OBESITY

In any discussion about chronic disease we have to talk about the problem of obesity.

People who are chronically overweight or obese are at greater risk for acquiring all sorts of other health problems, most notably diabetes, heart disease, hypertension, stroke and some cancers.

All these are indeed feared chronic diseases in their own right.

In fact, it is now being predicted that the average life expectancy in the USA is about to drop by 5 years because of the problems associated with excess weight.

What’s causing the obesity problem?

One of the main causes for the increasing numbers of overweight and obese people in many countries around the globe is that we are leading essentially sedentary lives but eating more than enough food.

When lifestyles were more active – we walked more, we worked in the fields etc – the intake of calories matched the requirement for fuel. Now, we have actually increased the caloric intake, and we spend most of our time in physically undemanding activities.

In fact, we spend much of our times developing more ways in which to reduce our need to be physically active for the sake of convenience!

Consider all the labour-saving methods that you have at your disposal, and how frequently you choose the least physically demanding way of doing things e.g. using the elevator instead of climbing the stairs, driving your car as close to the entrance of the mall as possible, never walking if you can avoid it and so on.

What can we do about it?

Exercise

So, one of the first things that we need to do to counter obesity is to add exercise to our daily programmes.

In fact, this would be a true win-win situation as exercise is very beneficial to our overall health in many ways beyond mere weight control – it builds healthy bones, muscles and joints, decreases the risk for heart disease, cancer and diabetes, keeps aging bodies fit and strong, and even contributes to emotional and mental wellbeing.

Provided that one does not go overboard, there is nothing to argue against a sensible exercise regime.

The good news is that even moderate exercise is beneficial. What counts as moderate exercise? An example would be a brisk 30 minute walk 5 times a week. Household chores and gardening on a regular basis would also be beneficial, so one does not even have to leave home unless one wants to.

However, many people enjoy doing things with other people – it motivates them to continue with regular exercise. So dancing, bicycling, playing games, doing yoga, going to a gym etc can all be considered. Just find something that you can enjoy, and get involved.

Children and overweight

Unfortunately, obesity is no longer a problem of adults alone – more and more children are being diagnosed with the condition.

Obese children become obese adults because they have not learned (or not been taught) how to maintain a healthy body weight. This is going to lead to a major public health crisis in many countries around the world, with an upsurge of the diseases associated with obesity – occurring at a younger and younger age.

In fact, claims have been made (for example by James O Hill, PhD, director of the center for Human Nutrition at the University of Colorado) that the increased incidence of obesity-related diabetes alone might bring the US health care system to its knees.

But this is not only an American problem. The WHO estimates that there are more than 1 billion overweight people worldwide, with at least 300 million being clinically obese.

Lifestyle and weight

Ironically, these woes are associated with rising average incomes and standards of living and increased urbanisation. People start eating diets high in refined carbohydrates, sugars and saturated fats, instead of complex carbohydrates which formed the staples of less affluent societies.

They also leave physically active lifestyles behind, and succumb to the sedentary and lazy lifestyles that characterise modern urban society.

How do we deal with our overweight issues?

Of course we all know about ‘going on a diet’, and that this usually turns into a yo-yo process of gaining and losing weight.

We also know about exercising more, but somehow these things seem not to work for us. What do they really mean, and how can we make them an integral part of our daily lives – in other words, what lifestyle changes need to be made?

So how does one set about losing weight, and maintaining a healthy weight once you have arrived?

You need to watch what you eat!

Follow the advice embodied in the food pyramid. Healthy eating is crucial to control obesity. Read about the food pyramid on our Nutrition and Food page.

Smaller, more frequent meals are encouraged as a way to keep blood sugar levels within a healthy range as well as to control weight.

You need to incorporate physical activity into your daily life. Exercise can control body weight but you need to take it seriously – a casual stroll now and then will not burn the required calories. We have already mentioned the value of a brisk 30-minute walk five times a week, but rather aim at an hour a day – not necessarily all at the same time.

Things like taking the stairs instead of the elevator all contribute. Something that can be incorporated into the lives of anyone, including the frail and elderly, is rebounding, which has many health benefits beyond the exercise alone.

Take care of your gut!

Health scientists are giving more and more attention to probiotics that ensure that your body has the right balance of the bacteria that keep you healthy.

Reduce stress.

Stress is extremely bad for your health. Elsewhere on this site you will find a page on how to keep your stress levels - and your obesity levels - down.

What about going on a diet?

In general the popular diets are only temporary solutions, and don’t give you the lifelong benefits of changing your eating habits. In fact, there are probably three main reasons why going on diet usually fails you:

* It is approached as a ‘quick-fix’ solution. Once you have lost the desired weight, you return to ‘normal’ eating patterns, and the weight comes right back. It happens so often that it even has a name – the yo-yo effect.

* Many diets encourage you to eat a truly unbalanced diet for the duration of the weight loss process. This is in fact a kind of starvation – the body is being denied essential nutrients at the same time as calories are being reduced. It cannot continue this way as ill health is sure to follow.

* Many diets do not pay attention to the glycemic response to different foods. This means that insulin levels go on a roller-coaster ride. As a result you are not taught to eat well into the future, and the maintenance of a good healthy weight cannot happen.

Learn about leptin

Sometimes we gain weight because our brain is unable to read the signals that tell us to eat more, or stop eating.

This communication between the brain and fat cells is mediated by a hormone called leptin, which was only discovered quite recently, in 1994. It is secreted into the blood by fat cells, so the higher the mass of fat in the body, the higher the concentrations of leptin in the blood stream.

How does leptin work?

One of its roles is to influence the appetite response in the brain. High levels of leptin in the blood signal to the body to stop being hungry and therefore stop eating.

The body also tries to stop fat being deposited, but rather to step up metabolism and burn it off.

The problem is that many people have become leptin resistant – the brain can no longer recognise the signals being sent by leptin.

How does this happen? By having consistently high levels of the hormone in the blood. So the body stays hungry and continues to store more fat long after it should have heard the message to stop.

The effects of leptin do not stop there. High levels promote inflammation which has been linked to all sorts of diseases including heart disease and diabetes. In fact, this inflammation might well be the reason that obesity is linked with so many other chronic ailments.

Keep your brain listening to the leptin

Do this by using the same tried and tested ways:

* Stop eating processed foods, refined grains and sugars

* Eat lots of fresh fruits and vegetables

* Eat lean meat and make sure that your intake of healthy fats is adequate.

Keep at it!

And finally: persevere! Obesity is linked to many serious health problems. The lifestyle changes that we suggest here will have positive outcomes that impact on every aspect of your life.