Cancer, obesity, diabetes and heart disease constantly hog the media’s attention when it comes to health, but Dr. Mark Hyman thinks more of us should be worried about what he calls “diabesity“—something that he says affects one in two Americans today, and is brought on entirely by lifestyle factors like diet and exercise. And unlike celebrities like Paula Deen, Hyman also says diabetes and obesity aren’t genetic, and are completely reversible without the use of prescription drugs.
Hyman’s bestselling book, The Blood Sugar Solution, corrects myths about obesity and diabesity, and provides personal solutions for restoring your health. We interviewed him about why diabesity is a such a big problem, and why so many of us don’t know what it is:
What is diabesity in a nutshell?
Diabesity is calling attention to the fact that obesity and diabetes are not two separate things. Even early on in the process of gaining weight problems occur that are really a disease, and most of it gets missed: 90% of people with pre-diabetes are never diagnosed by their doctor; 25% of people with diabetes are never diagnosed. And this isn’t a problem that can cause issues in the future; pre-diabetes causes heart disease, it causes cancer, memory problems, causes even things like depression, infertility and many other things.
Is there a difference between what you’re calling diabesity and what some people call pre-diabetes?
Yes: I think the conventional criteria for pre-diabetes are too strict and it misses people who have problems even at a so-called “normal” blood sugar level. In other words, if your blood sugar’s at 99 it’s considered normal, but in fact any number over 85 or 87 on an increasing trajectory it increases your risk of heart attacks, strokes, cancer and many other things.
So who needs to worry about diabesity?
There are a few clues that you could have diabesity: One is a little extra belly fat; another sugar or carb cravings, or high blood sugar, high triglycerides and low cholesterol. And then there’s also things like a family history of obesity, heart disease, or diabetes, or an ethnicity that predisposes you to this such as being African-American, or Asian, Hispanic, or Native American.
And very often people who are not overweight can have this. We call this being “skinny-fat.” So they’re under-lean but over-fat, and what this means is that you end up having the same metabolic traits as someone who’s fat, but look skinny. And you have all the same risks.
So what solutions do you believe in?
Really the solution has to be a three-part solution, which I outline in The Blood Sugar Solution. First is a personal plan for fixing your biology based on treating your body as a system, not all the different symptoms, and by treating the root causes of diabesity which is our diet, lifestyle environmental toxins, stress, and so on. The second is a plan for us to get healthy together. And the third is to take back our health as a society.
In every area of our life, health has been taken from us. For example in our homes, schools, workplaces, Facebook communities, in the media and democracy and our health care system; every area of our life our health has been taken from us. For example the food industry has hijacked our kitchens by replacing cooking with microwaving and factory-produced foods. Most people now spend more time watching cooking on television than actually cooking. Schools have deep fryers and microwaves that make it impossible to cook food that’s health-promoting for children. Or our health care system focuses on drugs and surgery, which has been proven not to work for many chronic diseases. So really we have to focus on everywhere we eat, live, work, play and pray to take back our health.
A lot of people debate over whether health is an issue of personal responsibility or whether we should play the blame game with food companies, media, government and so on. So who’s responsible?
I think there’s a real issue with the deflection of this problem onto personal responsibility. We have to take into account that industrial food is biologically addictive, and that we have an obesogenic environment that makes it either impossible or unsafe to do things that improve our health. For example it’s hard to exercise in certain neighborhoods, or there are food deserts where calories that are subsidized by the government to be cheap are high sugar, high trans-fat foods whereas fruits and vegetables are not subsidized or available. There’s hundreds of examples of where personal responsibility can only take you so far, and if you’re feeding kids Coca-Cola and they’re getting psorosis at five years old that’s no longer about personal responsibility, which I saw the other day. This is a more complex issue, it’s certainly about choice but it’s also about what our environment is like. I used to work in a hospital and I’d have to eat at McDonald’s because I worked in the ER and during my shifts the cafeteria wasn’t open, and when it was open the food was horrible…So it’s very difficult to survive in American culture by actually trying to find healthy options.
There’s so much controversy over whether you can reverse diabetes and even obesity, so what’s your stance on what’s possible to reverse through lifestyle change?
This isn’t a genetic condition: They’ve looked high and low for the obesity and diabetes gene and haven’t found it, because think about it: A hundred years ago there was no diabetes epidemic, very little heart disease or obesity. The Pima Indians were one of the healthiest populations on the planet a hundred years ago and now they’re the second most obese population in the world and 80% have diabetes. So we actually can ourselves into it, but we can also eat ourselves out of it. In fact a European study found that intensive dietary changes could mobilize blood sugar levels in one week; in 12 weeks it could heal the pancreas and liver in diabetics, and show no signs of diabetes. So these conditions are reversible, and as Benjamin Franklin said an ounce of prevention is worth a pound of cure, and some of these patients need a pound of cure but I have many patients who were on insulin who are no longer on insulin, people who were diabetic who are no longer diabetic. People say if you were diabetic once, aren’t you always diabetic? Well if you go back to eating sugar and soda, yeah. I could probably make myself diabetic if I ate a shitty enough diet!
People in medicine don’t see these kinds of results because they don’t know how to apply the levers of lifestyle in the right way.
Why is the idea that diabetes isn’t genetic so refuted in the media? Why are people like Paula Deen telling us that no one has proven a relationship between obesity and diabetes?
It’s just misinformation – it’s absolute absurdity. You know, Mark Twain said the problem with common sense is it’s not too common. How can we say that an eight or nine-fold increase in the prevalence of diabetes in the last 30-40 years could happen if it was genetic, and just an inevitable consequence of life? It’s just not. It’s clearly driven by food and lifestyle, and I think the evidence for that is overwhelming. In fact the New England Journal found that 93% of all diabetes can be prevented by lifestyle change.
It’s a completely false idea that this is a genetic problem and it’s just something that’s inevitable, in fact there are genetic predispositions but we’re triggering all the wrong genes by the diet we eat. The fundamental flaw here is it’s not just calories, it’s information. If you put in the wrong information, it’s gonna turn on the wrong genes. If you put in junk, you’re gonna get junk out. If you put in the right food you can upgrade your biological software, and beneficially effect thousands of genes by eating the right foods.
So what are some concrete things we can do?
There are a few simple things that are driving this that you can work on. we can all work on to work towards solving the problem. One is that you have to end your biological addiction to sugar and processed foods. I think that’s liberating and effecting. The average american has 53 gallons of soda, 150 pounds of sugar, 50 pounds of white flour a year. We know that one can of soda a day increases a woman’s risk of getting cancer by 82%. We know that two slices of whole wheat bread raises your blood sugar more than two tablespoons of table sugar. And we know that the high fructose corn syrup in processed food has adverse affects on the liver, which we now see in 70-90% of Americans. We know that the trans-fats which are in most processed foods still are causative agents in heart attacks, diabetes and cancer, and have been banned in some states. So we can’t ignore that. Eating real food is really important: real, fresh whole food in terms of fruits and vegetables, beans, nuts, grains, whole seeds, protein, good oils…Focusing on quality not quantity is critical. There’s a lot of ways to shift your diet from an industrial diet to a real food diet and that can make an enormous impact.