There’s an uncomfortable truth for many individuals to face regarding their health. Rates of obesity in the USA have increased by an average total of 15% since 1990. In the majority of states more than 25% of the entire population is obese. In many more rural states these numbers regularly exceed 35%. These climbing rates affect a whole host of health issues and have been directly linked to exceptionally slow mortality improvement when compared to other western nations.
America, this is a wake up call. You’re too fat.
Talking about weight issues is a complex and dicey proposition. It involves acknowledging human emotions, combating negative and hurtful social stigmas, and risking insult to the person in question. As a society, we have trended away from confrontation over weight issues and towards acceptance, and even celebration. While fat-shaming is counter-productive and inhumane, it is likewise so to go to the other extreme.
If you saw someone you knew bloodied and battered, or looking gravely ill, you wouldn’t pretend not to notice and especially not tell them that they look great. On the other hand, you also wouldn’t rush to judge them for being sick or injured. You’d compassionately do what you could to help them, including telling them that they appeared ill or injured. Yet social awareness campaigns dealing with the overweight have been focused around “fat acceptance” and body positivity. While these goals are worthy as far as mental health is concerned, they are self-destructive to the reality of body health.
The statistics around obesity and the many diseases and conditions that are directly tied to it do not lie. Globally, rates of NAFLD are above 24%. That’s over 1.8 billion people. Recent studies have shown rates of progression from NAFLD to NASH and eventually fibrosis as high as 44%. That’s 800 million people. In the USA alone, one third of the population or nearly 100 million people has NAFLD, with estimates of NASH prevalence as high as 30 million people. And most people have no idea that they have either condition. We must find properly sensitive yet factual ways to address obesity and increase awareness of these dangers.
If you are here seeking out information and reading this blog, it means that you are more educated and aware than the average person regarding the dangers of fatty liver disease and NASH in particular. With knowledge comes responsibility. If friends or loved ones are chronically overweight talk to them. While there are a plethora of risks without even addressing liver disease, there is a lot more information and treatments available for the majority of them. Even massive heart attacks can be survived today with emergency bypass surgeries and the risks mitigated through pro-active medication. Late stage NASH leads to sudden and usually completely unexpected liver failure, and there are currently no real treatment options outside of a full liver transplant. And while recent research has demonstrated that NASH can be more severe based on genetic modifiers, no genetic precursors are necessary for the disease to advance. What that means is that everyone is susceptible to NASH.
The hard truths cannot be denied. If you have been overweight for a significant amount of time, you likely already have some form of NAFLD. Even mildly obese individuals can progress to advanced NASH and fibrosis in as little as six years. The only solution is to take action to reduce weight, through healthier lifestyle choices.