HEALTH TALK: Obesity – Part two

Here beginneth the second of what I had thought would be a two-part series on this topic. But as it turns out, obesity is such a huge issue – pun intended – that we may well run into a part three. Let’s see.

Last time around, we discussed mostly risk factors for obesity and tried to look into some socio-economic aspects (which I hope most of you understood and took seriously). Let’s get medical this time.

Obesity is more than a cosmetic concern. It puts you at greater risk of developing high blood pressure and many other serious health risks, and can ultimately even be life- threatening.

The good news is that even a modest weight loss can bring health improvements. How can you achieve this? Eat healthier, exercise, and change behaviors. If lifestyle changes don’t help, prescription medication and surgical techniques are at your disposal.

WHAT CAUSES OBESITY?

Obesity is having and abnormally high portion of body fat. If your body mass index (BMI) is 30 or higher, you’re obese. If your BMI is 25 or higher, you’re overweight. BMI = weight in kg/height in m2. There has been a lot of debate about the usefulness of the BMI, but until I find a better index, that is what I will work with.

Weight is largely determined by how you balance your intake of calories from food with the energy you use. If you take in more calories than you use, you gain weight. The calories you don’t need are stored for energy as fat.

This is not to say that fat is not at all important. It stores energy and insulates your body, among other functions. The human body can handle carrying some extra fat, but beyond a certain point, body fat can start to mess with your health.

Simply put, eating too many calories and not getting enough physical activity, and especially a combination of both, are the main causes of obesity. But there are other factors that contribute. There were covered in Part I.

WHEN TO SEE DOCTOR

How do you know whether you need to shed some pounds for medical reasons? Read on.

•    Body Mass Index (BMI). If your BMI is between 19 and 24, you have a healthy weight. Between 25 and 29, you’re overweight. At 30 or greater, you’re obese.

Now you should talk to your doctor about losing weight for the sake of your health.

•    Waist circumference. If most of your weight (fat) is around your waist or upper body, we say you are apple shaped. If most of it is around your hips and thighs and lower body, we say you are pear shaped. In terms of your health it’s better to be pear shaped than to be apple shaped. If you have the latter – a pot belly or spare tires – you carry more fat in and around your abdominal organs. This increases your risk of many of the serious conditions associated with obesity. A woman’s waist should be less than 35 inches, and a man’s should be less than 40 inches. If yours is above these, time to get serious.

ALSO BE CAREFUL IF:

•    You drink
•    You smoke
•    Live with a high stress level

In combination with these behaviors, excess weight carries even greater health implications.

COMPLICATIONS

High blood pressure. Weight gain is mostly in the form of fatty tissue, which like other tissues, relies on oxygen and nutrients in the blood to survive. As this demand increases, the amount of blood flowing through your arteries means added pressure on your artery walls. Weight gain also typically increases insulin levels, which leads to retention of sodium (salt) and water, which increases blood volume.

In addition, excess weight can lead to an increase in your heart rate and a reduced capacity of your blood vessels to transport blood. All of these factors can increase blood pressure.

Diabetes. Obesity is the leading cause of type 2 Diabetes. Your body becomes resistant to insulin when you have excess fat. This will of course result in high blood sugar levels, diabetes, and all its attendant negative health effects.

Abnormal blood fats. A diet high in saturated fats, such as red meat improperly prepared, and fried foods, can lead to obesity as well as elevated levels of LDL cholesterol or “bad” cholesterol. Obesity is also associated with low levels of HDL or “good cholesterol”, and high levels of triglycerides. This is the form in which most fat exists in food, as well as in your body. Over time, abnormal blood fats can contribute to atherosclerosis – the buildup of fatty deposits in arteries throughout your body. Now you’re at risk of coronary artery disease and stroke.

Coronary artery disease. This occurs when there is a buildup of fatty deposits in arteries that supply your heart. As time passes, these deposits can narrow your heart’s arteries, causing less blood flow to your heart. This can lead to chest pain (angina). Complete blockage can result in a heart attack. See how obesity is no small matter?

Stroke. Atherosclerosis, as just discussed, can affect arteries throughout your body, including those in your brain. A blood clot can form in a narrowed artery in your brain, blocking blood flow to an area of your brain. The result is a stroke. Being obese raises your risk of a stroke!

Osteoarthritis. This disease of the joints mostly affects the knees, hips, and lower back. Excess weight puts extra pressure on these joints and wears away the cartilage which protects them, resulting in joint pain and stiffness.

Sleep apnea. This serious condition causes a person to stop breathing for short periods during sleep and to snore heavily. It’s because the upper airway is blocked during sleep, resulting in frequent awakening at night and, of course, drowsiness during the day. Most people who have this are overweight, which contributes to a large neck and narrowed airways.

Cancer. Surprised by this one, right? Many types of cancer are associated with being overweight. In women, these include cancers of the breast, uterus, cervix, ovaries and gall- bladder. In men, the risk is for cancers of the colon, rectum and prostate.

Fatty liver disease. Obesity causes fats to build up in the liver. This can lead to inflammation and scarring of the liver. This scarring can lead to cirrhosis of the liver, even if you’re not a heavy alcohol drinker.

Gallbladder disease. Overweight people produce more cholesterol. This can be deposited in the gallbladder, increasing the risk of gallstones in obese persons. Rapid weight loss – more than four pounds a week – can also increase the risk of gallstones.

Part 3 on obesity will deal exclusively with treatment of obesity.

See you next week.