Dr. A.T. Still Connected Overeating to Health Problems - by: Jason Haxton, MA, DO (h.c.)

The health concern alarm due to excessive weight and obesity in our population has been ringing for several decades and yet people keep gaining weight - not gaining on the problem of obesity.

It is understandable that society has changed. Technology, access to foods that are portable and less outdoor physical activity has moved us from a more active and physical job lifestyle and outdoor activities to a sedentary population. Think of an average day, most people spend a majority of their waking hours sitting or lying down. Whether it be at work on the computer or mobile phone, commuting by car or public transportation, watching shows, playing video games, spending time on social media, video phone visits much of one’s day is sedentary.  This coupled with a plethora of snack foods that are tasty but lacking in nutrition have Americans, and for that matter the world population expanding the average size by an extra 20 pounds. Excessive weight, fat (adipose tissue) has major physical health and mental health consequences. Excessive weight places the population at greater risk for mortality through cardiovascular diseases (20.1%), type 2 diabetes (15.2%), malignant tumors (10.8%), and liver diseases (7.6%) (Global Health Observatory, WHO 2020).

Has this past year’s lock down to slow the spread of Covid-19 changed anything? Americans' self-described weight remains roughly the same as last year with 41% saying they are overweight, similar to the 42% reporting this in 2019. Meanwhile, just over half (now 51%) continue to say their weight i about right, while a small percentage (6%) report being underweight.

The amount that Americans say they weigh also has not changed in 2020, averaging 181 pounds among all U.S. adults. But that is nearly 20 pounds higher than the average that men and women reported in 1990.  As Americans' actual weight has increased, so has their ideal weight. This might be due to a reluctance to describe themselves as overweight which creates the problem of not needing to lose weight.  That said, the percentage who would like to lose weight is unchanged, registering 55% each of the past two years. For some the challenge has been being even more sedentary while switching to remote work or school and struggled to avoid the temptations of overeating at home.   https://news.gallup.com/poll/328241/americans-average-weight-holds-steady-2020.aspx

In contrast to the generally negative view of “excess” body weight today, scholars note that fatness was regarded positively in the past, as it indicated either wealth or health, and often both (Green 1986; Stearns 1997). These accounts have been supported by research suggesting that fatness was widely valued in the nineteenth century, even becoming fashionable as an appearance ideal for women in the form of voluptuousness (Dinh 2012). While this bodily “plumpness” was indeed praised by the fashion world, it was also extolled by nineteenth-century physicians who associated a plump figure with good health.

However, Dr. Andrew Taylor Still, founder of the first school of Osteopathic Healthcare in 1892, had a very different and accurate take on plumpness - excessive weight. Dr. A.T. Still understood anatomy and how the body best functioned knew excessive food meant excessive energy that needed to be stored as fat and that was a problem for the body. His advice “Eat three conservative meals a day.  Do not be a glutton!   You can poison your system with too much food too often and of the wrong kind. 

Food is for energy only.  As the body uses same, it should be replaced.  When more food is added, you have cinders in your stomach and bowels.”  Dr. Still’s way of describing the excess energy - body fat -adipose tissue. He further noted in nature: “All long-lived birds and animals, that live on but few kinds of food, should be a lesson for man not to eat and drink till the body is so full that no blood-vessel can pass in any part of the chest or abdomen.  Let me eat quick and trot, and I will have health and strength.”- Dr. A.T. Still Autobiography, p. 447.                               

Dr. A.T. Still had it right. Current understanding of adipose tissue’s ability to secrete hormones, places a greater importance on the role of body fat-adipose tissue. White adipose tissue may represent the largest endocrine tissue of humans. Its pleiotropic nature is based on the ability of fat cells to secrete numerous hormones, growth factors, enzymes, cytokines, complement factors and matrix proteins. Adipose tissue also expresses receptors for most of these factors that are implicated in the regulation of many processes including food intake, energy expenditure, metabolism homeostasis, immunity and blood pressure homeostasis.  Too much adipose tissue is devastating to health.

Research shows a relationship between obesity and COVID‐19 disease severity - viral systemic spread, entry, and prolonged viral shedding in already “inflamed” adipose tissue may augment immune responses with consequences for cytokine cascade amplification.

Adipose tissue in control of metabolism   -  Journal of Endocrinology Authors: Liping Luo and Meilian Liu  December  2016 -- Link: https://joe.bioscientifica.com/view/journals/joe/231/3/R77.xml   and  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264526/

It is ironic that health issues caused by being overweight and sends a patient to the hospital also complicates a doctor’s ability to treat them in this unhealthy condition.