Health Risks of Obesity

What are the health risks of obesity? It is now presumed that the rising rates of obesity will reverse the increases in life expectancies that we’ve seen lately. Children that are born in the year 2000 would be part of the first generation that doesn’t outlive the previous one. Obesity-related diseases are also costing the American tax-payers billions of dollars. Overweight people are 2 to 6 times more likely to develop hypertension, have a stroke, thrombosis and clots in the legs. Excess body fat can lead to impaired cardiac function. These are only some of the health risks of obesity.

Excess body fat can lead to insulin resistance and increase the likelihood of type 2 diabetes in both adults and children. Obesity can be a factor in the development of cancer, because of the eating patterns that get us to obesity (most people don’t get obese by eating fruits and vegetables) also increase the likelihood of developing some kind of cancer. Inactivity also increases the risk of cancer. Some estimates suggest that poor diet and exercise may account for up to a third of the cancer risk.

Excess body fat can lead to different types of cancer, most notably endometrial cancer, prostate cancer, colon cancer and breast cancer. Obese people are more likely to have degenerative joint disease. It makes it more likely to have sleep apnea, mechanical breathing constraints (particularly during exercise). It just takes more effort to work the chest wall if it has huge amounts of fat.

Obese people have more problems with anesthesia during surgery, as well as compromised wound healing. It also increases the likelihood of developing gallbladder disease.

A newly discovered consequence is fatty infiltration of the liver. This is known as nonalcoholic steatohepatitis. Some estimates suggest that as the liver becomes infiltrated with fat, it causes hepatitis and that can lead to liver failure.

Psychological Burden

We’ve seen the physical risks of obesity. Obesity also has deep psychological effects: depression, being stigmatized by people, bullying and discrimination. This is really one of the least accepted forms of discriminations. We have made great advances in our culture: most of us accept that we can have different religious beliefs, or that we can have different ethnicity and still have the same rights. However, we are not sensitive to the individuals who are overweight.

In 2002, the cost of overweight in the US was estimated to be 92 billion dollars!

A Light of Hope

Losing weight can reduce the risks of all these diseases. Obese people that loose as little as 5% of their bodyweight can have improvement in blood pressure, insulin levels, glucose, cholesterol and triglycerides. You don’t have to lose 80 pounds to get good results. As little as 5% to 10% weight loss can help.

How Do You Know If You Are Overweight

How do you know if you are overweight? BMI is the gold standard of measurements of weight. There are web-based ways of calculating your BMI, you can google it. You can also do it yourself, it's not that hard. Take your weight in pounds times 703 and divide it by your height in inches squared. In general, a BMI of less than 24.9 is considered normal weight. If you’re between 25 and 29.9, you're considered overweight. A BMI greater than 30 is considered obese.

BMI is a population-based standard. It’s not necessarily the best assessment tool for an individual. For example, athletes have a high BMI because they have more muscle mass. If you are very physically active you might want another assessment technique.

BMI doesn’t account for individuals who have normal weight but are metabolically obese(high body fat percentage). For most of us, however, BMI is going to be great to asses our weight. It can help to predict risks of the big three: heart disease, diabetes and cancer; because they all increase with BMI.

The definitive assessment for body composition is the body fat percentage. Say for example that I have a normal BMI, but I want to see what that body composition is. How much of my weight is muscle vs. fat? If a woman has more than 30% body fat, or a man has more than 20%, they can be in the risk sector of the population. There are different types of tests, and I recommend you to go to an exercise facility to get them done.

More Facts About Obesity

As a continuation of my previous article, here we’ll continue exploring the facts about obesity. Race and ethnicity also plays a role in weight gain. American Indians, African Americans and Hispanic women are more likely to be overweight than white women. These races typically value thinness less than white Americans. They tend to have a more normalized view of what weight should be, not the distorted one that most white women have.

We now know that there is an actual science of satiety. Satiety is under the control of two relatively newly discovered hormones: leptin and ghrelin. Leptin signals that the body has had enough food. It is kind of an off-switch. Leptin resistance can occur, however. That means that you’re producing leptin, your body is not using it effectively and that off-switch doesn’t do its job. There are studies that suggest that sleep deprivation may contribute to obesity. This is because leptin decreases with sleep deprivation. Getting those 8 to 10 hours of sleep everyday should be part of every weight loss strategy.

In our bodies we always have opposing hormones. Ghrelin is the hormone that stimulates appetite. It is the on-switch. In the years to come we’re going to see some pharmacology directed at manipulating those hormones.

Social and environmental factors play a major role in the development of obesity. Americans are more likely to be obese if they have a low socioeconomic status. Individuals under the poverty line have very few resources to put together a healthy diet. Quite honestly, fat and sugar calories are unbelievably cheap. We also see obesity rising among the affluent also, so this isn’t the only factor.

The level of education is associated with bodyweight as well, mostly for women. This illustrates the different standards for men and women.

We are bombarded with images of individuals who are lean and fit in a country that’s getting heavier. In the last Olympics, where some women competing there were heavier, disparaging remarks were made about their bodyweight. We didn’t here this comments about the men, however. There have been some estimates that suggest that to be Miss America your bodyweight needs to be 10% to 15% below ideal.

One factor that doesn’t get explored very often is something called the built environment. For example, if you live in a neighborhood with no sidewalks, are you going to go out and walk? Without sidewalks I don’ feel safe, so I have to get in my car to go get physical activity. Think about inner city neighborhoods. If you don’t have good sidewalks people are not going to be out being physically active.

We have social factors as well that influence the way we choose our food. When we’re with friends we tend to overeat. Think about times you’ve spent time with relatives and there’s food everywhere. Science also suggests that we eat what’s in front of use. If the portions you’re given are large, you tend to eat them anyway.

A lack of exercise is a major factor contributing to obesity. Only 22% of Americans get the recommended amount of exercise (somewhere around 30 minutes a day most days of the week). 25% of US adults are not active at all. All they do is to get from their chair to the car, getting no real physical exercise.

Television viewing is highly correlated with a low level of activity for both children and adults. Why is that the case? Most of us are not terribly active while we’re watching television. Here’s a tip: make sure you’re riding that bike for at least 30 minutes of your television viewing a day.

Facts About Obesity

Let’s talk facts about obesity. Obesity is now a global problem. It has displaced malnutrition and infectious disease as the number one global nutrition-related problem. It is on the rise in every country in the world, mostly in the industrialized areas. In the United States, prevalence has increased over the last decade. Today, about 66% of Americans fall into the category of overweight or obese. Unfortunately, children and adolescents form the group that is getting the biggest the fastest. One in six children is overweight.

If obesity was an infectious disease, we would marshal all of our resources in fighting it. Clearly, we’re not there yet. The dichotomy is that as obesity increases, the societal emphasis on thinness and weight management also increases. Each year, the diet industry makes between 40 and 50 billion dollars from weight-loss products. In the year 2000, 38% of adults were trying to lose weight.

Does dieting work? Clearly it does. A recent study published in the New England Journal of Medicine suggests that any dietary strategy is going to work, but here is the caveat: YOU HAVE TO STICK WITH IT. The average dieter lasts 2 weeks. You’re not going to get where you want to be in two weeks.

There is more fraud and misinformation in this industry than in any other. We’re spending more money, but we’re not getting the results. We know that children and adolescents are concerned with weight. In a study involving high-school girls, 28% to 40% reported being on a diet or concerned with being fat. Teens believe the best strategy to lose weight is to exercise and skip meals. That is wrong. Calorie management and exercise is what really works, but surveys suggest that teens don’t believe that.

How do we get obese?

As with every other chronic illness, genetics can rule the day. When both parents are morbidly obese, there is an 80% chance that their children would be also. The good news is that when neither parent is obese, there is less than a 10% chance that children would be obese. However, about 25% to 30% of obese people have normal weight parents. Some studies with twins suggest that there is a genetic component. It is estimated that your genetic makeup can account for about 50% up to 90% of the variations you might have in terms of your ability to store body fat.

You can look at it this way: genetics can load the gun, but the environment pulls the trigger. You might have the genetic predisposition, but environmental factors activate those genes.

Fat-Cells

We have three different types of obesity. We have hyper-cellular, hypertrophic, hyperplastic. Hyper-cellular obesity is an above average number of fat cells. You can be born with them, or you can develop them through over-eating. Hypertrophic obesity happens when fat cells are larger than normal. These cells continue to expand as they fill with fat. When they are full, the body has the ability to make new fat cells. Here’s the scary part: when body fat is 3 to 5 times the normal amount, you have the ability to make more fat cells.

Weight loss doesn’t decline the number of fat cells, making it difficult to lose weight once the body has created them. Why is that the case? When the fat cell becomes empty, it sends triggers asking for more food.

Sex and Age

Sex and age also play a role in the development of obesity. This is because men and women set different standards for themselves. Growth and development occurs at different rates and has a different outcome for boys and girls. If I could rule the world, I would teach puberty a little bit different to adolescents: Boys grow up and out under the influence of testosterone, and add significant amounts of lean mass. Girls grow up and fill out. They add some body fat under the influence of estrogen. That is a normal phenomenon that should occur, but girls look at this as undesirable. They see their older brother getting bigger and more muscular, and then see how they get fat inside of their thighs and think it is wrong. That is absolutely normal and good.

Males, in general, are more accepting of personal weight gain. That makes sense. When I gain weight, I generally add a significant amount of lean mass, so I’m fine. Adult males tend to see themselves as overweight at higher weights, while women think they are overweight even when they are close to a healthy bodyweight. Some women only feel thin when they are about 10% below their ideal bodyweight.

Both men and women gain most of their weight between the ages of 25 and 34. For women, that weight gain can go on until menopause.