Well, then it isn’t a disease! I may certainly cause some diseases, but it isn’t a disease in itself.
Given that one of the primary causes of hypothyroidism is an autoimmune disease called Hashimoto’s Thyroiditis and its causes are unknown, I’d say that it’s entirely possible that a smaller percentage of the population suffered from it, and something in our environment that’s changed over the last 50 years has led to increased incidence.
Also, according to webmd, “[s]ome medications can interfere with normal production of thyroid hormone. Lithium carbonate, a medication used to treat people with bipolar disorder, is one of the most common medications that causes hypothyroidism. Others include amiodarone hydrochloride (such as Amiodarone, Cordarone, and Pacerone) and interferon-alfa (such as Infergen, Rebetron, and Wellferon).” If there has been an increase in the dispensing of these medications, it would follow that there has been an increase in the incidence of associated hypothyroidism.
In addition, it says that as many as “1 in 4,000 infants is born without a properly functioning thyroid gland. All children born in a hospital in the United States are tested for hypothyroidism at birth.” Since there are more children being born now than there were 50 years ago, this would also make sense as an answer as to why there are more hypothyroid patients now than there were then.
Also, “[p]regnancy, which requires an increased production of thyroid hormone, can cause hypothyroidism. About 3% of pregnant women in the United States develop hypothyroidism.” Consider the natural rise in population numbers over the last 50 years. Recall the “Baby Boomers” era. Do the math.
There seems to be any number of reasons that hypothyroidism may indeed be more prevelant in today’s society than it was 50 years ago.
Main Entry: ill·ness
Pronunciation: 'il-n&s
Function: noun
1 obsolete a : WICKEDNESS b : UNPLEASANTNESS
2 a : an unhealthy condition of body or mind b : SICKNESS 2
I think you’re right about that. If you’re particularly active, BMI probably won’t provide you that accurate a measurement for your body fat. My “official” BMI is 28, which puts me well into the overweight category, nudging close to obesity. In fact, I weigh 185 pouds and am 5’9." However, I also work out about 6-7 days per week for one to two hours per workout and wear a size 10-12 pant. My doctor indicates that I am not overweight, and that the number 28 is essentially meaningless when comparing my fat to muscle ratio.
Here’s a link to an MSN article on BMI:
Body Fat Measurement. It looks like even the medical community hasn’t completely decided. Still, considering that many Americans are quite sedentary, BMI, while probably not the most accurate measurement, might still be a useful tool in determining whether or not you need to lose weight. Like I said earlier - it really depends upon your level of activity, whether you’re very muscular, etc.
It might also be that medical conditions for obesity were present 50 years ago, but the social ones weren’t.
No, it’s not that simple. It’s not a matter of “suddenly developing an obesity gene,” but the effects of our contemporary diet on our prehistoric bodies. Humans evolved on the grasslands of the African continent, where our ancestors had to find sufficient calories to sustain the large energy expenditures associated with a hunter/gather lifestyle. We have evolved to crave fat and sugar, which was fine when those tastes helped our ancestors find high-calorie foods to help them sustain their high metabolism, but in our modern world, where we can easily satisfy our caveman cravings with calorie-packed foods but with much lower energy deficits, the result is that we become obese.
An example of this can be found in the Tohono O’odham Indians of Arizona, who showed no instances of obesity prior to the 1940s, but who, in the advent of high-calorie foods, now have a 70 percent rate of obesity with correspondingly high levels of heart disease and diabetes. Across the Mexican border, tribe members eat lower-fat diets and work in energy-intensive farm labor, don’t suffer from these health problems.
Living in the developed world insulates us from the hard work and deprivation that much of the world suffers from, but at the same time we pay for that by the betrayal of our prehistoric metabolism that store fat easily and give it up grudgingly.
In any event, laying censure and blame of obese people is cruel and judgmental, so knock it off.
For further reading:
“Food For Thought,” Scientific American, December 2002.
Um, that would be 27.3.
As I said, it’s one of many metrics used. It’s a useful number to know, but you can’t take it as a sole data point. If you have a 30 inch waist and bulging muscles, you’d have take the numbers with a grain of salt, and maybe an extra slice of cake.
IMO, obesity is not a disease. “Disease” is defined as “A pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms.” (Dictionary.com) Obesity is a condition – specifically, the condition of being significantly overweight – and it can and does lead to a whole host of diseases. I’m not sure why anyone, fat or not, would care whether it is called a disease or not, but IMO it does not meet the definition, nor the common social perception of what we mean when we say someone has a disease.
I don’t think we are required to blame obese people for their condition, or to refrain from helping them, simply by acknowledging that a significant component of that condition is, in the vast majority of cases, volitional action. There’s no judgment attached to this, but it is an uncontestable fact. So my chief concern with categorizing obesity as a disease is that by doing so, there will be a tendency to ignore the volitional component and overlook the healthiest treatments (in the majority of cases), which are diet and exercise, in favor of drugs and surgery, because drugs and surgery are how we treat disease in the West.
The volitional component of obesity is also why I can see why a person suffering from an actual disease, without an immediate volitional component, would find it obnoxious to hear obese people complaining about their “disease.” I have had a serious disease and I have been (and am) overweight. My experience of the two is nothing alike and, when I was sick, I would not have appreciated having my illness analogized to obesity. On the flip side of that same coin: I can also see why overweight people would not want to have to listen to how “diseased” they are. PHOUKA may be comforted to understand her condition in the terms of “disease;” others might not be. She does not appreciate people telling her she doesn’t have a disease; it seems reasonable for her to understand that some others would not appreciate her telling them they do.
Thanks for the correction - last time I went to the doctor, he measured my BMI for me, but I hadn’t actually done the calculation myself.
As for muscles, mine certainly aren’t bulging, but my waist is about 31 inches. So what about that cake - what kind did you say it was? 
Shayna, the problem with getting second hand information, such as from the URL you provided, is that it is often a custard doughnut’s throw from the truth. In the study you cited [Canaris et al. (2000) The Colorado thyroid disease prevalance study. Arch Intern Med 160, 526-534], the incidence of clinical hypothyroidism was actually 0.4%. Another 9% had subclinical hypothyroidism. It was also the case that hypothyroidism (clinical plus subclinical) remained at a level of c. 6% for men below the ages of 65. For women, the incidence of hypothyroidism only exceeded 6% for age groups 45 and above.
And a question remains - of those people with (subclinical or clinical) hypothyroidism, what proportion actually suffer from obesity? Or, to what extent might hypothroidism actually be a factor in obesity?
Some of these issues are addressed by Krotkiewski (2002) [DOI: doi:10.1016/S0014-2999(02)01420-6], some salient points emerging being:
Hypothyroid patients weight in at an average of 15-30% above baseline. However, after they are restored to a euthyroid state, overweight still occurs in, on average, 7-17% of individuals.
He also notes that:
“TSH secretion abnormalities may also be secondary, as indicated by findings that nutritional factors such as protein intake or postabsorptive protein oxidation can modulate the concentration of TSH. Therefore, the most probable explanation for the different TSH pattern in obesity is the effect of leptin and other neuropeptides on TSH-releasing hormone (TRH) (Buscemi et al., 1997).”
Which suggests that at least some thyroid abnormalities may arise through obseity, rather than vice versa.
There is a study that considers directly obesity and hypothyroidism (Murakami & Kato, 2003 - link ). In this case, approximately 30% of hypothyroid sufferers were classified as obese.
So, my warrant was reasonable, I think: If we consider the 35% of obese Americans, and the c.60% of overweight Americans, then less than 10% of these are expected to suffer from hypothyroidism, and perhaps in 30% of these cases we might expect hypothyroidism and overweight to co-occur.
Feel free to point out where I said that, and feel free to prove I feel that at your leisure. I believe that the problem mostly lies where personal responsibility and the society of plenty meet. Unless you can provide evidence to the contrary, I will continue to suggest that most people are exercising bad choices, rather than ‘ill’ and thus unable to make good choices.
Most likely it’s due to some combination of changes, including social, medical and environmental. I’m not a doctor or a research scientist, so I’m unqualified to guess. All I can tell you is that there are tens of millions of people suffering from an inadequately functioning thryoid, which is one medical cause that can lead to obesity. All that’s meant to do is counter those who keep saying they don’t believe that there are large numbers of overweight people who are that way due to a genuine medical condition, not interpret why or how this disease has increased over the last 50 years.
Some people are overweight because they don’t eat well and don’t exercise.
Some people are overweight in spite of eating well and exercising.
It’s really rude to tell people to shut their mouths and move more and they’d be less fat. It simply doesn’t work that way for millions of people.
Ah, from here:
(Emphasis mine)
The American lifestyle and diet has a lot to do with it. I’m only one data point, so take my anecdotal evidence with a grain of salt. I lived in Europe for the last 6 years. In my time there, without dieting or anything, my weight went down from 185 to 170. I returned to the US in November, and was amazed to find that when I weight myself two days ago, I rocketed up to almost 195.
The difference I notice is this: Junk food is everywhere here, restaurant portions are ridiculously huge, and I hardly walk anywhere anymore. Since I mostly cook for myself, the main reason for my weight gain is the sudden (relatively) sedentary lifestyle. While I do believe there are genetic causes to obesity, I think for the vast majority of the American population, it’s a result of lifestyle.
Budapest was just like Paris. Almost every girl was a size 4 and hot. It was incredible. You just don’t see anywhere near as high a percentage of obese people in continental European cities as you do in America. The reason must be more to do with environment and lifestyle than genetics.
Carrot. And it’s fat free, sugar free, and carb free. And crunchy. 
One thing I love about this board is that I can always learn something new every day. Want to know what I learned today? That I should be spending more time in Paris and Budapest.
My same experience. I see people walking and biking. Pre-packaged and fast food is not that prevalent and apparently people care more about their appearance (if the care as much about their health I can’t say, having seen way too many people smoking).
While I hesitate to call it a “disease” in the same sense that cancer is a disease, I know it’s more than just a state of being.
What some of you who are calling us fat and lazy lack is understanding (and compassion, I might add.) You have absolutely NO idea apparently, what the mental state of the obese is. And, oh, how easy it is for you to say, “Well, just lose the weight and you’ll feel better about yourself!” Well, newsflash, guys–it’s not always the extra pounds affecting self-esteem, but rather, self-esteem that affects weight gain!
Someone like me who had few friends growing up can indeed find comfort in food. Chocolate cake and ice cream really do seem to find the hurting place inside and soothe it. This, of course, leads to weight gain, which causes more pain, which leads to more chocolate cake and ice cream, and so it goes, on and on. And it’s not only the desserts, but the fatty foods that reach down into the hurt and cover it.
And there have been times that I’ve used food to punish myself as well. In self-hatred for my physical condition, I’ve said, “Well, fine, just eat all you can hold–you don’t deserve any better, anyway!”
Food is the disloyal friend that makes you feel better for a while, then stabs you in the back. It smiles and beckons, then later makes a fool out of you. It is your closest confidant, your worst enemy, and you feel helpless before it. It begins to control you. Now you are an addict, and like any addict, you hide your slavery to it. You eat mostly in secret–the squirrelled-away candy bars, the rest of that to-go order that the fast food worker would think was for your family, but was really your late-night snack after everyone else was in bed. The results are open and obvious, but your shame is such that you try not to let others actually SEE you overeat.
And exercise?? Where someone might see you??? Not a chance. And tapes at home are difficult (for the VERY overweight, like me), and they soon become boring (who wants to be bored AND extremely uncomfortable for 30 minutes?). And even then, all alone, you’re embarrassed by your body, so that you don’t like to do exercises that make you feel ugly and clumsy.
I don’t say all this to try to prove that we can do nothing about our problem. I am fighting the good fight (and have lost about 35 pounds, with more than 100 left to lose) on a daily basis. I was on the verge of having the surgery (and with five abdominal surgeries in 10 years under my belt [har!], please understand that this was no easy, quick-fix option), when I learned about the Weight Watchers Flex Point plan. But I just want to point out that you’re not being fair in minimizing the devastation of obesity. It isn’t fair to simply reduce it to being a character flaw!
As a practical matter, classifying obesity as an illness opens the door for treatment, which may include drugs and surgery, but just as well may include (and I expect to eventually see these required before drugs and surgery are authorized for payment) nutrition counseling, psychological counseling, and fitness/physical therapy, to name a few options.
I don’t have a problem with that. I’d far rather see my tax dollars helping someone learn proper eating habits or dealing with psychological problems that cause overeating than to have to pay for their heart attack later in life because they didn’t have the money to pay for help with their obesity before health problems began. Sure, there’s no guarantee that such treatment will work, but then there’s no guarantee that chemotherapy for a cancer patient will work either. In either case, if I’m paying for it via my tax dollars, I’d rather give the individual assistance and a real fighting chance rather than stand back and watch the trainwreck.
I’ve heard that, and it’s a matter of gravel concern if true, but AFAIK there’s not any concrete evidence one way or t’other.
I’m on this trainwreck myself. I went with an undiagnosed hypothyroid condition for 15 years. (I’m 25). After puberty, I started to put on weight, which made my thyroid worse, which caused more weight gain, which led to self-esteem issues which caused more weight gain… and on and on. The initial weight gain was encouraged because I was a painfully skinny child. My hip and collar bones stuck out like I never ate. So, when I did put on weight, I was encouraged by everyone at how healthy I looked. Etc, etc.
I’ll fully admit I don’t get enough exercise. I play softball once a week (second base) and I’ve started walking every day. It’s hard as hell, and if classifying obesity as a disease helps even one person go to their doctor and ask for help, then it needs to be done.