By Doris Obinna
Obesity is a condition in which excess amounts of fat accumulate in the body and can be harmful to one’s health. A global report by various organisations of the United Nations, The State of Food Security and Nutrition in the World 2020, found a staggering increase in the number of obese persons. World over, 650 million people over 18 years of age are obese.
In order to spread awareness on this condition by aspiring to tackle the root of the problem, World Obesity Day is observed every year on March 4 to help create a better future.
This year’s World Obesity Day had the theme “Every Body Needs Everybody.” According to WHO, obesity is not just an issue of weight, it is a disease. “People with obesity need respect, care, protection and policy change,” WHO stated that everybody should come together to drive change.
WHO, on this occasion, released a report titled “COVID-19 and Obesity: The 2021 Atlas.” The report addresses the issue of a high risk of death due to COVID-19 in people with obesity. It adds that not just COVID-19 but conditions involving respiratory viruses adversely affect people with obesity more.
According to Centers for Disease Control and Prevention (CDC), obesity does not occur in isolation and usually brings with itself a host of other complications. In women of reproductive age, obesity can increase the risk of conditions like polycystic ovary syndrome (PCOS) and diabetes, hence, affecting fertility. “PCOS, a common endocrine (hormonal) disorder among women of childbearing age is characterised by the presence of high male hormones called androgens, irregular menses (oligomenorrhea), dysfunctional ovaries, as well as the presence of cysts in one or both ovaries.
“About one in five women of reproductive age are believed to be afflicted with PCOS. Diabetes, on the other hand, is caused when a simple carbohydrate called glucose is not metabolised properly in the body.”
“Women with a BMI that reads obese are more prone to developing PCOS and diabetes. Both conditions have a fundamental aspect in common – insulin resistance. PCOS, in fact, can be a precursor to type 2 diabetes for this reason. Type 2 diabetes is caused when the cells of the body are unable to utilise insulin, that is, enough insulin may be produced but it cannot break down glucose.
“This resistance to insulin shoots up the levels of androgens in women, wreaking havoc on the hormonal balance in women. Those people diagnosed with PCOS and diabetes who are not physically active, have poor dietary consumption, and lead a stressful life further risk their health.
“All activities in the human body can be found in a cascade – one associated with another. Due to the similar functions of the body that are affected by these conditions, it is no surprise that they have been found to have an impact on the fertility of women as well. Ovaries comprise ova or eggs; one is released each month during ovulation in a bid to be fertilised. In PCOS, ovaries may have single to multiple cysts which cause the androgen levels to shoot up. This does not allow the menstrual cycle to occur as usual.
“Furthermore, it can lead to reduced quality of eggs and erratic ovulation, therefore, compromising on women’s ability to conceive naturally. It is known that women have a limited reproductive window between the start of their menses and its cessation. Diabetes can impact this duration by delaying menarche and hastening menopause – this decreases the window by 17 per cent. It also expedites ovarian ageing leading to deteriorated egg quality and hence, decreasing the chances of pregnancies and increasing the possibility of miscarriage and stillbirth.
“Diabetic women may observe oligomenorrhea and/or absent menstruation (secondary amenorrhea), affecting their ability to successfully conceive. These are all essential elements of what makes the female reproductive system functional, and hence, such aberrations impact their fertility. However, it must be noted that a couple’s infertility can be due to health conditions in both men and women,” state a CDC report.
Explaining further, a Lagos-based doctor, Sunday Olakekan, defined obesity as a body mass index (BMI) and further evaluated in terms of fat distribution via the waist hip ratio and total cardiovascular risk factors. Body mass index is closely related to both percentage body fat and total body fat.
The World Health Organisation (WHO) predicts that overweight and obesity may soon replace more traditional public health concerns such as under nutrition and infectious diseases as the most significant cause of poor health. Obesity is a public health and policy problem because of its prevalence, costs, and health effects.
He said: “Weight gain or obese occurs when you eat more calories than your body uses up. If the food you eat provides more calories than your body needs, the excess is converted to fat. Initially, fat cells increase in size. When they can no longer expand, they increase in number. If you lose weight, the size of the fat cells decreases, but the number of cells does not.”
Highlighting some of the causes, Olalekan said, the reasons for the imbalance between calorie intake and consumption vary by individual. Your age, gender, genes, psychological makeup, and environmental factors all may contribute.
“Genes, your genes may play a role in efficiency of metabolism and storage and distribution of body fat; family lifestyle, obesity tends to run in families. This is caused both by genes and by shared diet and lifestyle habits. If one of your parents is obese, you have a higher risk of being obese and emotions, some people overeat because of depression, hopelessness, anger, boredom, and many other reasons that have nothing to do with hunger. This doesn’t mean that overweight and obese people have more emotional problems than other people. It just means that their feelings influence their eating habits, causing them to overeat.
“Again, environmental factors, which is the most important environmental factor is lifestyle. Your eating habits and activity level are partly learned from the people around you. Overeating and sedentary habits (inactivity) are the most important risk factors for obesity; sex, men have more muscle than women, on average. Because muscle burns more calories than other types of tissue, men use more calories than women, even at rest. Thus, women are more likely than men to gain weight with the same calorie intake.
“While age, people tend to lose muscle and gain fat as they age. Their metabolism also slows somewhat. Both of these lower their calorie requirements; pregnancy, women tend to weigh an average of 4 to 6 pounds more after a pregnancy than they did before the pregnancy. This can compound with each pregnancy.”
“Certain medical conditions and medications like; Cushing syndrome, depression, antidepressants, birth control pills and polycystic ovarian syndrome can cause or promote obesity, although these are much less common causes of obesity than overeating and inactivity.
“Obesity can be associated with other eating disorders, such as binge eating or bulimia. The distribution of your body fat also plays a role in determining your risk of obesity-related health problems. There are at least two different kinds of body fat. Studies conducted in Scandinavia have shown that excess body fat distributed around the waist (“apple”-shaped figure, intra-abdominal fat) carries more risk than fat distributed on the hips and thighs (“pear” shaped figure, fat under the skin),” he added.
Overweight and obesity-related health challenges in adults
A research shows that in coronary heart disease; as your body mass index rises, so does your risk for coronary heart disease (CHD). Coronary heart disease is a condition in which a waxy substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.
Plaque can narrow or block the coronary arteries and reduce blood flow to the heart muscle
Also according to WHO, obesity also can lead to heart failure. This is a serious condition in which your heart can’t pump enough blood to meet your body’s needs. “High blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways. Your chances of having high blood pressure are greater if you are overweight or obese.
“Being overweight or obese can lead to a buildup of plaque in your arteries. Eventually, an area of plaque can rupture, causing a blood clot to form.”
Prevention and treatment
According to Olalekan, while some of the diseases that ail humans can be due to genes, some can also be traced to the way we lead our lives. In addition to genetic endowments, obesity, PCOS and diabetes can also have lifestyle attributes. “Women, who wish to circumvent these conditions and attain motherhood in the future, must first and foremost, adopt healthy lifestyle practices.
“A balanced diet comprising adequate quantities of proteins, unsaturated fats, whole grains, fresh fruits and vegetables, greens, and topped off with good quantities of water is important.
Regular physical activities will help to shed the additional kilos while also burning off excess calories. These measures not only enable one to keep the body fit, but also the mind.
“If planning for a pregnancy, it is advisable to consult a doctor who can detect in advance and treat many conditions that impact fertility.
This can include exhaustive diet charts beyond what is traditionally considered healthy, workout or yoga suggestions, and even medication. Such interventions are key to addressing hormone imbalances in the body and reducing the risk for obesity, PCOS, and diabetes. It is imperative that aspiring parents are healthy first, and then secure a healthy future for their children.”