At one point in time or another, many of us must have come across individuals who clearly have disproportionate figures and wondered how and why their bodies have reached such sizes. Such people are termed overweight or obese. Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health. It occurs overtime as a person gains more calories than they lose. Obesity differs from being overweight in that while being overweight means weighing too much, obesity means having too much fat. However, in both cases, the patient weighs more than is healthy for his or her height. Most ancient cultures recognised obesity as a disease while in others, it was considered a sign of fertility (in women) or affluence since only those with adequate access to food could afford to be obese while most faced a lack of food security. Obesity was recognised as a disease by the American Medical Association in 2013.
Obesity is generally diagnosed as having a Body Mass Index larger than 30 and is classified into severe obesity, morbid obesity and super obesity. Diagnosis of obesity in children is dependent on age and sex. It has been found that Asians face health risks at a lower BMI so, lower values are used to diagnose obesity in some parts of the region. The most common cause is excess food and lack of physical exercise. However, some cases may be attributed to a person’s genetic makeup or the presence of psychiatric conditions. Chemical imbalances caused by the use of medication such as corticosteroids, anti-depressants and seizure medicine as well as hormonal conditions such as hypothyroidism and Cushing’s syndrome may also contribute to obesity1. Studies have also shown that lack of sleep, especially in teenagers and adolescents may lead to obesity.
What does Body Mass Index mean?*
Obesity can be treated by adopting a healthy diet and physical exercise. It can also be prevented by making lifestyle changes. Another way of treating obesity sometimes used when desired results are not achieved through healthy eating and exercise alone is bariatric surgery which is a variety of procedures performed in
Normal weight 25.0-29.9 Overweight
30 and above
obese people usually involving reduction in stomach size, using balloons or removing portions of the stomach or rerouting the intestines to a small pouch(gastric bypass).
Obesity can lead to cardiovascular disease, Type 2 diabetes, sleep apnea, some cancers, osteoarthritis, asthma and reduced life expectancy. In many societies, a stigma is attached to obese people and they may find it difficult to start relationships or obtain employment.
Naturally, we seek to explain little understood phenomena about the body and metabolism. This has led to several myths about obesity. The adoption of such myths can lead to unhelpful or harmful practices and mistreatment of obese individuals.
Little, constant changes in caloric intake will produce long-term weight changes.
Studies have shown that individual variability can affect changes in body composition in response to changes in energy intake and expenditure.
Setting realistic weight loss goals is important because patients can get easily discouraged and lose less weight.
As reasonable as this may seem, data indicates no negative association between high goals and weight loss success. In fact, there may be a positive relationship between setting ambitious goals and losing more weight.
Weight lost quickly, will return quickly. MYTH DEBUNKED
Within trials, rapid weight loss, has resulted in lower weight at the end of the day. Recommendation to lose weight slowly may interfere with the ultimate success of weight loss efforts.
Assessing the will of patients to enter weight loss programs is important for predicting success.
Voluntary entry of obese individuals into weight loss programs has been found to have no significant effect on the success or failure of such programs.
Physical Education is important for childhood obesity reduction.
Analysis has shown that even specialised school programs directed at preventing childhood obesity have not been effective in reducing Body Mass Index. Although, there is a level of physical activity that could reduce obesity, it is uncertain whether it will be achievable in school settings.
Breastfeeding reduces obesity in childhood.
Existing data shows that although breastfeeding has important benefits for both mother and child, it does not have any significant anti-obesity effects in children.
One act of sexual activity burns 100 to 300 kcal in each participant and can thus help to reduce obesity.
Data collected has shown that you burn no more energy having sex than you do walking at a moderate pace. The amount of energy generally burned is equal to that expended walking at 4km/hr.
Although genetics play a role, heredity does not absolutely decide whether or not a person will be obese.
Dieting may reduce weight but not always work well in the long-term.
Increasing exercise regardless of body weight promotes good health.
Physical activity helps long term weight maintenance.
Continuing conditions that promote weight loss requires high maintenance.
For children, weight loss programs involving the home and parents are more helpful.
Provision of healthy food choices and the use of meal replacement products promote greater weight loss.
In cases where dieting and increased physical activity fail, drugs and surgery can be used to help obese patients.
1Cushing’s syndrome is a condition caused by over-exposure to cortisol from tumours of some endocrine systems or elsewhere in the body.
*Body Mass Index is measured by dividing a person’s weight in kilograms by the square of their height in meters
(New England Journal of Medicine, 2013)
Other sources: National Institutes of Health, Medscape.com