Big and strong. It's not just a saying.
An internet search for fat acceptance will yield a lot of good reading, and a whole pile of hate-filled results. People ask if it’s really possible to be healthy and fat, but in my current slightly cynical frame of mind, I find myself asking if it’s possible to be healthy and thin?
Thinness is not a protection against disease, and fatness does not seal your doom. Fitness trumps body size every time and I've often seen fat acceptance blamed for increased mortality - in relation to deaths that weren't even caused by being fat in the first place. So what gives? Obesity is popularly associated with all kinds of diseases, particularly diabetes, but let’s take a look at the mechanisms for a moment:
Type one diabetes is an autoimmune condition. Your immune system malfunctions, and your body mistakenly identifies certain pancreatic cells as foreign matter and starts to attack them. After this onslaught, the pancreas is no longer capable of producing insulin, so injections of insulin are therefore required.
The primary job of insulin – it has other functions too, but in the context of diabetes – is to get sugar out of the blood stream and into the muscles, where it is useful. Of course, this naturally happens in individuals who do not have diabetes; their pancreas continues to produce insulin just like it always did, so they don’t even notice that this process is going on.
Hence, insulin isn’t necessarily a ‘medication’ in the way we often think about medications, but is actually a hormone we all have circulating through our bodies, all the time.
Type two diabetes is generally caused by a combination of insulin resistance and pancreatic fatigue. The usual rhetoric states that if you eat a whole lotta sugar, for a whole lotta years, without fibre, fat or protein to delay its absorption, your pancreas will be working really hard to pump out enough insulin so you can metabolise it all. Sooner or later, your pancreas fails. To make matters worse, as your pancreas is busting a gut to produce enough insulin, your body is becoming resistant to insulin, further increasing your dependency. It’s a vicious cycle.
The way to recover from type two diabetes is to improve your insulin sensitivity and to repair your pancreas. Both of which are possible, and might well be easier than you think.
The take-home message from the physiology of the disease is that obesity does not cause diabetes. It just doesn’t.
Eating lots of sugar and having poor insulin sensitivity and the pancreatic fatigue which results – that may causes type two diabetes, but it doesn’t always, just as the very same stuff may also cause obesity, but doesn’t always.
In some, indeed many cases, eating lots of sugar (etc.) does not cause obesity and does cause diabetes, and in many cases, the opposite is also true.
Hence, I meet a lot of people who are thin, yet are surprised to discover that they have elevated cholesterol, or insulin resistance, or any one of the numerous problems we tend to think are reserved for the obese.
A friend of a friend was recently told by a doctor, upon inspection of her blood-work, that it’s like she’s "thin on the outside but obese on the inside". Apart from being extremely rude, what that means of course, is that obesity is kinda meaningless. If thin people can suffer from obesity-related diseases, and obese people can have low cholesterol and good sugar metabolising abilities, to be obese actually doesn’t mean anything.
If I had a dollar for everyone who’s been told “hey, the way you eat, you should be fat... but you’re not!” Or, just as common, “gee, the way you eat, you should be thin. I don’t understand why you’re not losing weight”. Yeah, I’d like a dollar for every time those words are spoken.
“I hate her. She can eat whatever she damn well likes, and it doesn’t make a difference”. How about that phrase?
Rather than question the prejudice and assumptions that inform those statements, we tend to assume that this particular case is an anomaly, that the rule is still true, despite the numerous cases that do not support it. We know, through and through, that different people still respond to the same nutrition and exercise program differently. So why do we pretend that they don't? Why do we think that everyone should respond the same, rather than recognise the simple fact that we don't?
Where do you fall on the bell curve? Are you really at risk? What does it mean if you are? What can you do to prevent these things?
Diabetes is both a hormonal and a metabolic condition. Exercise has a dramatic effect when it comes to increasing your insulin sensitivity. This is very useful for people who have either type one or type two diabetes, because it will, in the case of type one, reduce the amount of insulin you need to inject, and in the case of type two, it will result in improved insulin sensitivity which will lessen the strain on your pancreas.
And, since it seems all things are actually possible and what we think we know isn’t necessarily true, it’s also quite easy to exercise a whole lot and eat healthy, low sugar foods, improve your insulin sensitivity, and even heal your pancreas – all without losing any weight. It wasn’t your fat that gave you diabetes, and losing your fat won’t cure it. Exercise and good eating, however, that might. It might also make you thin, but it might not. These things are associated, they’re not causal, and we really, really need to let go of our prejudices, because they sure as hell aren’t what keeps us healthy.
Here’s what I hate about calorie-counting: 400 calories of sugar is not the same as 400 calories of butter. They don’t look the same, they don’t taste the same, they don’t smell the same, and they sure as heck don’t have the same effect on the human body or metabolism. 400 calories of sugar is different to 400 calories of carbohydrate, which is different to the same number of calories of protein or of fat.
You know what else? Eating fat doesn’t cause diabetes either. Quite the opposite, in fact: consuming fat delays the release of sugar into the blood stream, and will actually help to prevent the blood-sugar spiking effect of excessive sugar intake. In other words: adding fat to a food will lower the Glycaemic Index of said food, and will make you less likely to develop diabetes due to insulin resistance and pancreatic fatigue.
Are you eating too much sugar, or not enough fat?
In this context, chocolate is better to eat than jelly-beans. And here’s an interesting thought: full-fat ice cream is better for you than low-fat ice cream. That’s a nice take-home message.