What is Obesity?
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to a reduced life expectancy and/or increased health problems and it is one of the leading preventable causes of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public health problems of the 21st century.
Obesity is stigmatised in much of the modern world, particularly in the Western world, though it was widely perceived as a symbol of wealth and fertility at other times in history and still is in some parts of the world.
In children, from 2 to 15 years of age, a healthy weight varies with age and sex, but in 2008 1 in 6 boys and 1 in 7 girls in England were Obese; the number of overweight children was also around 1 in 7; and to make matters worse the number of overweight and Obese people is on the increase and it has been predicted that by 2025, nearly half of men and over a third of women will be Obese and being overweight or Obese can shorten life expectancy by 6 to 7 years.
See recent British Obesity Related Statistics from February 2012.
What is the Body Mass Index (BMI)?
Obesity can be measured in different ways, but an easy way is to simply step on the scales and compare your actual weight with your ideal weight and the most widely used way to measure your weight is to calculate your BMI, which is your weight in kilograms divided by your height in metres squared, which is typically expressed in metric units, kilograms and metres.
The BMI is a measurement which compares weight and height, and defines people as overweight 'pre-Obese' if their BMI is between (25 and 30) kg/m2 and Obese when it is greater than 30 kg/m2, and is further evaluated in terms of fat distribution via the waist hip ratio and total cardiovascular risk factors; BMI is closely related to both percentage body fat and total body fat.
Commonly used BMI Classifications are less than 18.5 underweight, between 18.5 and 24.9 normal weight, between 25.0 and 29.9 overweight, between 30.0 and 34.9 class I Obesity, between 35.0 an 39.9 class II Obesity and more than 39.9 class III Obesity or severe Obesity, between 40 and 44.9 or 49.9 is morbid Obesity and more than 49.9 is super Obesity.
In 2008, nearly a quarter of adults, over 16 years of age, in England were Obese, in other words had a BMI of over 30; just under a third of women, 32%, were overweight, with a BMI of between 25 an 30 and 42% of men were overweight and according to figures from 2009, almost a quarter of adults, 22% of men and 24% of women, in England were classified as Obese with a BMI of 30kg/m˛ or over; in the UK an estimated 60.8% of adults and 31.1% of children are overweight.
How Obesity is measured has been criticised, with BMI dismissed by some as an imperfect science; BMI fails to distinguish between body fat and lean muscle, meaning professional athletes can emerge as being overweight or even Obese, but this is just being plain silly, it is quite obvious to see if someone is really fit, or muscly, compared to being overweight or Obese, so BMI does not need to be used for those people; but for many it is still a good indicative measure and it is important to know if you are Obese or overweight because around 30,000 people die prematurely every year from Obesity related conditions.
However, the BMI calculation is not infallible, for instance it fails to account for those going through puberty, and it fails to look at where the excess fat is distributed on the body, so another way of assessing overweight and Obesity is by measuring the girth, waist circumference, or more importantly, waist to hip ratio; it is recognised that the central fat held in the abdomen is a greater health risk and is more dangerous than peripheral fat, found on the buttocks or thighs, and acts as a toxic inflammatory organ; for this reason, the World Health Organisation now recommends that people measure their waists; a circumference of over 37 inches (94 cm) on a man or 32 inches (80 cm) on a woman indicates a health risk; therefore, the waist to hip ratio is increasingly being used by doctors in preference to BMI as a better measurement of the risk of Obesity and Cardiovascular Disease.
What are the Complications of Obesity?
Obesity increases the likelihood of developing various diseases and problems such as certain types of Cancer, Cardiovascular Diseases, Endocrine deseases such as Type 2 Diabetes, non alcoholic Fatty Liver Disease, Gastrointestinal problems, Musculoskeletal problems, Neurological problems, Osteoarthritis, Psychosocial problems, Pulmonary Disorders, Renal disorders and Obstructive Sleep Apnea.
Obesity also causes High Blood Pressure, High Blood Cholesterol and High Triglyceride levels, which in turn could lead to a Stroke; as a result Obesity has been found to reduce life expectancy.
Complications are either directly caused by Obesity or indirectly related through mechanisms sharing a common cause such as a poor diet or a sedentary lifestyle; the strength of the link between Obesity and specific conditions varies.
One of the strongest links, is the link with Type 2 Diabetes, where excess body fat underlies around 64% of cases of Diabetes in men and around 77% of cases in women; the increase in body fat alters the body's response to insulin, potentially leading to insulin resistance.
Basically becoming overweight, or Obese, can lead to many health related deseases and problems and the best way to avoid these is to avoid becoming overweight, or Obese, in the first place; it is easier to keep the excess fat off, than it is to get rid of it once you have accumulated it, as many who have been on a diet, or diets, can tell you.
What Causes Obesity?
Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity and genetic susceptibility, although only a very small percent of cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness and 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 a greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body mass.
It is a fact that over time, eating and drinking excess calories leads to weight gain and without lifestyle changes to increase the amount of physical activity done on a daily basis, or reduce the amount of calories consumed, people can become Obese and experts are worried about the high fat and sugar levels in many convenience and mass produced foods; there is also concern about the advent of super-size portions.
However, the reality isn't as simple as that; a significant factor is that modern life is more sedentary than ever; a recent study showed that housewives in the 1950s ate more calories than their modern counterparts, but were significantly slimmer because their daily lives involved much more physical activity; sadly today’s way of life is less physically active than it used to be; people travel on buses and cars, rather than walking and many people work in offices, where they are sitting still for most of the day; this means that the calories they eat are not getting burnt off as energy; instead, the extra calories are stored as fat.
It is a fact that Drinking Alcohol and eating Junk Food and Fast Food stimulates the same part of the brain and some studies have suggested that people who drink too much alcohol overeat to satisfy their own addictions and are resorting to eating increasing amounts of fast food and junk food; experts report that the food that we consume today is much higher in calories and, more importantly, empty calories, a factor in increasing levels of Obesity today; junk food and fast food contain unhealthy amounts of salt, sugar and fat and if you eat too much of these kinds of foods, you're bound to gain weight; but, because these unhealthy food choices appeal to the so called reward centers of the brain, some people are prone to overeating them.
Fast Food & Baked Goods Linked to Depression:
Apparently, eating fast food and baked goods, not only increases your chance of becoming Obese, it can also have a negative effect on your mental health, as well, making those who consume it regularly feel depressed.
According to a study that was published in the peer reviewed journal 'Public Health Nutrition', which looked at how 9,000 people’s consumption of fast food and baked goods, such as pies and pastries, related to a risk of depression, researchers found that people who consumed the most fast food and baked good were 37% more likely to become depressed over a 6 year period than people with the lowest consumption.
This study established people’s diets before they were followed to see if they developed depression, which means that their diets preceded their depression; the study included people who did not have a clinical diagnosis of depression and who were not taking antidepressant medication, to ensure that the participants were free of depression at the beginning of the study; all participants were also free of Cardiovascular Disease, Diabetes and Hypertension; however, it cannot conclusively show that fast food directly causes depression.
The type of fast food included in the study were hamburgers, sausages and pizza and commercial baked goods such as muffins, doughnuts, croissants; this study found an association between the consumption of high levels of fast food and baked goods and the risk of developing depression; of the 9,000 people studied 493 developed cases of clinical depression.
How is Obesity Treated?
The best way to tackle Obesity is by not putting on too much weight in the first place; a combination of a healthy, balanced diet and regular exercise should be sufficient in most instances; experts recommend vigorous exercise such as brisk walking, swimming or cycling 5l times a week for 20 to 30 minutes.
Obesity is treated by losing weight, which can be achieved through a healthy, calorie controlled diet and increased exercise; the lifestyle changes necessary for long term weight loss can be challenging to achieve, but there is a wide range of support available; for those who are already Obese, weight management clinics are available to provide expert help and advice; though diet quality can be improved by simply reducing the consumption of energy dense foods such as those high in fat and sugars and by increasing the intake of dietary fiber.
In severe cases, doctors may prescribe drug therapies, which have been shown to have some positive impact; anti-Obesity drugs may be taken to reduce the appetite or inhibit fat absorption and is meant to work together with a suitable diet; amongst these types of drug are orlistat, brand name Xenical, which works by blocking the digestion of fat.
If diet, exercise and medication are not effective, Surgical Intervention can be performed; a gastric balloon may assist with weight loss, or surgery may be performed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.
Surgery can be used to treat people who are severely Obese and have tried other methods of weight loss with no success; there are a variety of techniques, most of which reduce the size of the stomach, meaning that less food can be ingested and the person feels full quicker and therefore eats less; although these do carry risks and may not be suitable for everyone.
A technique using an adjustable band around the top of the stomach has gained popularity, as it is a simpler and quicker option than some other options; research has shown that gastric band surgery can bring a rapid improvement in blood sugar control in those people whose Obesity has lead to Type 2 diabetes.