Recently a patient told me his entire family is fighting obesity. He shared a conversation he had with his daughter, a freshman in college. He says he told her, “Honey I love seeing you but when you come home again, I want to see less of you.” She responded, “Yes daddy.” When she returns to college, she may have plenty of friends to join her in the gym.
In the United States of America, obesity is considered a chronic disease. It is a worldwide problem and a leading cause of death. Every year, nearly 3 million adults die from obesity related illnesses. Today, more people die from obesity related deaths than from malnutrition. [i] Some examples of illnesses associated with obesity include hypertension, hypoventilation syndrome, pulmonary disease, fatty liver, hypercholesterolemia, type 2 diabetes, coronary heart disease, stroke, obstructive sleep apnea, gallbladder disease, osteoarthritis and cancer. Some cancers related to obesity are endometrial, breast, colon, kidney, gallbladder and liver.
What causes obesity?
Obesity is a complex illness caused by a combination of factors. Dietary choices, patterns of eating, reduced physical activity, medications,
Eating too many calories
Exposure to endocrine disruptors
Eating high fructose corn syrup
Not getting enough sleep
Atypical antipsychotics: olanzapine, quetiapine, risperidone
Mood stabilizing drugs
Hypoglycemic medications: tolbutamide
Some medical conditions
Do Genes Cause Obesity?
Researchers have not identified a single gene that causes obesity. The research does suggest that genes can be modified by diet, environment and lifestyle. These genetic modifications may explain why some people become obese. Genetic modifications may also be an explanation for the inability to maintain weight loss. and keep from regaining the weight.
When a person is obese for long periods of time, it may be difficulty to lose weight because prolonged obesity can cause the body the turn on a gene that produces a protein called sLR11. In addition to srL11, in some cases a faulty gene known as the obesity-associated gene (FTO) is responsible for obesity. The FTO gene determines how much ghrelin a person produces. Ghrelin is a hormone that affects appetite. A high ghrelin level causes an increase in appetite.
How Can I Determine If I’m Obese?
Obesity is determined by body mass index and waist line measurement.
What is Body Mass Index
Body mass index (BMI) is an indirect way to measure body fat. The BMI is a calculation based on height and weight. The BMI can be calculated manually using the formula:
There are now many internet sites programed to do this calculation and easily provide the BMI after inputting height and weight into the website.
There are also charts or tables that can be used to help most people find the BMI associated with a height and weight.
A body mass index less than 25 and greater than 18.5 is recommended. People with a BMI between 25-29.9 are considered to be overweight. Obesity is defined as a BMI of 30 or higher. There are different categories of obesity.
According to the National Institutes of Health (NIH) , the ideal BMI is 18.5-24.9.
Class 1 BMI 30-39
Class 2 BMI 39.1-40
Class 3 BMI greater than 40
Some people believe a waist or hip measurement is a better indicator of obesity and that the BMI should not be used as a sole indicator of obesity. For example of why BMI alone can be misleading is the well- fit athlete with high muscle mass. The BMI may be high but the risk for complications due to obesity is not the same as the risk in an deconditioned person with the same high BMI.
The distribution of body fat should also be considered. People tend to accumulate excess body fat either around the waist or around the hips. The accumulation of fat around the waist gives the body and apple shape. Accumulation around the hips gives a pear shape. People with the body shape described as “apple” have large waist lines and truncal obesity. Truncal obesity has a greater association with heart disease compared to the risk associated with body fat concentrated around the hips. Therefore, people shaped like apples have a greater risk for obesity related illnesses and death due to obesity.
Risk associated with a high BMI and excessive body fat
Body fat is inflammatory tissue. It is fatty tissue that produces inflammatory proteins that affect multiple body organs.
Limitations of the BMI
In muscular people, the BMI overestimates body fat. In people with sarcopenia, the BMI may underestimate body fat.
Ten Easy Steps to Calculate Your BMI
Step 1: Empty your bladder
Step 2: In a private location, remove your shoes and clothes
Step 3: weight yourself in pounds
Step 4: Stand against a wall and put one hand on top of your head. Move your hand toward the wall until your fingertips just barely touch the wall. Mark the spot lightly with a pencil.
Step 5: Measure the distance from the floor to the mark on the wall. Record the number of feet and the number of inches. This is your height. For example 5 feet 7 inches
Step 6: Find the formula to calculate your BMI (click here -->) Adult BMI Calculator or copy and paste this shortcut link into your browser. http://bit.ly/2qCUxUe
Step 7: input your height in feet and inches in the spaces provided
Step 8: next, input your weight in the space provided
Step 9: Select calculate
Step 10: Congratulations! A page with details about your BMI and suggestions appears.
What to Do Next
If your BMI is above 24.9 get nutritional counseling. Learn the difference between real food and fake food. Just eating real food will help you lose weight.
Become familiar with portion size. I saw a video of Chris Rock reading a food label, “ Who says this feeds two! I say this feeds 1.” Does this sound like you? Learn more about portion size at this website: https://www.nia.nih.gov/health/serving-and-portion-sizes-how-much-should-i-eat
Get moving. Before you start an exercise program, talk with your health care provider. If you’ve sedentary for a while, you need to the type and how much exercise you can do without causing harm. Once you get the okay, find a physical activity you enjoy and get busy. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/fitness/art-20048269
Get a good night’s sleep. You need between 7-9 hours of sleep each 24 hour period.
If you can’t sleep well you might have obstructive sleep apnea syndrome (OSAS). Sleep apnea is a common sleep disorder. If you were diagnosed with OSAS and have a CPAP machine somewhere in the back of your closet, it’s time to dust it off and head to your health provider to restart your therapy.
If you never enjoyed using your CPAP machine, let me share some tips for falling in love with your CPAP Machine. Read my tips at www.bit.ly/loveCPAP.
Don’t know if you have sleep apnea? Complete this DIY questionnaire to see if you are at risk for OSAS. Then talk with your health provider to get treatment. http://www.stopbang.ca/osa/screening.php
[i] Bueno, et al (2013). Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomized controlled trials. Bristish Journalof Nutrition, 110,1178-1187.