Weighing up the fat

Issue 76 January 2011

With obesity on a steady rise all around the globe, Dr. Noreen A Kassem looks at how the growing weight problem can be tackled through some simple lifestyle changes.

Obesity and excess weight gain has nearly doubled in the UK since the mid-1980s. More than 45% of men and 30% of women in the UK are overweight, while almost 17% of men and 20% of women are considered obese. These health conditions affect more individuals living in middle-class and lower socioeconomic neighborhoods and holds true across age, ethnicity and gender. This occurs because ‘empty’ calories – those that are filling but provide little nutritional value – are cheaper and calorie-dense. They include foods such as fizzy drinks, burgers, chips, crisps, kebabs and other processed and fast foods. Healthy and fresh foods are harder to find and actually cost more in lower income areas.

 In the USA, by 2020 half of all adults are predicted to have developed health conditions related to excess weight and obesity. The obesity epidemic has spread to less developed nations, where it almost entirely affects wealthy citizens, while the poor in these nations remain underweight and undernourished. This is true in countries such as India, Pakistan, Bangladesh, Egypt and Ethiopia. Weight trends for developing countries showed lower rates of obesity and excess weight, which increased as levels of education and income rose. However, obesity in these nations is still less common than in the richer west.

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Definition

In medical terms obesity is defined as having an excess amount body fat and is calculated using a ratio of height to weight, called the body mass index (BMI). Adults with a BMI of 30 or higher are diagnosed as obese, while a BMI of 40 or more is considered severe to morbid obesity.

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When to see a doctor

If you are overweight or obese, it is important to discuss healthcare options with your doctor. Obesity and excess weight can have several causes and even modest weight loss can improve your health outlook and reduce related problems.

Causes

Although there are hormonal and genetic influences that can lead to obesity and excess weight, it usually occurs because there is a greater calorie intake from food that is burned through normal daily activity. The excess fats and calories in foods are stored in the body as fat. Most individuals have a combination of factors that cause obesity. These include the following -

• Inactivity: Low physical activity caused by a sedentary lifestyle such as a desk-job, watching television, spending a lot of time on the internet, playing video games and not getting enough exercise burns fewer calories causing fat to accumulate in the body.

• Unhealthy Eating Habits: Consuming a diet high in calories such as snacks, fried foods, processed foods, fast foods and sugary foods adds excess weight. Other unhealthy eating habits that can lead to obesity or excess weight later in life include skipping breakfast, eating most of your calories in the evening or close to bedtime and consuming high-calorie drinks such as specialty lattes, energy drinks and fizzy drinks.

• Pregnancy: A woman gains weight naturally during pregnancy. However, after the birth of the baby some women find it difficult to lose the excess weight, which can lead to obesity. Breast-feeding the baby actually helps the mother lose this weight faster.

• Poor Sleeping Habits: Getting less than seven to eight hours sleep on most nights can cause hormonal changes in the body that decreases metabolism and energy levels and increases appetite, particularly for foods that are high in calories and carbohydrates.

• Health Problems: Some medical problems can increase the risk of weight gain and obesity. These include Cushing’s syndrome, polycystic ovary syndrome and thyroid problems. Conditions such as asthma, arthritis and knee pain can lead to decreased activity causing weight gain and worsening these health conditions.

• Medications: Some medications can cause unwanted side effects such as weight gain and patients on these drugs should be monitored regularly by the prescribing doctor. These medications include some diabetes medications, antidepressants, high blood pressure medications, steroids and anti-seizure medications.

• Genetics and Family: Your genes can affect the amount of stored body fat and where that fat is distributed in the body. Metabolism – how the body burns calories – is also affected by genetics.  Obesity and excess weight tends to run in families, but this may also be due to learned lifestyle and eating habits. Studies show that men who marry women that are more educated tend to have better health and lower levels of obesity and excess weight.

• Childhood Diet: Medical studies show the diet that a baby and child are fed can affect their risks of being overweight or obese later in life. These include high sugar, high fat and processed diets for children, and some baby milk formulas that are high in carbohydrates. Research published in the International Journal of Obesity used evidence from 11,000 individuals in the UK to show that diet and social class at the age of seven years affected their risk of obesity at 33. Mothers with higher levels of education tend to raise children that have healthier weight ranges. Breastfed babies are also thought to have lower risks of obesity and other diseases later in life.

• Age: Obesity can occur at any age, even in young children. However, it generally increases with age because adults have more hormonal changes and a less active lifestyle. Additionally, the body’s muscle mass decreases with age leading to a slower metabolism and faster weight gain. For this reason, doctors recommend decreasing calorie intake and changing the diet as you age.

• Social and economic issues: Certain social and economic issues are linked to obesity. This occurs because individuals with less income may lack financial means and access to exercise areas, healthier foods and education about health. Additionally, your social network affects your lifestyle and eating habits; you are more likely to exercise, play sports, and enjoy other healthy outdoor activities if you have friends that participate in these activities.

Risks of Obesity

Obesity is a serious health concern that drastically increases the risk of diseases such as type 2 diabetes, high blood pressure, high cholesterol, heart disease, and even certain cancers. Other health problems and symptoms related to obesity include - 

1. Insomnia or difficulty sleeping

2. Snoring and sleep apnea

3. Back pain

4. Joint pain and damage

5. Arthritis

6. Foot pain

7. Excess sweating and overheating

8. Rashes or infection in folds of the skin

9. Chest pain or shortness of breath with minor exertion

10. Daytime sleepiness or fatigue

11. Depression and loss of motivation

12. Disability and lower quality of life

13. Social isolation