The Obesity Epidemic

Health risks

       Health risks associated with obesity

 

 

 

• Bone and cartilage degeneration (Osteoarthritis)
  Obesity is an important risk factor for osteoarthritis in most joints, especially at the knee joint (the most important site for osteoarthritis). Obesity confers a nine times increased risk in knee joint osteoarthritis in women. Osteoarthritis risk is also linked to obesity for other joints. A recent study indicated that obesity is a strong determinant of thumb base osteoarthritis in both sexes. Data suggest that metabolic and mechanical factors mediate the effects of obesity on joints (University of Bristol).
• Coronary heart disease
  Obesity carries a penalty of an associated adverse cardiovascular risk profile. Largely as a consequence of this, it is associated with an excess occurrence of cardiovascular disease morbidity and mortality. (Department of Preventive Medicine, University of Tennessee)
• Gallbladder disease
  Being overweight is a significant risk factor for gallstones. In such cases, the liver over-produces cholesterol, which is then delivered into the bile causing it to become supersaturated. Some evidence suggests that specific dietary factors (saturated fats and refined sugars) are the primary culprit in these cases (University of Maryland Medical Center)
• High blood pressure (Hypertension)
  There are multiple reasons why obesity causes hypertension, but it seems that excess adipose (fat) tissue secretes substances that are acted on by the kidneys, resulting in hypertension. Moreover, with obesity there are generally higher amounts of insulin produced. Excess insulin elevates blood pressure. (Weight.com)
• High total cholesterol, high levels of triglycerides (Dyslipidemia)
  The primary dyslipidemia related to obesity is characterized by increased triglycerides, decreased HDL levels, and abnormal LDL composition. (Howard BV, Ruotolo G, Robbins DC.)
• Respiratory problems
  Obesity can also cause respiratory problems. Breathing is difficult as the lungs are decreased in size and the chest wall becomes very heavy and difficult to lift. (Medical College of Wisconsin)
• Several cancers
  In 2002, approximately 41,000 new cases of cancer in the USA were thought to be due to obesity. In other words, about 3.2% of all new cancers are linked to obesity (Polednak AP. Trends in incidence rates for obesity-associated cancers in the U.S. Cancer Detection and Prevention
• Sleep apnea
  Obesity has been found to be linked to sleep apnea. Also, weight reduction has been associated with comparable reductions in the severity of sleep apnea. (NHLBI)
• Stroke
  Rising obesity rates have been linked to more strokes among women aged 35 to 54. (Medical News Today - "Stroke Increase And Obesity Linked Among Middle-Aged Women")
• Type 2 diabetes
  One of the strongest risk factors for type 2 diabetes is obesity, and this is also one of the most modifiable as it can be partially controlled through diet and exercise. 

Treatments for obesity

Obesity treatments have two objectives:

1. To achieve a healthy weight.

     2.   To maintain that healthy weight

 

People who are obese are often discouraged because they think they have to lose a lot of weight before any benefits are experienced. This is not true. Any obese person who loses just five to ten per cent of their body weight will have significant improvement in health - this would mean between 12-25 pounds for an obese person who weighs 250 pounds.

It is important for patients to realize that a small drop in weight is a good start and a great achievement. Experts have found that obese people who lose weight slowly and constantly, say one or two pounds each week, are more successful in keeping their weight down when they have reached their target weight.

According to the Mayo Clinic, successful and permanent weight loss is best achieved as a result of increased physical activity, changing how and when you eat, and modifying your behavior. Some patients may be prescribed medication, while others might undergo weight-loss surgery.

Dietary changes

The Mayo Clinic advises obese people to reduce their total daily calorie intake and to consume more fruits, vegetables and whole grains. It is important that your diet is varied - you still need to feed yourself, and should continue to enjoy the tastes of different foods. The consumption of sugar, certain refined carbohydrates and some fats should be reduced significantly.

Ideally, you should work with your doctor, a dietician, and/or a well-known weight-loss program.

Trying to lose weight quickly by crash-dieting carries the following risks:

• You may develop health problems
• You will probably experience vitamin deficiencies
• You chances of failure are significantly higher

People who are seriously obese may be prescribed a very low calorie liquid diet. These must be done with a health care professional.

Physical activity

The more you move your body the more calories you burn. To lose a kilogram of fat you need to burn 8,000 calories (1 pound of fat = 3,500 calories). Walking briskly is a good way to start increasing your physical activity if you are obese. Combining increased physical activity with a good diet will significantly increase your chances of losing weight successfully and permanently!

Try to find activities which you can fit into your daily routine. Anything that becomes part of your daily life, weaved into your existing lifestyle, is more likely to become a long-term habit. If you use an elevator, try getting off one or two floors before your destination and walking the rest. You could try the same when driving your car or taking any form of public transport - get off earlier and walk that bit more.

If any of your regular shops are within walking distance, try leaving your car at home. Several surveys indicated that the majority of urban car trips outside the rush hours are less than a mile long - we can all walk a mile, and should!

If you are very obese, are unfit, or have some health problems, make sure you check with a health care professional before increasing your physical activity.

Prescription medications for losing weight

Prescription medications should really only be considered as a last resort. If the patient finds it extremely hard to shed the pounds, or if his obesity has reached such a point as to significantly undermine his health, then prescription drugs may become an option.

According to the Mayo Clinic prescription medications should only be considered if:

• Other strategies to lose weight have failed
• The patient's BMI is over 27 and he also has diabetes, hypertension, or sleep apnea.
• The patient's BMI is over 30

There are two approved drugs a physician may consider, Sibutramine (Meridia in USA/Canada, Reductil in Europe and much of the world) or Orlistat (Xenical). Bear in mind that as soon as you stop taking these drugs the overweight problem generally comes back - they have to be taken indefinitely. Some patients may not respond to these drugs, while others may find their beneficial effects may lessen somewhat after a few months.

Weight loss surgery (bariatric surgery)

Weight loss surgery (WLS) is also known as Bariatric Surgery. It comes from the Greek work baros, which means weight.

WLS is a development of cancer/ulcer operations that consisted of removing part of a patient's stomach or small intestine. Those cancer/ulcer patients subsequently lost weight after surgery. Doctors decided the procedure might be beneficial for morbidly obese patients.
In 2008 about 220,000 bariatric operations were carried out in the USA (American Society for Bariatric Surgery). As obesity levels in America and many other parts of the world grow, so does the number of bariatric procedures. About 15 million people in the U.S. have morbid obesity; only 1% of the clinically eligible population is being treated for morbid obesity through bariatric surgery. According to the American Society for Bariatric Surgery, the average female surgery patient weighs about 300 pounds.
The American Society for Bariatric and Metabolic Surgery says that Bariatric surgery can improve or resolve more than 30 obesity-related conditions, including type 2 diabetes, heart disease, sleep apnea, hypertension and high cholesterol .

Basically, bariatric surgery alters your stomach or small intestine so that you are unable to consume much food in one sitting. This reduces the total number of calories you consume each day, thus helping to lose weight.

There are two types of bariatric surgeries:

• Restrictive procedures - These make your stomach smaller. The surgeon may use a gastric band, staples, or both. After the operation the patient cannot consume more than about one cup of food during each sitting, significantly reducing his food intake. Over time, some patients' stomachs may stretch and they are gradually able to consumer larger quantities.
• Malabsorptive procedures - Parts of the digestive system, especially the first part of the small intestine (duodenum) or the mid-section (jejunum), are bypassed. Doctors may also reduce the size of the stomach. This procedure is generally more effective than restrictive procedures. However, the patient has a higher risk of experiencing vitamin/mineral deficiencies because overall absorption is reduced.