Pointing the finger at fat as the major or sole contributor to contracting type 2 diabetes is misleading and wrongly promotes the idea that the condition is entirely self-induced, research at Flinders University has found.
Flinders public health researcher and medical anthropologist Dr Darlene McNaughton (pictured) has completed a project that investigated how diabetes is being presented in research and in the media, covering the past 15 years. She says that weight is increasingly being posited as the primary or sole cause of diabetes, and that this is a dangerous oversimplification.
"There is still a lot of uncertainty about the etiology of diabetes and there are a number of potential risk factors at play include ageing, gestational diabetes, genetics, under nutrition, poverty and family history, many of which are beyond individual control," Dr McNaughton said.
"Despite this, overweight and obesity are increasingly depicted not only as risk factors, but also as the central cause of the disease," she said.
"If you have two parents with diabetes then your likelihood of developing the condition is high, some suggest as high as 70 per cent."
In the past two decades – coinciding with assertions that we're in the midst of an obesity epidemic – is a rise in the idea that weight or fatness causes diabetes, when it is much more complicated than this. Indeed more often than not, a gain in weight is actually a symptom of diabetes.
"However, it is being promulgated in research, in the media, and generally, that weight, and obesity in particular, is driving diabetes rates up. This overemphasises weight and lifestyle and downplays those things that people can't control, like genetics or poverty."
Dr McNaughton said that research has demonstrated that obese people do have slightly higher rates of diabetes than people of ordinary weight.
"But at the same time, there are an awful lot of obese or overweight people who don't have diabetes and who never will, because it's more complicated than 'weight equals diabetes'," she said.
Conversely, Dr McNaughton said the presumption that weight generates diabetes means that people who are not overweight may think that they cannot contract diabetes, leading them to overlook symptoms that indicate the disease.
"And it is key that if you have diabetes that it is picked up early, to help avoid the very serious long-term complications that can occur, like blindness, kidney failure or amputations."
Dr McNaughton said while the general population does identify genetics as a factor, many people also attributed diabetes primarily to weight, including those with the condition.
"The dominant message that people with diabetes seem to be getting is 'you have done this to yourself because you are overweight or obese, as a result of an unhealthy lifestyle'," she said.
"This is very worrying."
People who are overweight or obese experience considerable negativity and judgement in Australia and, like people with diabetes, are frequently viewed as a drain on the health system.
"Such stigmatisation is almost always counterproductive in terms of seeking support for the treatment of type 2 diabetes", Dr McNaughton said.
"The last thing we want is a situation where people feel ashamed for a condition that has very complex causes that we still really don't understand, and are not seeking social or medical support."