Obesity
Obesity is a complex, chronic disease with several causes that lead to excessive body fat and sometimes, poor health. Body fat itself is not a disease, of course. But when your body has too much extra fat, it can change the way it functions. These changes are progressive, can worsen over time, and they can lead to adverse health effects.
The good news is that you can improve your health risks by losing some of your excess body fat. Even small changes in weight can have a big impact on your health. Not every weight loss method works for everyone. Most people have tried to lose weight more than once. And keeping the weight off is just as important as losing it in the first place.
Symptoms and Complications
The health risks associated with obesity include:
⦁ breathing disorders (e.g., sleep apnea, chronic obstructive pulmonary disease)
⦁ certain types of cancers (e.g., prostate and bowel cancer in men, breast and uterine cancer in women)
⦁ coronary artery (heart) disease
⦁ depression
⦁ diabetes
⦁ gallbladder or liver disease
⦁ gastroesophageal reflux disease (GERD)
⦁ high blood pressure
⦁ high cholesterol
⦁ joint disease (e.g., osteoarthritis)
⦁ stroke
⦁ reproductive system disorders, including decreased fertility
People who are obese may have the symptoms of the medical conditions mentioned above. High blood pressure, high cholesterol levels, breathing problems, and joint pain (in the knees or lower back) are common.
The more obese
Causes
Obesity occurs when your body consumes more calories than it burns. In the past, many people thought that obesity was simply caused by overeating and under-exercising, resulting from a lack of will power and self-control. Although these are significant contributing factors, doctors recognize that obesity is a complex medical problem that involves genetic, environmental, behavioural, and social factors. All these factors play a role in determining a person's weight.
Recent research shows that in some cases, certain genetic factors may cause the changes in appetite and fat metabolism that lead to obesity. For a person who is genetically prone to weight gain (e.g., has a lower metabolism) and who leads an inactive and unhealthy lifestyle, the risk of becoming obese is high.
Although a person's genetic makeup may contribute to obesity, it's not the primary cause. Environmental and behavioural factors have a greater influence – consuming excess calories from high-fat foods and doing little or no daily physical activity over the long run will lead to weight gain. Additionally, not getting enough sleep and certain medications may cause weight gain leading to obesity. Childhood obesity that persists beyond early childhood can make weight loss in adulthood more difficult. Around 15% of women permanently gain 20 or more pounds with each of their pregnancies.
Prevention
Changing your lifestyle
Obesity is managed and treated to decrease the health risks caused by obesity and to improve quality of life. An appropriate weight management program usually combines physical activity, healthy diet, and change in daily habits. Other programs may also involve psychological counselling and, in some cases, drug therapy. Losing weight and keeping it off is very challenging because lifestyle and behavioural changes are required.
What's important is to eat a healthy, balanced diet. Fad and crash diets don't work and can be dangerous. The body needs a minimum amount of energy from food to function normally. No daily diet with less than 1000 to 1200 calories should be used without medical supervision. "Crash diets" are never successful in the long term because once the diet is stopped, the weight usually comes back. Commercial weight-loss plans and clinics are successful businesses because they have so many return customers.
To lose weight successfully, and to maintain a healthy weight, requires lifelong changes in eating and exercise habits as well as an understanding of emotional factors that lead to overeating. It also involves setting and achieving specific and realistic goals. People who are medically obese should consult a doctor or dietitian for a safe and personalized weight-loss program. Behavioural therapy or modification can also help. Seeing a therapist or counsellor can help you understand the emotional and psychological reasons for overeating and can teach you ways to manage your eating triggers.
Regular physical activity is an important part of weight management. In addition to managing weight, exercise also improves overall health and can help reduce the risk of diseases such as certain cancers, heart disease, and osteoporosis. Regular physical activity doesn't mean you have to join the nearest gym. It can be as simple as climbing the stairs instead of taking the elevator, walking or cycling to work and leaving the car at home (if at all possible), or going for a walk at lunchtime with coworkers. What's important is to add exercise to your daily routine, and to work towards a higher activity level. Choose activities and exercises you enjoy.
Medical intervention
Medications may be part of a weight management program. Medications aren't "magic cures" leading to permanent weight loss. They're generally used in combination with a proper diet and exercise program. They are only for people who are classified as obese (i.e., those with a BMI over 30), or people with a BMI of 27 and extra heart disease risk factors such as high cholesterol or diabetes.
Some medications are approved for short-term use only. One example of a weight-loss medication available in Canada is orlistat*, which blocks the absorption of fat from the bowel. Liraglutide, a medication used mainly to treat type 2 diabetes, may also be used for weight loss, as it decreases appetite and food intake. A combination of naltrexone and bupropion may be used to help with weight loss. Naltrexone is thought to help by suppressing appetite, while bupropion (traditionally used as an antidepressant) changes the amount of certain chemicals in the brain which causes a reduction in food intake. Talk to your doctor about whether medications are an option for you. Surgery is only considered when other weight management options have not been successful. There are many forms of obesity surgery, but often surgery reduces the size of the stomach so that only a small amount of food can be eaten comfortably. Some of the terms used to describe the surgeries used to treat obesity include:
⦁ gastric surgery
⦁ gastric bypass surgery
⦁ laparoscopic band surgery
⦁ Roux-en-Y gastric bypass
⦁ stomach "stapling"
When reviewing suitable management options, it's important to consider the risks and benefits of each option. Your doctor and other health care professionals can provide you with the information you need to make an informed choice about what options are best for you.
What causes obesity?
Eating more calories than you burn in daily activity and exercise — on a long-term basis — can lead to obesity. Over time, these extra calories add up and cause weight gain.
But it’s not always just about calories in and calories out, or having a sedentary lifestyle. While those are indeed causes of obesity, some causes you can’t control.
Common specific causes of obesity include:
⦁ genetics, which can affect how your body processes food into energy and how fat is stored
growing older, which can lead to less muscle mass and a slower metabolic rate, making it easier to gain weight
not sleeping enough, which can lead to hormonal changes that make you feel hungrier and crave certain high-calorie foods
pregnancy, as weight gained during pregnancy may be difficult to lose and might eventually lead to obesity
Certain health conditions can also lead to weight gain, which may lead to obesity. These include:
polycystic ovary syndrome (PCOS), a condition that causes an ⦁ imbalance of female reproductive hormones
⦁ Prader-Willi syndrome, a rare condition present at birth that causes excessive hunger
Cushing syndrome, a condition caused by having ⦁ high cortisol levels (the stress hormone) in your system
hypothyroidism (underactive thyroid), a condition in which the ⦁ thyroid gland doesn’t produce enough of certain important hormones
osteoarthritis (OA) and other conditions that cause pain that may lead to reduced activity
How can you prevent obesity?
There’s been a dramatic increase in obesity and in obesity-related diseases in the last couple decades. This is the reason why communities, states, and the federal government are putting an emphasis on healthier food choices and activities to help turn the tide on obesity.
On a personal level, you can help prevent weight gain and obesity by making healthier lifestyle choices:
Aim for moderate exercise like ⦁ walking, ⦁ swimming, or ⦁ biking for 20 to 30 minutes every day.
Eat well by choosing nutritious foods, like ⦁ fruits, ⦁ vegetables, ⦁ whole grains, and ⦁ lean protein.
⦁ Eat high-fat, high-calorie foods in moderation.
