The Potbelly Syndrome

By Ron Hunninghake, M.D.

The Potbelly Syndrome (PBS) sounds like a rather quaint way to name such a vast and serious disease epidemic that is currently sweeping through the entirety of modern Western civilization much like the Black Plague, which engulfed medieval Europe. In America alone, some 68% of our population has been afflicted with this “potbelly plague,” leaving in its wake, not catastrophic infection or global death, but the even more daunting prospect of life-long disease, expensive debilitation, and the increased risk of premature death. Millions and millions of people are now PBS afflicted, with medical experts repeatedly making the looming prediction that our current sickness care system will soon be totally overwhelmed when the full devastation of this disease comes home to roost.

Unlike the terror of medieval plague, the initial stages of PBS may be innocently mistaken for a bad cold, or a persistent cough with a flu-like set of symptoms that are slow to clear. This is how the infecting bacteria that can cause PBS slowly but progressively invades the host’s immune cells, which then go on to spread the germ to all parts of the body. The combined effects of stress, lack of quality sleep, poor diet, toxic overload, and concurrent chronic viral infections, especially in males and older individuals, creates the weakened host conditions that this bacterial species seeks and thrives in.

After the initial phases of the illness, the infected individual will gradually (it can take years) notice a pervasive sense of fatigue setting in. Unexplained night sweats or generalized muscle aches may occur over time. Low-grade inflammatory symptoms ranging from strange new inhalant and food allergies, dry skin, irritable bowel—and a whole host of annoying and quality of life diminishing symptoms will inexorably begin to show up. But the hallmark symptom that seems to resist all forms of physical, medical, nutritional, and even psychological intervention is the notorious potbelly.

This potbelly is not due to subcutaneous fat that can be “crunched” away with intense calisthenics. This is visceral fat that is actually situated deep in the abdomen, surrounding the visceral organs. All manner of diets, contraptions, calisthenics, weight training, liposuction, and total body makeovers have been invoked to exorcise this demonic GUT! These intense efforts are often to no avail as numerous studies have repeatedly shown that a potbelly “loss” is inexorably followed by potbelly “regain” in over 90% of cases. The latest U.S. statistics bear this out: obese people now outnumber overweight people!

But why?

Obesity has historically been viewed by the medical profession as a food addiction disorder—often seen more as a mental illness that has taken on a physical form. More often than not, health professionals harbor the hidden belief that obesity is a character flaw or weakness. Besides amplifying the pervasive sense of helplessness and shame that afflicts so many overweight patients, these medical attitudes have done little to impact the nutritional, societal, cultural, and environment factors that make obesity so ubiquitous in our society today:

1. The universal availability of processed and packaged, cheap, high glycemic, non-whole foods that are low in both micro- and phyto-nutrients that we now know would otherwise help to modulate the body’s inflammatory system.

2. The shift from agricultural or blue-collar jobs requiring large amounts of physical exertion and calorie expenditure to a sedentary, overly mechanized, spectator and TV/computer monitor culture with very low calorie expenditures.

3. Changes in the family, the school, and the work culture—for example, consider today’s working mothers, who rarely have the time or energy to fix, let alone schedule, “a family meal together.” Instead, a bucket of fried chicken, mashed potatoes, and white flour biscuits are picked up on their way home from work.

4. The buildup of various xenobiotic herbicides and pesticides, endocrine-disrupting chemicals like plasticizers and toxic metals, and the “anti-nutrients” like fructose corn syrup solids and trans fats—these can occupy fat cells and contribute to the inflammatory cytokine signaling that perpetuates insulin resistance, metabolic syndrome, and other weight gaining disorders.

These inflammatory cytokines are the key to understanding the major underlying cause of therapy-resistant obesity: chronic low-grade infection serving as a perpetual stimulus to chronic inflammation, giving rise to a counter-regulatory adrenal mechanism that stimulates visceral fat. Whew! That’s a mouth full, and needs to be broken down step-by-step.

So, starting with the first step of this complex sequence of events…what are inflammatory cytokines?

Cytokines are cell-signaling proteins. Cytokines signal the inflammatory system to turn on when injury or infection occurs. Cytokines direct the white blood cells to the site of injury. Cytokines amplify the inflammatory response when the infection does not resolve. Unfortunately, these cytokines can also produce an exaggerated immune response, beyond what is needed to address the infection.  This can result in even more damage than the infecting organism if the cytokines continue to be produced in an unregulated manner (such as in auto-immune diseases like rheumatoid arthritis).

The body attempts to regulate excessive inflammation through the production of a stress-modulating hormone called cortisol, which is made by the adrenal glands. High levels of an important cytokine, C-reactive protein, trigger the gland to make more cortisol. (Be sure and ask your doctor to measure your personal C-reactive protein to assess your own risk for PBS.)

Cortisol is the body’s natural cortisone. Cortisone counter-regulates or modulates the pro-inflammatory effects of cytokines. When more cytokines like C-reactive protein are released, more cortisol is made to control the powerful and sometimes self-damaging effects of what can easily become an excessive inflammatory response to infection.

This is precisely what happens when an individual is infected with the germ currently thought to cause the potbelly syndrome: Chlamydophila pneumoniae—which is abbreviated CPN. CPN belongs to a class of germs sometimes referred to as middle-path germs. Germs can either kill the host or exist in a symbiotic relationship with the host, such as occurs with the friendly flora of the intestinal tract. Middle-path germs exist somewhere between these two extremes. They are smart enough to not immediately kill the host, but their tendency is to progressively infect cells,
slowly causing cellular dysfunction and disease, and thereby insidiously robbing the host of its inherent health.

Indeed, medical research has connected CPN to a long list of health-robbing conditions that slowly develop in the unsuspecting host:
Alzheimer’s disease
Kidney failure
Syndrome X
Giant cell arteritis
Immune suppression                                                                                                                                                                                                                                                                                                                      Lung Cancer

As the host gets progressively sicker, stress levels increase. In a futile attempt to regulate the mounting inflammation and stress, more and more cortisol is pumped out by the sick host’s adrenal glands. The result is a kind of mini-Cushing’s Syndrome—a disease produced by a benign tumor in the adrenal gland that over-secretes cortisol. It is characterized by weight gain, central obesity, fatigue, diabetes, depression, insomnia, and even psychosis, to name just a few of the more salient symptoms of this syndrome.

PBS closely resembles Cushing’s Syndrome and has been described as Metabolic Syndrome X + chronic low-grade hypercortisolism. Take the increasing waistline, high blood pressure, high serum glucose, and high blood lipids of Syndrome X…add some stress and a middle-path germ and…presto! You’ve got The Potbelly Syndrome!

The temptation is to run to the pharmacy for an antibiotic to kill the CPN germ. There are protocols at that will steer you in this direction. This is like spraying for mosquitoes…without draining the swamp. Attacking the germ without addressing the host susceptibility issues is only half the battle.

At the time of this writing, there is no proven therapy for PBS. The author, having been quite ill this winter for the first time in 20 years, suspects that he, too, was afflicted with a middle-path germ. Rather than using antibiotics, high dose vitamin C (40-60 grams orally per day!) was successfully utilized to neutralize the infection, restore adrenal balance, and get this victim back to work! In the process, he lost 18 pounds…and part of his early-stage potbelly. Now he’s fighting to keep it off.