By now we all know we’re too fat. It’s in all the media, and we see it at the mall, the airport, and in our closets. We know it raises the risk of many serious diseases, including several types of cancer as well as diabetes, hypertension, and heart disease. What we may not know is what it means for our ability to get good care.
I read a lot of sonograms, and that’s a good thing: ultrasound is noninvasive, not super costly, and free of harmful radiation. Even after years in practice, I still feel magic as images spring in real-time from a slender wand moved across an abdomen. How amazing, to see so much so quickly and with so little effort! It’s not a Star Trek tricorder, but it’s darn close.
These days, though, the degree of difficulty is increasing along with our collective waistlines. Ultrasound is great for thin people, but sound waves have trouble penetrating the abundant fat that more and more of us possess. This makes it hard to see what’s going on, and that’s not only frustrating, it can be downright dangerous. What you don’t know, it turns out, can indeed hurt you.
One such problem is accumulation of fat in the liver, which interferes with liver function but isn’t usually serious; in rare cases, it can lead to liver cancer. The fat in the liver, like the fat beneath the skin, resists the sound waves and masks what lies within. This condition, called ‘fatty infiltration,’ used to be uncommon, but now I see it several times a day. Too much fat also makes ultrasound in pregnancy more difficult, which can mean increased risk of complications. And obesity isn’t just an issue for ultrasound: it poses problems for all diagnostic imaging, x-rays to MRI.
Being obese or overweight is complicated, to be sure. But if you need more motivation to fight against it, think forward to a day when you might feel that wand on your stomach, struggling to see inside. You—and your doctor—will want answers, not uncertainty.
This essay aired on KQED-FM (88.5 in the SF bay area) on 5/25/2010 as part of its ‘Perspectives’ series. See their website for downloadable MP3. (program = perspectives; search = peggy hansen)