Obesity is an American public health crisis. Someone once said: “Americans dig their own graves with a knife and fork.” Truer words were never spoken. There are many trends in our culture that pull us in this direction, but it does not have to be this way. The choice is up to us.
What is Obesity?
Obesity is defined as the accumulation of excessive body fat or an abnormal amount of body weight for one’s size. To be classified as obese, a person must meet one of three criteria. The first is having a body-fat percentage of over 30% for females and over 25% for males. The second criterion is having a body mass index (BMI) of over 30. The third is being over 20% above your “ideal” body weight, as defined by a formula considering gender, height, and age. Obesity is further classified as mildly obese (20-40% over ideal body weight), moderately obese (40-100% over ideal weight), or morbidly (severely) obese (100% or more over ideal weight).
The health implications are huge for obesity, as we will discuss in more detail in a moment. But, how widespread is obesity? Latest estimates place about 66% of American adults as overweight, with half of those (about 33% of the adult population) being considered obese. The number of obese children and teens (ages 6-19) has risen dramatically over the last 20 years, now reaching to over 15%. Overall, greater than 25% of the American population is obese, 4 million of them considered morbidly obese. Over 300,000 deaths per year are linked to obesity in the United States. Obesity is the second leading cause of preventable deaths in the U.S. Smoking is number one, but obesity is doing its best to close the gap.
What Causes Obesity?
The answer to this question is more complex than one might think. Basically, if you consume more calories than you can use, you gain weight. Excess calories that are not needed by the body for immediate energy are stored as fat tissue (adipose). We need a certain amount of fat. It serves to insulate the body and as an energy reserve. But too much fat begins to cause health problems. Taking in too many calories and not getting enough exercise are the main causes of obesity. Food is converted into energy, and when we do not burn enough energy, the excess calories accumulate as fat in the body. The typical American lifestyle sets us up for obesity: too much food, much of it of the wrong kind, combined with a sedentary lifestyle.
But obesity is more than just eating too much and not exercising enough. These are always significant factors, but it also seems that some individuals are constitutionally able to convert food into energy better than others. There is a process known as diet-induced thermogenesis that is the body’s way of “wasting” calories by turning them immediately into heat. Some people are able to do this quite efficiently, and some are not. What this actually means is that some of us can eat large amounts of food and not accumulate much of it as fat, while others are just the opposite. Folks with inefficient diet-induced thermogenesis are more prone to being overweight or obese. These people must be even more aware of what (and how much) they eat, and be sure to get adequate physical exercise.
While the main cause of obesity is a lifestyle of too much high fat food and too little physical activity, there are other risk factors that can make one more susceptible to being obese:
- Genetics: Researchers are taking a close look at this connection. People’s metabolisms and abilities to process food through diet-induced thermogenesis seem to vary on a sliding scale and significantly impact their propensity to gain weight. These tendencies seem to have a genetic link. Statistically, if one or both of your parents are obese, you have a greater chance of being obese yourself. Studies done on adopted children have shown that they most often they will follow the weight gain patterns of their birth parents more closely than those of their adoptive parents. However, there is a definite environmental factor involved as well. The habits that lead to obesity are often passed on in your family of origin, and studies show that this may have a significant impact as well. I like to call this phenomenon “generational obesity.”
- Diet: The types of food consumed may actually play a bigger role in obesity than the amount of calories alone. Some foods like carbohydrates, cereals, fruits and vegetables, and some proteins are turned into fuel almost immediately after they are eaten. Higher fat foods, such meat and fried foods, are directly stored in fat cells. Many high fat foods are very dense in calories too, which only adds to the problem. Other calorie-dense foods such as soft drinks and sweets also lead to weight gain.
- Age: As we get older, the amount of muscle mass in our bodies decreases, which tends to lower our metabolism as well. Many folks are less active as they age too. In short, as we age, our need for calories decreases. Unless we eat less and stay active, we will gain weight.
- Stage of Life: A second factor associated with age is that of how old a person is when they first become obese. In childhood, the body takes extra calories and converts them into new fat cells, a process called hyperplastic obesity. In adults, however, excess calories can only be stored in existing fat cells (hypertrophic obesity). Individuals who were obese as children may have as many as five times the number of fat cells as those who became obese as adults. Since diet and exercise can only shrink fat cells and not eliminate them, folks who were obese as children may have a much harder time losing weight than others.
- Medications: The use of certain medicines causes weight gain in many individuals. Tricyclic antidepressants and antipsychotics are especially known for this, as well as some blood pressure medications and steroids.
- Psychological Factors: This is a big one. Ever hear the term “comfort food?” Well, many people tend to overeat to deal with stress in their lives. They use food as a sedative, to numb their emotional pain. This is often a learned behavior that is picked up by children as they grow up. Maybe Mom and Dad didn’t drink or use drugs to escape emotional pain, but they may well have raided the refrigerator in times of stress. This is a particularly tough “addiction” to deal with. People who have a chemical dependency can learn to totally eliminate their drug of choice. However, we all must eat to survive, and moderating can be more difficult than abstinence. Our society does not encourage people to act responsibly and use self-control.
- Medical Conditions: Some disorders can be associated with obesity as a side-effect:
- Cushing’s Syndrome: Involves abnormally high levels of the hormone cortisol.
- Hypothyroidism: Due to an under active thyroid gland.
- Hypothalamus damage: This is often due to neurological problems that damage this structure found deep inside the brain and is responsible for, among other things, regulating the body’s appetite.
What Health Problems Can Obesity Cause?
High blood pressure is one of the most common and serious side effects of obesity. As we gain weight, the new tissues need oxygen and nutrients from the blood just like the rest of the body. This increases the amount of blood that is circulating throughout the body, raises the heart rate, puts more pressure on the arteries, and thus increases blood pressure. In addition, weight gain also increases the output of insulin in the body, which tends to cause the retention of more sodium and water in the blood. This also leads to hypertension.
Obesity is one of the leading causes for Type 2 diabetes. Since weight gain increases the amount of insulin in the body, the body’s ability to properly manage glucose (blood sugar) is impacted.
When there is too much fat in the body, some of it often accumulates in the arteries that supply the heart. This can obstruct blood flow to the heart and cause angina (chest pain) or a heart attack.
If the arteries to the brain become constricted or blocked from fatty deposits, the result can be a stroke.
Excess weight is hard on the hips, knees, and lower back. It wears away the cartilage, causing pain and stiffness. Another joint disorder called gout is also aggravated by obesity.
Obesity increases the risk of many types of cancer. Obese women are more likely to get cancers of the breast, ovaries, uterus, cervix, and gallbladder. Obese men have a higher risk of cancers of the prostate, colon, and rectum.
Obesity can lead to fatty accumulations in the liver. This can result inflammation and scarring that can lead to cirrhosis of the liver.
An overweight person is more likely to have abnormally high cholesterol levels, which can lead to gallstones. Incidentally, losing weight too quickly (more than 3 pounds per week) can also increase the chances of developing gall stones.
This sleeping disorder is characterized by excessive snoring and serious disruptions of breathing for short periods of time while sleeping. Most sufferers of sleep apnea are overweight. Excess weight narrows the airways and enlarges the neck, both increasing the risk of sleep apnea.
How is Obesity Treated or Prevented?
There are several tactics used by mainstream medical providers to treat obesity, other than lifestyle management, which can also prevent obesity in the first place. These “therapies,” which include medications and surgery, are quite controversial, and can have serious and dangerous side effects. The medications given to encourage appetite suppression and weight loss often contain amphetamines and other stimulants that can be addictive. It is also proven that these “diets” do not lead to permanent weight loss. As soon as the drugs are stopped, the weight often quickly returns. This “yo-yo” effect can be more dangerous than even obesity itself. Studies have shown that this practice can lead to serious complications. Gradual, consistent weight loss is the best way to shed punds.
Various weight loss surgeries are available, but they all have serious potential side effects such as blood clots, infection, and pneumonia. These surgeries are also relatively new procedures, so there is not a lot known about long-term effects. Personally, I would be very hesitant to undergo any of these operations.
Practical changes in lifestyle are the best way to lose weight if you are obese or to prevent weight gain if you are not. The two most obvious ways to manage weight are diet and exercise. Common sense is the rule here. A whole foods diet loaded with fruits and vegetables is the best course. These foods are generally high in nutrition and low in calories. It is very difficult to get fat eating too many fruits and vegetables. Drinking ample amounts of water can aid weight management as well.
The benefits of exercise are many. It seems to have a catalyst effect by making watching what we eat even more effective. Studies have shown that those who exercise during and after weight loss have a much better success rate at keeping it off. It also helps us to deal with stress and avoid overeating for comfort. Success leads to success. The more positive changes we make, the greater the chance we will not return to the habits that made us unhealthy in the first place.