How did we get here?

I think most of us have some sense that there is a link between weight loss and health. I see so many people struggling to lose weight every day. Depending on personalities, some people are super driven. Once they commit to losing weight, they go for it and there is no turning back. Unfortunately, this is the minority, not the majority.  

Most of us know that we need to lose weight if we are overweight. However, changing your lifestyle to incorporate healthy foods and exercise is not so easy. Major life changes, regardless of what they are, are difficult for most of us. In addition, if you are very overweight, it is much more complicated than this.

Weight management is about much more than having your clothes fit better or just going back to an old weight. Weight loss is directly tied to health. We know it is better for our bodies and our overall health. However, how many people really know what is at stake here? Today, obesity is a true health crisis and an epidemic. I think it is time we start thinking about it as a disease unto itself and not just mere “problem”.

Perspective

According to the Center for Disease Control (CDC), the prevalence of obesity has gone up at an alarming rate:

In 1991, only 4 states had a prevalence of obesity of 15-19% and no states had rates at or above 20%. Today, NO state has a prevalence of obesity below 20%.

Furthermore, 20% – 25% of adults were obese in 2 states (Colorado and Hawaii) and the District of Columbia, 25% – 30% of adults were obese in 19 states, 30% – 35% of adults were obese in 22 states, Guam, and Puerto Rico. Lastly, 35% or more adults were obese in 7 states (Alabama, Arkansas, Iowa, Louisiana, Mississippi, Oklahoma, and West Virginia) 😱

If you compare the data, from 1991 to 1998, we had an increased rate of obesity of 50%!

What is going on world wide? Well if you see the map below, the darker the green, the higher the rate of obesity, you can see it is spreading. The darkest green equals a prevalence of obesity of 30% or more and the second darkest green represents a prevalence of 20-29.9%

If we look at the numbers by age, we see that the lowest rate of obesity is in the 20-39 y/o group, followed by the over 60 y/o group and then the highest rate, which is in the 40-59 y/o group.  

Definition

Ok, so now we know the magnitude of the problem, let’s look at how we decide who is obese.

Just what defines obesity? Your body mass index (BMI) is a measurement that looks at the relationship between your body weight and your height.

A person is considered overweight if their BMI is greater than or equal to 25 kg/m2 and obese if their BMI is greater than or equal to 30 kg/m2.

BMI = Weight in Kg

            Height in m²

Why is this happening?

If we all know there is a connection between weight loss and health, why is obesity a crisis? Well there are many reasons for this.

Overall, society as a whole is more sedentary today. At the same time, everything went “biggie”. We have increased our plate sizes and we have come to value restaurants that serve bigger portions. 

Fast foods have also caught on to the size game. In addition, fast food today contains more fat and sugar than it did 30 years ago.

What else? We eat out more. We eat less together as a family. All things that lead to increased caloric intake. We tend to prefer foods that are easier to prepare with our busy lifestyles. These are often loaded with calories and preservatives.

I think it is also worth mentioning, there is a genetic component to weight loss and health. I would argue that this was always there, though, and what we see today is more an impact from our environment.

Nonetheless, when studies look at adopted twins, the twins’ weight tends to correlate more with their biological parents’ weight, than that of their adoptive parents. As mentioned, environment also plays an important role, but I think it is vital to know that this is not just a will-power issue, which is unfortunately part of the stigmatization obese people often face.

There are also medical conditions that predispose patients to weight gain, but this is not the majority of cases, so I will not discuss these any further in this post.

Why is it so hard to lose weight?

From an evolutionary standpoint, our bodies have a stronger resistance against weight loss than defense against weight gain. In the olden days, food was scarce and hard to come by, so you were likelier to die from starvation than from weight gain (ooops, looks like we reserved that problem). It was better for you to have a nice reserve to protect you when food was hard to come by.  

We no longer have to hunt or look for food and in most developed countries you have a constant food supply. Unfortunately, our bodies have not caught up to these changes, because these occurred relatively recent in our human history.

Obesity as a disease

Obesity is the culprit behind so many health ailments. Let’s look at a few of these:

Overall Death

According to the Framingham study, for every extra pound of weight you gain from age 30 to 42, you increase your risk of death over the next 26 years by 1% and by 2% for every extra pound between 50-62 years of age.

Metabolic problems

Obesity is associated with the development of Type II diabetes, insulin resistance, high blood pressure, high triglycerides and low good cholesterol levels.

Psychological

Obese individuals face higher rates of mental illness including depression and anxiety disorders.

Not to mention that, unfortunately, society does stigmatize obese individuals. According to the Obesity Society:

Experimental studies have found that when two resumes are sent, accompanied by pictures, the overweight applicant is rated more negatively and is less likely to be hired.  In addition, overweight employees may suffer wage penalties, as they tend to be paid less for the same jobs, are more likely to have lower paying jobs, and are less likely to get promoted than thin people with the same qualifications.

At the college level, some research shows that qualified overweight students, particularly females, are less likely to be accepted to college than their normal weight peers.

It is certainly worth mentioning that research indicates that stigmatization and weight shaming most often have the opposite effect. People who are made to feel bad about their weight tend to engage in more “binge” eating behaviors as a coping mechanism. Discrimination of any kind is not acceptable and we should certainly steer away from it. You cant “shame” somebody in to losing weight.

Cardiovascular

Obesity is associated with higher risk of coronary artery disease, stroke, heart failure and abnormal heart rhythms.

Gynecological

Pregnant obese women have a higher rate of complications and obese women in general have higher rates of infertility.

Gastrointestinal

Higher incidence of gastric reflux, gallbladder disease and fatty liver are seen in obese patients.

Respiratory

Sleep apnea is much more common in obese individuals. This makes it harder to have restful sleep. In turn, research shows that people who sleep less than 7 hours per night experience higher rates of obesity. According to the NHANES I study, if you sleep less than 5 hours per night, you have a 73% increased rate of obesity! 😱

Other health complications for the lungs related to obesity include a higher risk of asthma and pulmonary embolus.

Bone and joints

Our bodies were not made to carry large amounts of weight for prolonged periods of time, so obese individuals have faster “wear and tear” of joints. This leads to higher rates of osteoarthritis and back pain.

Cancer

Obesity is associated with various types of cancer. These include: breast, endometrium, colon, rectal, esophageal, pancreas, kidney, thyroid, gallbladder, blood and skin.

Just this morning, in a rather timely manner, this popped up in my medical news feed:

HealthDayreports the researchers found that “women aged 20 to 49 who were overweight or obese had up to twice the risk for colon cancer before age 50, compared with normal-weight women.”

The good news

So, if you are obese or you have someone in your life who is obese (chances are pretty good if you live in the United States or a few other developed countries), you may be feeling scared or worried after reading this. You may be wondering about achieving weight loss and health.

There is good news though! By losing weight, you can reverse all of these possible risk factors. You can even reverse type II diabetes!

Yep, if you didn’t know it, weight loss reverses disease! Among other things, according to the Framingham study, when you lose weight you lower your blood pressure, improve your blood lipids and your blood sugar.

Sometimes people have been trying for years to lose weight by dieting and exercising, only to bounce back to the start line after some improvement. Weight loss is HARD and the longer you have been overweight, the harder it is.

Don’t be discouraged though! These days, there are medications and surgical procedures that can help if you are feeling frustrated and defeated by years of difficulties losing weight. Don’t give up, talk to your physician and explore your options because, to be honest, your life depends on it.

Stay motivated or help someone in need get there,