Health: What causes cancer in obese people?

What decreases the risk of cancer? A colonoscopy detects polyps before they become malignant. Also, a rapid response to unusual bleeding, a cough that lasts a few weeks, or a suspicious mole. But a report funded by The Canadian Cancer Society now links excess weight to the development of several types of cancer. So what is it about obesity that triggers malignancy? And what to do about it?

For years health authorities have labelled obesity a health hazard. The reason is that it often leads to Type 2 diabetes, then later to heart attack. But now, researchers claim that excess weight will soon be the second leading cause of cancer, just behind tobacco. Sadly, being overweight has not received the attention it deserves when 60 percent of North Americans are obese.

For doctors this news is not a surprise as several types of malignancy have been linked to excess weight for years. But this new study will generate public awareness that the epidemic of obesity is becoming statistically significant.

Researchers at The National Cancer Institute believe that obese people suffer from chronic low-level inflammation. This condition over a period of time causes DNA damage that eventually leads to malignancy.

But why do obese patients develop chronic inflammation? It’s because they are more likely to suffer from a number of diseases that set the stage for this condition.

For example, obese patients are more likely to develop gallstones. The smaller stones can easily enter the small duct that drains bile from the gall bladder. This results in severe pain and the need for an emergency operation. But we also see patients who have had silent gallstones for years. In these cases, the best treatment may be to do nothing. But silent stones are not so silent when they cause chronic inflammation of the gallbladder wall and eventually cancer.

Chronic heartburn, following a heavy meal, often forces irritating gastric juices into the lower end of the esophagus (food tube). This is also more common in obese people and repeated attacks of heartburn cause inflammation and may set the stage for a precancerous lesion, finally leading to esophageal cancer.

But inflammation is not the whole story. For example, obese women are two to four times more likely to develop uterine cancer. And very obese women are seven times more likely to develop it. The answer here is that fatty tissue in overweight women produces increasing amounts of the female hormone estrogen which has also been linked to ovarian and breast cancer. Fat cells also produce adipokines, hormones that, with increasing body fat, have the ability to stimulate cell growth.

Looking at the overall picture, overweight people are twice as likely to develop liver, stomach, kidney, pancreatic, thyroid, large bowel and brain malignancy. So, this Cancer Society report should be a wakeup call that obesity must be added to the list of health problems associated with malignancy.

For years I’ve proposed that obesity is today’s number one health problem. Decades ago, when I wrote the book, “Medical Survival”, the formula I suggested was EP = A + D (extra pounds = atherosclerosis and diabetes). It was on the cover of the book. History has now proven this to be true.

Obesity is the result of several factors. Genetics plays a role. But by far the larger factor is the huge change in lifestyle. Too many adults use the car rather than their legs for short distances. Children are getting less exercise in playgrounds and few walk to school. There’s also been a huge change in dietary habits with increasing reliance on packaged foods loaded with salt, sugar and other calories.

Consumers must realize that food companies and the government cannot protect them from themselves. The only solution is to become an educated consumer. Start checking the number of calories on packaged foods. Say no to fancy desserts and second helpings. Remember the journey of a thousand miles begins with the first step. And the first step should be to step on a scale daily so there are no surprises.

Dr. W. Gifford-Jones can be reached at

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