Too many patients, as documented in an on-line study of 12,000 individuals conducted by the American Thyroid Association published in June 2018, (https://doi.org/10.1089/thy.2017.0681) , complain of persistent symptoms of hypothyroidism despite what their doctors believe is successful treatment with levothyroxine (brands include Synthroid, Unithroid, Tirosent, Levoxl). We believe something needs to be done to resolve this conflict between patients and their doctors.
Imagine locking the family dog in a cage for a week with an endless supply of its favorite treats. What would you expect at the end of the week? It’s obvious, isn’t it? A fat and possibly very ill pooch.
Subject a human counterpart to similar conditions and expect the same thing to happen. Yet, unbelievably, there is a huge industry devoted to creating this kind of environment and we pay a fortune to support it. It’s called the cruise industry.
During summers thirty years ago in the New York metropolitan area, many of my parent’s friends spent their vacation time in the Catskills. The Catskills is an area of rolling hills and farms and at that time years ago also the scene of a vibrant hotel industry. Hot, tired and stressed New Yorker could eat and drink themselves silly for a week or two while feeling they were healthier for breathing the fresh, cool mountain air. Because the hotels were set in an apparent wilderness vacationers had no guilt about never moving their bodies outside the compound. Eating, “schmoozing” and taking in the nightly Borscht Belt entertainment were the only activities available.
Fast forward to the present. The Catskill hotels have been replaced by mammoth floating hotels called cruise ships. The original beauty of these ships as a method of refined transportation to Europe or the islands has been lost. In transforming from Borscht Belt hotel to gigantic cruise ship merely substitute ocean for mountains. Sequestered on board the ship with no risk of being required to move more than a few hundred steps in any direction, what else to do but consume what is constantly in your face…massive quantities of food and drink and passive entertainment.
It is my impression (supported by numerous studies) that the average weight of our population is growing steadily. Paralleling the phenomena of the growing size of the average person is the ever increasing size of the cruise ships. Last week the most obscenely massive cruise ship of them all made its debut in Florida. Oasis of the Seas is 40% bigger than the next largest cruise ship and 5 times bigger than the Titanic. Oasis of the Seas will confine together 6300 passengers and 2800 crew members. Despite its size, being alone on this ship will be like trying to find a quiet corner in Times Square on New Years Eve. Looking at the ship one wonders how something so big could float. It is oddly shaped, no sleekness to this vessel with more vertical than horizontal lines. Maybe we shouldn’t call it a boat, at all. In fact I would put it into a different category altogether…something I would call a “bloat” for being a really big, big, floating boat.
I am troubled by the existence of the ‘bloat’ because as the size of the population and cruise ships increases so has the incidence of diabetes. Since I treat diabetes as a profession, I get the feeling my job is increasingly hopeless as more and more of my patients jump on board the cruise craze. As cruising has become a generally accepted way of vacationing with a vast advertising budget glamorizing this lifestyle, my advice about diet and exercise is drowned out. Once on board, there are few people who could resist the urge to say, “I paid for this, so I might as well do what everyone else is doing”.
I expect more bloats to be commissioned in the future, each one a miracle of engineering and excess. If things continue in this direction we may wind up wiping ourselves out with metabolic diseases like diabetes, coronary disease and high blood pressure. In our wake we will leave behind colossal deserted monuments of our civilization, pyramids of the sea.