What is Obesity?
What is Obesity?
Contributing factors
Important facts about obesity
Risks associated with obesity
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 reduced life expectancy and/or increased health problems.
For most of us, at some time in our life, we are able to maintain a steady weight from day to day, despite the amount of energy that we consume (eating food) and without balancing the amount of energy we burn off with different types of activities. The ability to do this without thinking about it is called the Weight Homeostasis mechanism:
ENERGY IN = ENERGY USED
This evolved in our primitive ancestors. They did not have fridges, so they could not store food, until a genetic aberration occurred, that allowed primitive man to store any excess food requirements as fat, which was used to keep them alive during the lean hunts and long winters. We all have this mechanism, as it is/was essential for survival. However, note that the mechanism is really about storing fat….not just keeping our weight stable. So, we all are genetically programmed to have a certain amount of fat present from day to day. Everyone is different, so in the real word “Ideal Weight” really does not exist. It differs for different races or ethnic groups and therefore it is sometimes difficult to define obesity in some of these ethnic groups.
For most people, being overweight is usually a simple imbalance between the food consumed (calorie intake) and the amount of activity (calorie burnt). The more we eat, the heavier (more fat) we get if we do not burn off those excessive calories. By eating less and exercising more, weight loss will occur as we are burning more calories.
However, at a certain size (body weight) in some people, some changes in their body chemistry occur, and they are unable to lose the excess weight by either dieting and/or exercising. The changes are almost always irreversible. Therefore despite their best efforts, some people slowly and steadily start gaining weight and eventually become obese. At this stage, lifestyle modifications (low-caloric diet and exercise) are of limited benefit – mean weight loss is about 5% of initial body weight after 1 year. Randomised Controlled Trials of a variety of diets showed final weight loss averaged <5% of initial body weight after 2 years. This is because the weight homeostasis mechanism has changed and the altered chemistry makes long term weight loss impossible. This process is called a genetic and neurohormonal breakdown in the weight homeostasis mechanism.
Contributing factors
1. Genetics
There is a saying “The genes load the gun and the environment pulls the trigger“.
As obesity is a genetic problem (not necessarily inherited as damage to a gene may occur after conception), there is often a family history of obesity, associated with other chronic diseases such as diabetes, abnormal blood fats, hypertension, and heart disease occurring in the family. The weight problem can be present from birth or develop later in life.
The risk times for females are puberty, childbirth, and to a lesser degree, approaching menopause. Typically, a person is able to lose weight for a while, but then the loss plateaus, and despite the best intentions in the world, all weight lost is regained, usually with a further weight increase i.e. a stepwise weight gain over the years. This happens repeatedly, so it becomes incredibly demoralizing and depressing.
2. Additional factors
Other factors can also contribute to weight gain. These are:
- Dietary choices
- Eating behaviours
- Sleep patterns and disturbances
- Stress, anxiety and depression
- Endocrine disorders (especially thyroid etc)
- Medications (e.g. steroids, antidepressive and antipsychotic medications etc)
- Reduced variability in ambient temperature (use of heaters and air conditioners) and other modern conveniences
Important facts about obesity
Obesity is a global epidemic. There are certain important facts about obesity which are worth noting:
- It is a chronic, relapsing disease, representing a significant and global medical challenge
- By 2015:
- 2.3 billion adults will be overweight (BMI 25-29 kg/m2)
- more than 700 million adults will be obese (BMI >30 kg/m2)
- The Australian National Health Survey (2011-2012) have found that 63.4% of adults are currently estimated to be overweight or obese, with males remaining more likely to be overweight than women.
- Cost of obesity to the Australian community is $58.2 billion
Risks associated with obesity
Once morbidly obese, patients have an increased risk of early death, and a huge list of illnesses attributable to the excess fat.
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The good news is that with fat loss, conditions attributed to excess fat will either improve substantially or disappear! These include diabetes, hypertension and sleep apnoea.
Imagine the satisfaction of no longer having to deal with chronic diseases, as well as being able to wear a swimsuit!
