Skip to Content

Who Is Profiting From The Rise In Obesity And Diabetes?

This was unbelievable. To see this kind of frankness in a public report just made my jaw drop. Virtually all of the diabetes- and health-related material I've laid my hands on over the years has skirted these issues. Most of those publications, however, were either produced by drug companies directly, or indirectly influenced by them. My non-profit is.

The following is an excerpt from the report I posted yesterday. It was produced by the City University of New York, Campaign Against Diabetes and the Public Health Association of New York City:

Reversing The Diabetes And Obesity Epidemics In New York City: A Call To Action To Confront A Public Health, Economic And Moral Threat To New York City’s Future
________
Pharmaceutical and Medical Supply Companies

For pharmaceutical companies diabetes is big business. Avandia is one of a number of medications available to treat diabetes. It has been prescribed nearly 60 million times and generates $3 billion a year for its producer, GlaxoSmithKline. Recently published evidence that Avandia increases the risk of heart attack has spurred debate over the drug’s safety and the regulation of pharmaceutical drugs. Similarly, Pfizer’s diabetes drug Rezulin was pulled off the market because it was found to cause liver damage. Drug industry opposition to legislation that would reduce the cost of prescription drugs has meant that many people with diabetes have been unable to afford their medications. Similarly, medical supply companies profit by selling their products to the growing ranks of people with diabetes. “Controlling my condition isn’t that hard,’’ an 82 year old man with diabetes told The New York Times. “The hard parts are the things outside my control, like getting the test strips and the medicines’’.

Insurance Companies

A 2006 investigation by the New York Times points out that most insurance companies refuse to pay small fees for preventive care but do pay for major medical procedures. For example, seeing a podiatrist costs $150 and could prevent a $30,000 amputation. By limiting the diabetes related services they cover, insurance companies do their best not to attract patients with this and other chronic illnesses. By not paying for prevention, these companies are betting that patients with diabetes will have changed insurers by the time the costly complications kick in. Withholding preventive care saves the companies money and forces their competitors and taxpayers to pay for the long-term consequence of this practice.

Hospitals

Hospitals make money by providing expensive procedures that address diabetes complications but not from less expensive preventive services. By charging tens of thousand of dollars for amputations, dialysis, and coronary bypass surgery, hospitals generate income. According to the New York Times investigation of diabetes care in New York City, some local hospitals have opened and subsequently closed diabetes centers because they were so effective at reducing complications they also reduced hospital income.

Food and Beverage Companies

These businesses profit from selling the inexpensive, calorie dense and nutrient poor foods that contribute to growing rates of obesity and diabetes. By saturating our neighborhoods, schools, and workplaces with their products and advertisements, they promote and profit from the over consumption of their products. In addition, our national agricultural policies subsidize the production of key ingredients for their products such as high fructose corn syrup. This helps make their products the cheapest and sweetest calories on the market.________
The following was the preface to the above list of social influences:"If diabetes were mainly the result of individual decisions, some might argue that the inequitable burdens it imposes are unfortunate but “just desserts” for over eating, exercising too little and failing to seek appropriate health care. In our view, however, the current diabetes and obesity epidemics can best be explained by changes in the environment, not individual decisions. In fact, as shown in Figure 6, many in our society have profited by participating in the circumstances that contribute to diabetes. We call attention to those who have gained from the rise in diabetes not to point fingers but rather to fairly apportion responsibility for reversing the epidemic.

To expect individuals to take the main responsibility for stopping diabetes is both ineffective – it doesn’t get at the roots of the problem – and unfair because it blames the victims."You can read the rest of the report at:

Reversing The Diabetes And Obesity Epidemics In New York City: A Call To Action To Confront A Public Health, Economic And Moral Threat To New York City’s Future________

Similar entries
  • Oh. A trend!

    A few weeks ago I posted a report by the UK's Government Office for Science which said:"The obesity epidemic cannot be prevented by individual action alone and demands a societal approach."
    ...
    "The people of the UK are inexorably becoming heavier simply by living in the Britain of today. This process has been coined 'passive obesity'."I lamented that government agencies in the US still frame America's weight problem as the creature of an individual's nefarious choices. "Eat less refined corn and soy products!" they say, as if our weight problem is our fault.

    It's incomprehensible to me that those same agencies, backed by Congress, turn around and fund the production of those very corn and soy products they tell us not to eat - making them cheaper, more accessible, and, well, downright popular.

  • The buzz at work this week is that pesticides could increase the risk for diabetes, and insulin resistance - big time. This week's Lancet came out with a commentary highlighting the work of Dr. Duk-Hee Lee, et al. Dr. Lee's group found the odds of having diabetes were 38 times higher! for people with high blood levels of toxic persistent organic pollutants (POPs, such as dioxin and PCBs) than for people with low levels. And the association was dose dependant - the higher your levels, the higher your risk.

  • I got a call from my doctors this morning that I failed the glucose tolerance test and will have to take another one, but this one will be a 12 hour fast followed up with three blood draws spread over a three hour period. If I fail this one it means that I have gestational diabetes , which is a type of diabetes you can develop during pregnancy.
    Like the type 1 and type 2 diabetes you can get when you're not pregnant, gestational diabetes causes the glucose to stay in your blood instead of moving into your cells and getting converted to energy. Why does this sometimes happen when you're pregnant?

  • I've been meaning to post this for months and now is a good time, given my previous post about deaths linked to an intensive diabetes drug regimen. This study shows that diet, and diet alone, can affect a change in glycemic measures, e.g. HbA1c, that rivals what can be had with drug therapy.

    It's one of the studies Melinda mentioned in comments. I like it because it's a diet study, not a nutrient study. Diet studies are harder to conduct than nutrient interventions. But to me they're more real. They're about foods and what people eat, and how that day-to-day behavior can affect health.

  • This is a depressing story, no matter how you look at it. The government calls it a mystery.

    Study: Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial
    Population: 10,251 patients with type 2 diabetes at high risk for heart disease

    About half of those folks were assigned to an intensive BG treatment arm, the other half to a standard treatment arm.

    Intensive Treatment Goal: HbA1C < 6.0%, fasting BG 100 mg/dl or less, 2-hour postprandial BG 140 mg/dl or less
    Standard Treatment Goal: HbA1C of 7.0 to 7.9%, fasting BG of 90 mg/dl or more, postprandials not used

    After about 4 years (range: 2 to 7 years), there were 254 deaths in the intensive treatment arm and 203 deaths in the standard treatment arm ... a difference of 54 deaths ... a difference which went in the wrong direction.

  • This is a follow-up to my post, Dietary Fat Raises Insulin Levels.

    Warren asked:"I am curious whether there is any detail provided in these studies regarding the types of fat, or is all fat, i.e., saturated, unsaturated, etc. lumped together?"The type of fat matters. The more saturated the fat, the more often it's associated with reductions in insulin sensitivity. The following study is often cited:

    Substituting Dietary Saturated For Monounsaturated Fat Impairs Insulin Sensitivity In Healthy Men And Women: The KANWU Study, Diabetologia, 2001

  • I was as confused as hell today when I first read this in the New York Times, then I checked out this week's NEJM and read this (abstract only for you uncredentialed scum).

    Item One:

    For decades, researchers believed that if people with diabetes lowered their blood sugar to normal levels, they would no longer be at high risk of dying from heart disease. But a major federal study of more than 10,000 middle-aged and older people with Type 2 diabetes has found that lowering blood sugar actually increased their risk of death, researchers reported Wednesday. . . .

    Among the study participants who were randomly assigned to get their blood sugar levels to nearly normal, there were 54 more deaths than in the group whose levels were less rigidly controlled. The patients were in the study for an average of four years when investigators called a halt to the intensive blood sugar lowering and put all of them on the less intense regimen.

    Item Two:

  • Talk about polarizing issues. While campaigning in South Carolina yesterday, presidential candidate Fred Thompson said:"I don’t think that it’s the primary responsibility of the federal government to tell you what to eat."Thompson: Don't Let The Government Tell You What To Eat

  • As I have said before, I'm not going to be all over the health care proposals of the presidential candidates because whatever they are saying now is not miraculously going to become reality after January 20. It's all going to get processed through the Congressional/K Street/Moronic Corporate Media meat grinder anyway, and who knows what vile offal might emerge?

    But, the debate last night has no doubt raised questions in people's minds regarding what that was all about with the mandates and the amputations and what not. Let me say, first of all, that the debate as a whole was extremely heartening. It was largely substantive, we've got two capable candidates who both demonstrated a willingness to submerge their competing personal ambitions for the good of the nation, and it would be absolutely shocking if one of them doesn't become president. Whoever it is will spend the next few years shoveling out a shitpile that makes the Augean stables seem like your cat took a dump on the rug, but maybe they'll get something done on health care.

    So, you can go to the respective web sites and read it all for yourselves, but here's my executive summary.

  • This morning we heard from Dr. Kelly Kelleher about how it's a great idea for primary care doctors to screen for alcohol and other drug abuse problems. There are, however, some difficulties.

    Every disease advocacy organization in the world wants primary care doctors to be screening -- for asthma, diabetes risk, cancer, depression, domestic violence, you name it. In fact there are something like 700 questions that primary care docs are supposed to be asking their patients. However, they generally see 4 or 5 patients an hour. Since the patients are presumably there for some reason other than to be asked the first 30 or so of 700 questions, it's unlikely we're going to get very far with that.

  • The UK Department of Health released its "Health Profile of England 2007". They noticed a trend:

    The UK Government Office for Science projected that trend 40 years into the future and determined that a "bold whole system approach is critical":

  • Can you believe what those Rachael Ray recipes have done to my belly? It almost looks like I'm pregnant! Oh wait, I am pregnant! Yes, I have been keeping it a secret for awhile. I'm now at about seven and a half months and am feeling great. Scroll down to read today's post about Rachael Ray or continue reading here for more about what's up with me.

    So, what pregnancy complication could happen to someone who loves to cook (and eat) so much that she writes a blog about it? Gestational diabetes, of course! I'm pretty mad at my placenta, which creates the hormones that are blocking insulin production and raising my blood sugar levels. This means I get to test my blood sugar four times a day (yes, with the little pokey thing), eat small portions six times a day, completely avoid sugary treats, and eat a certain amount of carbs with each meal.

  • I probably wouldn't have posted this a year ago. I didn't think milk could possibly be so unhealthful. All these years I've been eating dairy products and recommending them. I feel duped.

    I've been researching like a fiend this past year the relationship between certain compounds in dairy foods, especially the milk protein casein and the milk sugar lactose, and certain chronic diseases, cancer and diabetes to name two that have caused I and my family no trivial amount of stress.

    With no further ado, here's a one-minute trailer put together by a group of earnest folks at Unleashed Productions. Thanks to Shira Lane for bringing her work, and this important message, to our attention.

  • Some sad irony here:
    Rising Food Prices Are Likely To Worsen US Obesity Rate"... she lives on public assistance and eats junk food because it's cheap and more readily available in her Philadelphia neighborhood than carrots and apples."

  • The USDA has jurisdiction over meat, poultry, and eggs. The FDA has jurisdiction over just about all other food products. The FDA does not currently have recall authority, but they are in the process of asking Congress for it.

    In my previous post I said I did not know whether the USDA had recall authority. The article below suggests they do not have recall authority, nor do they want it:

  • I haven't ranted very much lately about the democratization of science, and mea culpa. So the theme for today is that we can't have a more democratic scientific institution if most people lack the basic knowledge they need to participate.

    This is the story of my professional life, actually. My day job is with a community based public health agency, and my academic half is concerned with people's control -- or usually lack thereof -- over their own health and health care. (As I often say, I am a community-academic partnership.) My work concerns all sorts of issues -- mental health, addiction, environmental justice, diabetes, heart disease, you name it -- but HIV is a particularly big piece of it, in part because it has paradigmatic qualities that make it particularly instructive for many of the principal concerns of medical sociology.

  • The Mississippi House of Representatives has floated a bill (HB 282, below) that would make it illegal to serve obese patrons.

    The gentlemen below are the Bill's authors. From left to right: W. T. Mayhall, Jr. (R), John Read (R) , Bobby Shows (D). It appears to be a bipartisan effort.

  • Or at least I thought I did. Last summer my fasting blood sugars were pushing 120 mg/dl. (100-125 is prediabetes, 126 or more is full-fledged diabetes). I went on a very low-carbohydrate, Atkins diet. My fasting sugars came down, hovering near 100.

    I went off the Atkins diet when I experienced some precancer, and when others in my family were diagnosed with cancer. I went on an animal-free, high-carbohydrate diet. Now, over 70% of my calories come from carbohydrate.* And my fasting blood sugars are always in the 70s!

  • I sure am glad it's not my job to come up with the best eating plan for all Americans, let alone the world.1 (The World Health Organization has my sympathy.) The choices and defenders of those choices are numerous and polarized.

    Regarding carbohydrates, it may be that a low-carbohydrate diet, around 10% of calories, is the best eating plan for overall health for everyone. Alternatively, it may be that a high-carbohydrate diet, above 45% of calories, is. Research has not sufficiently compared and contrasted the two.

  • This is another in my series of posts on low-carb diets. I've been reducing the amount and changing the type of carbohydrate I eat, which by default changes the amount of fat and protein I eat. I'm wondering what the long-term effect of this pattern of eating is.________

  • And no free pass for President Obama either. As you know if you've been reading -- because I mentioned it a few days ago -- Obama's health care proposals include requiring insurers to cover preventive services, which he claims will reduce health care costs. Hillary Clinton makes some vaguer claims along the same lines, to the effect that universal coverage will end up saving money because people will get timely preventive care.

    Joshua Cohen and colleagues in NEJM consider this proposition. (And you'll be pleased to know that this is one of those articles of broad public interest that the editors have made available to the rabble, so go ahead and read it.)

    Alas, as a general proposition it isn't so. Screening and prevention may be worthwhile, but that isn't the same as saving money. Very few procedures actually produce a net cost saving. Cohen et al don't point it out, because it isn't really the focus of their analysis, but the really bad news is that extending people's lives actually costs money. If somebody drops dead of a heart attack, you only have to pay for the funeral. But if they live for 20 years taking beta blockers and ACE inhibitors and statins and getting angioplasties etc., you've prevented a heart attack, but spent a helluva lot of money.

  • Here's another study I stumbled across while investigating the milk and cancer link that keeps cropping up.

    Dairy Products, Calcium, and Vitamin D and Risk of Prostate Cancer

  • Around the time Fred Thompson proclaimed, "I don’t think that it’s the primary responsibility of the federal government to tell you what to eat.", the USDA was issuing a press release describing changes it planned to make to its food assistance program WIC.

  • Here's the thing about cancer ... Our energies are placed on either detection (expensive, profit-generating, and sometimes invasive screenings) or treatment (expensive and toxic drugs, radiation, and removal surgeries). Blasting good tissue along with cancerous tissue seems crude. Even cruder is excising whole swaths of good, usable organ. I would rather see energies placed in prevention (inexpensive, although hard to gage its effectiveness) and tumor-containing/shrinking therapies. Both of those respect the human body and its ability to heal itself.

  • Lavender Blue sent me this article from Newsweek:

    Junk Food County: Why many rural Americans can't get nutritious foods. The unhealthy truth about country living.

    I can't stop thinking about it. It's troubling, on a number of levels.

    An excerpt:

  • Oh no, another myth bites the dust ?

    Gina Kolata is a health reporter for the New York Times and author of the recent book (May, 2007) Rethinking Thin: The New Science of Weight Loss - and the Myths and Realities of Dieting. She recently reviewed Gary Taubes' new book, Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control and Disease for the New York Times. She concluded, "I’m sorry, but I’m not convinced."

  • A few more thoughts on why I believe social influences play a role in health and disease:

    I have a friend who has serious weight and health problems. If he was born in Abkhasia or Okinawa, would he have turned out similarly? My feeling is he wouldn't.

    By the same token, if a person from Okinawa, a place that experiences extraordinary health and longevity, were to migrate to the West, would they die earlier and experience our diseases?

    One study found they would:

    Impact Of Diet On The Cardiovascular Risk Profile Of Japanese Immigrants Living In Brazil

    Study Basics

    • Cross-sectional study
    • Participants: 234 Okinawans living in Okinawa (OO) and 160 Okinawan immigrants living in Brazil (OB) (aged 45–59 years)

    Findings

  • In 2006, the Food and Agriculture Organization (FAO) of the United Nations published a 400-page report detailing the impact of livestock on the environment:

    Livestock's Long Shadow, FAO, 2006 (PDF)

    It's been a real eye-opener for me:

    Climate Change:"The livestock sector is a major player [in climate change], responsible for 18% of greenhouse gas emissions measured in CO2 equivalent. This is a higher share than transport."The major portion of those emissions comes from gases other than CO2, gases with a greater potential to warm the atmosphere, such as:

    • Methane - from enteric fermentation by ruminants
    • Nitrous oxide - from manure

    Land Use:

  • "No," says Gary Taubes.

  • No, really. A comprehensive, online, free!, encyclopedia of every living thing on the planet. One page for each. Millions of pages. And it's a wiki - a collaborative, updatable effort from people all over the world. I can't think of a more ambitious project facing the internet.

    And it went live on Tuesday (although it may be slow, it's getting over a million hits per hour):
    Encyclopedia of Life (EOL)

    Here's what the New York Times had to say:
    The Encyclopedia of Life, No Bookshelf Required

    Here's its official blog:
    Encyclopedia of Life Blog

    Here are some sample pages (clicking the image will take you to EOL's demo page):

    Yeti Crab

    Death Cap Mushroom