Obesity the Disease
What is Obesity?
Obesity is a Chronic Disease marked by excess fat storage.
Obesity is often a life long battle and progressive in nature. It is often genetically related, but it is always costly to both the individual and society. Obesity takes a toll on an individual's productivity and self-esteem in addition to creating a multitude of health related issues that further degrade wellness and greatly increase healthcare costs. It is also important that we understand that the factors in obesity are often genetic and environmental and not always within an individual's control. While obesity is almost never cured with a diet, will power or counting calories, (if it was, the weight loss industry wouldn't be worth approximately 60 billion dollars - we would be "cured" and never "diet" again) there are solutions to this disease. However, it is important that we first understand how obesity has come to be.
Is obesity often cured with a diet?
Where Are We Now and How Did This Happen?
You are not alone
Approximately 100 million adults are clinically overweight.
- 60% being more than 50 pounds overweight
- 40% being classified as obese (A body mass index over 30 )
- Additionally, 33% of children are considered overweight/obese
- With childhood obesity on the rise, obesity has reached epidemic status. As a result, we are now starting to see a decrease in life expectancy by approximately 3-5 years.
Why did this happen?
The answer to this question goes back to our pre-historic bodies. 10,000 years ago humans had a life expectancy of 14-20 years filled with arduous labor and a diet that was largely based on plant matter, animal meats and were naturally low salt and sugar. Meals were infrequent and survival was based on how efficiently a body utilized its food for fuel.
Fast forward to today and it is easy to see that we have come a long way from days filled with strenuous labor and an "earth based" nutrition plan. In today's society, we are commonly sedentary in front of a computer to earn our paycheck and eat convenience foods approximately 25% of the time. Meals are frequent (food is available everywhere), engineered and heavy in carbohydrates and simple sugars. Other factors that affect our nutrition and bodies are (but are not limited to):
- Genetic predisposition
- Environmental factors
- Socioeconomic factors
- Cultural influences
- Hormonal influences
- Digestive abnormalities
- Dysfunctional sleep
As the world has evolved, many of these factors are out of people's control. Individuals can not control how our food system evolved and the sedentary nature of how we earn our living. Additionally, if one's body has not adapted well and now excessively stores fat, this trait can be passed genetically to the next generation.
Do you know what your BMI is? Please use the chart below to calculate. This will be important when we later discuss weight loss interventions. It is also important to understand that individuals with a BMI of 30 or above are considered clinically obese.
True or False. Approximately 100 Million Americans are overweight.
The Physical and Monetary Cost of Obesity
The cost of obesity is reflected in our health and our bank accounts.
Obesity taxes multiple organs and the systems our body needs to function. Medical complications and systems failure that can be associated with obesity are:
- High cholesterol
- Coronary heart disease
- liver disease
- gallbladder disease
- Hiatal Hernia
- Immune = Cancer
- Obstructive sleep apnea
- Restricted oxygen
- Pulmonary embolism
- Abnormal menses
- Polycystic ovarian syndrome
- Stress incontinence
With all of these common side effects due to being overweight, it is important to understand that the strain/overload on one or more of these systems equals premature death.
There is a significant cost of obesity to both the individual and to society.
- There are over 400,000 obesity related deaths per year
- Obesity is the second leading cause of preventable death
- On average, an obese person lives 22 years less than their healthy weight counter parts
- Nationally, obesity creates $147 billion in health care costs
- An obese individual spends 44% more on direct healthcare costs (examples of direct costs include physician visits, and pharmaceuticals)
It is clear that due to the costs to both the individual and society that being a healthy weight needs to be a priority.
True or False. Obesity is the second leading cause of preventable death
When is it Time to Take Action?
When is time to say "enough" and seek interventions beyond diet and exercise? Read on for some guidelines that can help answer that question.
Metabolic Set Point. What is it and why is it important?
The metabolic set point theory states that the body has a natural tendency to maintain a specific weight and will adjust internal body processes accordingly. If our bodies go above or below our set-point range, our metabolism will speed up or slow down to get our weight back in line.
What if your metabolic set point is high?
Diet and exercise can help bring your metabolic set point to a lower range, but if this is not carefully maintained, it will go back up to it's typical higher point.
Do you remember your number from the BMI chart previously shown in this presentation? If your BMI is over 40 and has been there for a year or more, clinically, it will be very difficult for you to bring your metabolic set point back to a healthy range.
In cases where BMI is in excess of 40 and has been over the course of several years, bariatric surgical treatment may be the only practical solution. Weight loss surgery disrupts the association between obesity and genetics which can fundamentally change the body’s set-point.
If your BMI is between 30 and 40 and diet and exercise has not worked, there is an intervention known as gastric ballooning that is another option in addition to surgery that could be right for you.
We explore both of these options in the next two sections.
True or False. There are interventions available if your metabolic set point is naturally high.