HEALTH TALK: Obesity – Part One

It occurred to me to make obesity the topic of my column this week because Diabetes Day was last week, (two weeks ago by the time you read this) and since obesity is a leading cause of type 2 Diabetes, it seemed to make a bit of sense.

Those of you who have been to or lived in France or its Departments will not have failed to notice that for the most part, these nationals, especially female, and especially black female, are among the finest people in the world to look at.  But it seems that as a result of the influence of American fast food and drink franchises into Europe, this is changing, to the extent that the EU recently has begun to actively and aggressively address it.  We all know that it has been a problem in the U.S., but imagine that obesity is now a major problem in France and Guadeloupe! But don’t worry, Dominica is by no means left out.

I want to do this in two parts, maybe three, because I want to look at it from different angles, diverging from the usual pattern somewhat.

RISK FACTORS

Some of the factors that increase your risk of being obese include the following:

•    Diet. Regularly eating high-calorie foods, such as fast foods, contribute to weight gain – surprise, surprise! High-fat foods may taste good, but are loaded with calories.  Candy, deserts, and soft drinks also promote weight gain.  High amounts of sugar and calories are present in these foods and beverages.

•    Psychological factors.  Some people overeat in their attempt to deal with emotions, such as stress or boredom.

•    Genetics.  If one or both of your parents are obese, you stand a greater chance of being overweight. Your genes may affect the amount of body fat you store and where that fat is distributed.  Your genetic makeup doesn’t guarantee that you’ll be obese though.

•    Age.  As you get older you tend to be less active. Let’s just say it goes with the territory. In addition, your muscle mass tends to decrease with age, leading to a decrease in metabolism. Your calorie needs are also reduced. If you don’t take in less calories as you age, you’ll likely gain weight.

•    Pregnancy.  A woman’s weight necessarily increases during pregnancy. Some women find it difficult to shed the weight after baby is born, sometimes setting the stage for obesity.

•    Medications.  Corticosteroids and tricyclic antidepressants, in particular, can lead to weight gain. I won’t give you any specific names for you to stop taking them and blame Dr. Emanuel when you get sick. The same goes for some high blood pressure medications and antipsychotic drugs. Good thing there are so many, so you can’t guess. But always remember, folks. It’s benefit versus risk.

•    Medical problems.  This is uncommon, but examples exist, such as low thyroid function, excess production of hormones by the adrenal glands (Cushing’s syndrome), or other hormonal imbalances such as polycystic ovaries. Having a low metabolic rate rarely leads to obesity. A problem such as arthritis can lead to decreased activity, which can result in weight gain.

•    ALCOHOL.  Drinking alcohol adds calories to your diet. One regular beer is about 150 calories. If you don’t cut back on calories somewhere else, adding just one beer a day could put a pound a month on you. Furthermore, excessive drinking can stimulate your appetite and make you less likely to control your portion sizes.

•    CIGARETTE SMOKING.  You smoke, you’re at risk for a million problems. You quit, you’re at risk for gaining weight. This may be partially due to nicotine’s ability to raise your metabolic rate (burn calories). When smokers stop, they burn fewer calories. Smoking also affects taste; quitting smoking makes food taste and smell better. Former smokers often gain weight because they eat more after they quit.  However, cigarette smoking is still considered a greater threat to your health than is extra weight. Why ever does one start?

•    INACTIVITY.  This is what I really want to focus on for this column.

INACTIVITY

The authorities tell us that obesity is a problem among our kids and that they’re carrying it into adulthood. When I was a boy, I had to walk two miles almost every morning to catch a bus to get to school; my village was off the usual main route, so I had to walk that distance to that route. And often in the afternoon, I would walk back the same two miles. This is four miles a day plus my other country-life chores. This is a story I’ve told in many fora, so those of you who have heard it before, forgive me for the repetition.

So you can understand how hard it is for me to understand that parents in Citronier and Newtown are giving their kids money to take a bus to St. Martin school and St. Mary’s Primary. Give me a break!

When the bus drops someone off ten yards from your house, get off and walk the ten yards, instead of having the bus stop ten yards on. In fact, if your house is fifty yards away from the Bus Stop, that’s the distance you should be walking!!

COST OF OBESITY

In Part II, I will delve into the complications of obesity, which include diabetes and hypertension. For those of you who didn’t hear sometime in the last three years or so, the Pharmaceutical Procurement Service (PPS) of the OECS has said that 34% of our expenditure on drugs goes toward those for treating these two conditions alone, out of any number of diseases that are treated annually. Perhaps we don’t, but should, appreciate the amount of money we’re talking about. And that it has to come from somewhere. If you can save yourself and the government, and your fellow citizens some had-to-come-by cash, simply by changing your lifestyle and getting off your butt, is that too much to ask?

And what about every other adult learning to drive nowadays and acquiring a used car from Japan so they can drive everywhere? There are now more driving schools than schools, teaching 45 and 55 year old women already obese to drive.  This is inactivity, this is a sedentary lifestyle. These are all practices that are interwoven that have direct and indirect implications for our health and our economy. We need to stop, sit back, and think about what we’re doing and how we’re thinking, or not thinking, populace and policy makers alike.

See you next week.