be a disease of the middle-aged and elderly, but those days are long gone:

  • The prevalence of type 2 diabetes in kids rose by 30 percent between 2000 and 2009 and continues to climb (16)
  • The number of new cases of type 2 diabetes in kids is expected to quadruple in the next several decades (17)

Each year, kids are gaining more weight. Childhood obesity has more than tripled since the 1970s: (18, 19)

  • Among American children two to five years of age, almost 14 percent are now obese
  • From ages six to 11, 18 percent of children are obese
  • 20 percent of adolescents and teenagers ages 12 to 19 are obese

Most alarming is the rise of obesity in children under five years of age. Research shows that early childhood obesity rates have doubled since 1980. (20) And this isn’t because babies are eating more donuts and cheese doodles while cutting back on their workouts, either. Let’s look at why there’s more to the diabesity story than eating junk food and not exercising enough.

Why We Need to Change Our Behaviors and Lifestyles

From 1993 to 2017, the number of people in the world with diabetes increased 12-fold from 35 million to 450 million and is expected to rise to 690 million by 2045. (21) This is roughly 18 times the number of people affected by HIV/AIDS worldwide. In the United States, the incidence of diabetes is projected to increase to 60 million by the year 2060. (22)

What accounts for such an explosion of new cases? One reason is that the standard treatment for diabesity is not only ineffective, but it’s also contributing to the problem.

Once they have developed, diabetes and obesity are characterized by insulin resistance, which in turn results in carbohydrate intolerance. Yet prominent organizations such as the American Diabetes Association have been recommending a low-fat, high-carbohydrate diet as a treatment for diabetes for decades. It didn’t work in 1985, and it still doesn’t work today. Einstein once defined insanity as doing the same thing over and over again and expecting a different result. Clearly, we need to shift our thinking away from the conventional approach, challenge our current beliefs, and embrace more unconventional options, like:

Research Spotlight: Health Coaching and Diabesity

Lifestyle Coaching for Overweight and Obese Adults

A healthy diet, physical activity, sleep, and stress-management behaviors are crucial for the management of obesity, yet many people have difficulty sustaining positive lifestyle changes over the long term. This study sought to examine whether lifestyle-related behavior change could help obese adults and children, or those at risk for obesity, sustain a healthier lifestyle.

Study Summary

  • The coaching on lifestyle (CooL) intervention is a lifestyle program developed in the Netherlands in which professional health coaches counsel obese adults and children on how to implement a healthy diet and lifestyle behaviors. The intervention includes eight group sessions and three and a half individual hours of coaching for adults. Children are offered eight group sessions and seven hours of one-on-one coaching.
  • In this longitudinal study, lifestyle changes in adults and children were examined eight and 18 months after initiation of the CooL protocol.
  • Adults who went through the CooL program experienced positive changes in perceived health autonomy, motivation to engage in healthy behaviors, perceived barriers to healthy living, engagement in healthy behaviors, quality of life, and body weight.
  • Consistent benefits were not observed in children who went through the program, suggesting that different strategies may be needed to help children who are obese, or at risk of obesity, successfully implement sustainable diet and lifestyle changes.

Key Findings

This research indicates that a combination of group and individual health coaching can help adults who are obese or at risk of obesity increase their engagement in health-promoting behaviors. However, for children who are obese or at a high risk for obesity, different health coaching tactics may be required to produce sustainable improvements in diet and lifestyle behaviors and body weight.

Reference: The Coaching on Lifestyle (CooL) Intervention for Overweight and Obesity: A Longitudinal Study into Participants’ Lifestyle Changes

Health coaches are facilitators of change. They empower their clients to tackle diet and lifestyle changes and offer unconditional support, which can help people take actions to manage or even reverse chronic conditions like obesity. With the help of a health coach, clients are often able to better understand their diagnosis and treatment plan, as well as process the sometimes difficult emotions that come with chronic illness. What’s more, clients who have been through coaching often see additional benefits in their lives as they gain the confidence to take action and make changes. In the ADAPT Health Coach Training Program, we offer instruction on how to master the art and practice of health coaching from a Functional and ancestral health perspective. Our students learn how to help clients change their lives and adopt healthier habits. Find out more about what the ADAPT Health Coach Training Program has to offer.

  1. As a type 1 diabetic and the mother of a 7 yr old type 1 diabetic, I find the word “diabesity” offensive. You mention that it is in reference to type 2, but most people I have run across over my 23 years as a diabetic, don’t even know the difference. You do not do enough to differentiate the two diseases and leave us trying to explain how we got diabetes even though we are not fat and that we take injections/use a pump to survive, not because we don’t want to exercise and eat right.

    • I agree, Jess. I think the public would be better served if we created two separate words for T1 and T2 diabetes. I some respects, they are completely opposite diseases: T1 is too little insulin, and T2 is often too much insulin, and the ensuing insulin insensitivity. T2 is often quickly reversible with weight loss, diet and exercise, but T1 is generally a lifelong condition. People often use “childhood” and “adult-onset” also, but that’s not really accurate either.
      Metabolic syndrome might be a more helpful word to describe T2 than diabesity.