13 Weeks: Week 13 — in Which We Speculate
What if we looked at obesity and "Syndrome X" with fresh eyes?
February 2, 2013 - 1:00 pm
“… the history of 20th Century medicine includes several dramatic wrong turns and blind alleys. Many of them were based on ‘Freudian Analysis’, the 19th century pseudoscience that is, nonetheless, the direct ancestor of today’s psychiatric neurology. Under the influence of Freud and his contemporaries, there was a period of about fifty years in which physical illnesses like monoamine synaptic disorder (MSD), mesolimbic development disorder (MLDD), and chronic glucose-sensitive lipodystrophy (CGSL) were called ‘depression’, ‘schizophrenia’, and ‘obesity’ and ascribed to childhood trauma, parental neglect, or in the case of CGSL, simply as a character flaw.”
(From “The 20th Century Detour”, PJ Discovery, published 21130201T0000)
Imagine you are the apocryphal Drug Rep from Arcturus. You’ve heard through the grapevine that the Arcturan Chamber of Commerce plans to initiate First Contact, so you’ve come undercover (you miss your fifth and sixth finger but they’ll grow back) to see what the new market might offer. Through a peculiarity of Arcturan patent law, otherwise out of patent drugs can be re-patented in an emerging market, so new planets are big moneymakers. And you love your job — it’s perfect for a veterinarian who lost his license for rishathra.
Which really was unfair. You just really love animals. You ran into another Arcturan who’s here writing a cookbook, and that’s just wrong.
The key, as always, is to look for diseases that aren’t being effectively treated by the native savages’ own medicine men. And Earth has a doozy: a lipodystrophy that disrupts normal weight regulation, depositing fat in a stereotypical pattern that results in a characteristic fruit on a stick shape.
It’s not just a cosmetic issue, either. Humans with the disease have lots of other consequences — cardiovascular problems, disorders of blood-glucose regulation that lead to neurological problems, just a whole host of issues that cause victims of this degenerative syndrome to sicken and die earlier than their already short-lived contemporaries.
One night — night mail being so much cheaper — you message back to your husbands, wives, pod-mates, children, siblings, and clones.
“… what really crazy is that they do have the beginnings of science here, but they lose their science on the oddest things. This lipodystrophy I’ve been investigating — which would be a lot easier if the Chamber of commerce would just let me perform some experiments — is really widespread and causes immense suffering. But they can’t figure out the cause, so they blame it on a character flaw, something they call the ‘sin of gluttony.’
“So millions of the Earth natives die every year, and the best treatment they seem to offer is to shame the victims and complain that the problems caused by the lack of treatment of this chronic disease are expensive.”
We’ll leave our Arcturan for now — with his love of animals and predilection to rishathra, he has a date for the night anyway, and isn’t she in for a surprise? — and think about the issue he raises. He doesn’t have our human history, so he can look at this with fresh eyes, and he sees something peculiar. There are a couple of rather different populations: one of them regulates their body fat effectively and homeostatically, and the other group can’t.
If we look at it with fresh eyes too, we see this is a pretty significant disease. It kills millions through one mechanism or other related to the symptoms — heart failure, liver failure, diabetes, possibly even Alzheimer’s disease. It’s clearly what we would normally consider a disease, because we know there is a large population who don’t have it: the people who eat what they want and don’t develop the apple-on-a-stick body shape, or slowly lose their ability to regulate blood sugar.
If we forget the notion of shaming obesity and think of this as an actual disease, a syndrome, what would be the result?
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