By Doris Obinna
A time was when fat people were thought to be more healthy. Owing to their mass of flesh, they were considered to be enjoying life, which showed in their size. But times have changed. Being too fat is actually a problem. It is a health concern.
To be sure, battling weight issues or obesity is an issue. In such a state, food becomes both friend and foe. You cannot live without it and living with it is a problem.
Obesity is a leading preventable cause of death worldwide, with increasing rates in adults and children. It is a medical condition in which excess body fat has accumulated, to the extent that it may have a negative effect on health, leading to reduced life expectancy and/or increased health problems.
According to the Center for Disease Control, in United States, from 2011 to 2014, the incidence of obesity was just over 36 per cent in adults and 17 per cent in youth. The rate of obesity was higher in women, with 38.3 per cent than in men, with 34.3 per cent.
Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis. It is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes endocrine disorders, medications or psychiatric illness.
Evidence to support the view that some obese people eat little, yet gain weight due to a slow metabolism is limited. On average, obese people have greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body mass.
According to a specialist, Dr. Sunday Olakekan, obesity is defined by 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.
Weight gain or obese occurs when you eat more calories than your body uses. 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.
Obesity, however, has many causes. 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.
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.
Environmental factors: The most important environmental factor is lifestyle. Your eating habits and activity level are partly learnt 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.
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 and health issue: 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).
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
Heart failure, high blood pressure and stroke
Obesity can also lead to heart failure. This is a serious condition in which your heart can’t pump enough blood to meet your body’s needs
The blood pressure also plays a role. 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.
If the clot is close to your brain, it can block the flow of blood and oxygen to your brain and cause a stroke. The risk of having a stroke rises as BMI increases.
Type 2 diabetes
Diabetes is a disease in which the body’s blood glucose, or blood sugar level is too high. Normally, the body breaks down food into glucose and then carries it to cells throughout the body. The cells use a hormone called insulin to turn the glucose into energy.
In type 2 diabetes, the body’s cells do not use insulin properly. At first, the body reacts by making more insulin. Over time, however, the body can’t make enough insulin to control its blood sugar level.
Diabetes is a leading cause of early death, CHD, stroke, kidney disease, and blindness. Most people who have type 2 diabetes are overweight.
Abnormal blood fats
If you are overweight or obese, you are at increased risk of having abnormal levels of blood fats. These include high levels of triglycerides and LDL (“bad”) cholesterol and low levels of HDL (“good”) cholesterol.
Abnormal levels of these blood fats are a risk factor for CHD.
Lack of energy balance
A lack of energy balance most often causes overweight and obesity. Energy balance means that your energy IN equals your energy OUT.
Energy IN is the amount of energy or calories you get from food and drinks. Energy OUT is the amount of energy your body uses for things like breathing, digesting, and being physically active.
To maintain a healthy weight, your energy IN and OUT don’t have to balance exactly every day. It’s the balance over time that helps you maintain a healthy weight.
Treatment and drugs
According to Olalekan, the goal of obesity treatment is to reach and stay at a healthy weight. The initial treatment goal is usually a modest weight loss, three to five per cent of your total weight. That means that if you weigh 200 pounds (91 kg) and are obese by BMI standards, you would need to lose only about six to 10 pounds (2.7 to 4.5 kg) for your health to begin to improve. However, the more weight you lose, the greater the benefits.
“All weight-loss programmes require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your level of obesity, your overall health and your willingness to participate in your weight-loss plan,” he stated.
Keep in mind, though, that weight-loss medication is meant to be used along with diet, exercise and behaviour changes, not instead of them. If you don’t make these other changes in your life, medication is unlikely to work.
Dietary changes: Reducing calories and practicing healthier eating habits are vital to overcoming obesity. Although you may lose weight quickly at first, slow and steady weight loss over the long term is considered the safest way to lose weight and the best way to keep it off permanently.
Avoid drastic and unrealistic diet changes, such as crash diets, because they’re unlikely to help you keep excess weight off for the long term.
Exercise and activity: Increased physical activity or exercise is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, even simply walking.
Behaviour changes: A behaviour modification programme can help you make lifestyle changes and lose weight and keep it off. Steps to take include examining your current habits, to find out what factors, stresses or situations may have contributed to your obesity.
Everyone is different and has different obstacles to managing weight, such as a lack of time to exercise or late-night eating. Tailor your behavior changes to address your individual concerns.
Weight-loss surgery: In some cases, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery limits the amount of food you’re able to comfortably eat or decreases the absorption of food and calories or both. While weight-loss surgery offers the best chance of losing the most weight, it can pose serious risks.
Weight-loss surgery for obesity may be considered if you have tried other methods to lose weight and it did not work.
Preventing weight regain after obesity treatment
Unfortunately, it is common to regain weight, no matter what obesity treatment methods you try. If you take weight-loss medications, you will probably regain weight when you stop taking them. You might even regain weight after weight-loss surgery if you continue to overeat or overindulge in high-calorie foods. But that does not mean your weight-loss efforts are futile.
One of the best ways to prevent regaining the weight you have lost is to get regular physical activity. Aim for 60 minutes a day.
Keep track of your physical activity if it helps you stay motivated and on course. As you lose weight and gain better health, talk to your doctor about what additional activities you might be able to do and, if appropriate, how to give your activity and exercise a boost.
You may always have to remain vigilant about your weight. Combining a healthier diet and more activity in a practical and sustainable manner are the best ways to keep the weight you lost off for the long term.
Take your weight loss and weight maintenance one day at a time and surround yourself with supportive resources to help ensure your success. Find a healthier way of living that you can stick with for the long term.