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- Age
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- Buenos Aires, Argentina
- Medical Student
Show me where fat alone, minus any other normally associated markers (high BP, abnormal blood sugar, high cholesterol) is indicative of future disease. I'd love to see the study.
Overweight and obesity has been correlated with dislipidemia, Diabetes mellitus type two, and hypertension. And this would correlate well with the increased mortality from cardiovascular disease published in a Korean study from a couple of months ago in the NEJM which I have already referenced to.
A high BMI has also been associated with an increased mortality from cancer in the same study.
If all their numbers are fine other than the scale, and their habits are reasonably normal, what's wrong with telling them that they are healthy?
Might be just me, but I believing in preserving health, rather than fixing it when it "goes all wonky". It's better for the health system, and for the patient in the long run.
If they are among the fat people who eventually start getting wonky blood sugars or high BP, sure, nip it in the bud when it starts getting wonky or high and make sure they get it under control
Firstly, you assume, often quite wrongly, that the patient will continue coming in for regular check ups. If you keep telling a person, year after year, that they're healthy, they're going to stop going to the doctor. Chances are, you're going to miss it when their variables start "going wonky".
Secondly, we know that there is a correlation between BP, LDL, HDL and glycemia and the progression of atherosclerotic plaque. We know that atherosclerotic plaque begins to form in young adulthood. So your fat patient would obviously benefit from exercise and shedding weight, because if you lower LDL, increase HDL, lower BP and glycemia, the plaque will progress at a slower pace. If you wait 40 years to encourage them to lose weight and exercise, you're too late. First: because the plaque is there, happily progressing all these years. Secondly: because you can't teach an old dog new tricks, and lifestyle changes are going to be a lot harder from a 40 year old fat person than a 20 year old fat person.
What diet do you plan to use? Do you plan to add exercise as well?