Commonly described as an epidemic, obesity affects a disproportionate amount of the American population. Not only are more than 36% of U.S. adults obese (as well as 17% of children and teenagers), but obesity rates tend to be higher in Southern states. Obesity in children and adolescents has almost tripled since 1980, indicating a trend towards higher adult obesity in the future.
By Rashad Gober
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Understanding What Causes Obesity—and How to Fight it
It’s not just excess weight that does harm to a person’s health; it’s also the high likelihood of obesity-related illness. High blood pressure, cancer, asthma, and heart disease are all more common in those who are obese.
But it doesn’t have to be this way. Positive lifestyle choices, including a balanced diet and regular exercise, can be key to getting rid of excess body fat and its many side effects. In more critical instances, weight loss surgery may be an option.
Whether it’s by taking preventative measures or developing a comprehensive weight-loss plan, Americans must address this far-reaching problem head-on or suffer serious health consequences.
What is obesity?
The Obesity Action Coalition (OAC) defines obesity as a condition that is “associated with having an excess of body fat.” It is usually characterized by a Body Mass Index (BMI) over 30. BMI is a statistical measurement that takes into account a person’s height and weight and classifies a person as underweight, normal, overweight, obese, or severely obese. The higher the number, the higher a person’s BMI.
BMI, however, is not a comprehensive determination of body fat. A person with more muscle mass (and therefore, more weight) may be “overweight” on the BMI scale, while someone with more fat (and less weight) may be “normal.” This is why many experts also recommend measuring waist circumference.
How it affects the body
Obesity at any age has a number of detrimental effects on the body. Obese kids and teens are more likely to develop cardiovascular disease, high blood pressure, and high cholesterol. Research has also shown that obese children are likely to become obese adults.
Obese adults are likely to develop other chronic health issues as they age. Extra weight puts a lot of pressure on joints, and can lead to painful loss of ligament and cartilage tissue. Obesity also increases risk of developing sleep apnea (a disorder in which a person intermittently stops breathing during sleep), arteriosclerosis (a buildup of plaque in the arteries that can lead to stroke or heart attack), and certain gastrointestinal cancers.
Health problems aside, obesity has negative effects on overall quality of life. Increased medical issues can put a strain on your wallet. Those with obesity also report decreased energy levels (which can perpetuate a cycle of sedentary living and high body fat) and difficulty performing activities of daily living like cleaning, taking care of children, and grocery shopping.
Causes and Risk Factors
Why does obesity affect certain people and not others? The answers lie in individual-specific biology and lifestyle/environmental factors. Genetics play a role in your metabolism and how efficiently your body uses energy. This, along with family lifestyle, is why obesity tends to run in families.
“Studies have shown that genetics play a major role in obesity, but the good news is that your risk is only ‘permissive’ and not ‘determinative,’” says Dr. Jack F. Rutledge of Memorial Metabolic Surgery. “If you never fall into the trap of eating two or three times the calories your biology requires, you may never express the disease. Once established, though, the elevated set-point can be difficult to reverse because of highly adapted biological protections against starvation. Metabolic surgery appears to lower the set-point, giving a second chance to get the lifestyle part right for life.”
The majority of risk factors for obesity have to do with lifestyle choices. The most obvious is having a poor diet: eating high-calorie, low-nutrient foods, and drinking high-calorie beverages. Another lifestyle factor that contributes to obesity is not getting enough sleep. Lack of sleep can cause drastic changes in hormones that increase your appetite. Other risk factors include lack of physical activity (the average American exercises far less than his predecessors), and age (incidences of obesity double between the ages of 20 and 55).
Compounding the issue, portion sizes have become significantly larger. According to the National Heart, Lung, and Blood Institute (NHLBI), food portions at American restaurants have doubled over the past 20 years.
The good news is that, in many cases, obesity is preventable. It’s especially important to recognize and prevent obesity in children, because physical effects of extra weight can prevent normal growth.
Obesity prevention for children begins at home. Take steps to make your family’s diet healthier and encourage an active lifestyle. “Helping your child maintain a healthy weight can be a challenge in our fast-food culture,” says Dr. Teresa Baysden, a physician with Doctors Express Urgent Care in Hixson. “Parents can encourage healthy eating habits by preparing nutritious meals and snacks that include fresh fruits, vegetables, and lean proteins. Keep unhealthy, sugary snacks out of the house, and limit fast food as much as possible.”
The American Heart Association (AHA) recommends kids get at least 60 minutes of moderate to vigorous physical activity daily. Instead of action figures and video games, give your kids toys like balls and jump ropes. Limit television time, and don’t allow them to have televisions in their rooms. “Promote exercise by sharing in fun activities with your child,” says Baysden. “Put down the TV remote, and go for a walk together! Remember that your child will look to you for guidance in choosing healthy foods, and will often eat what YOU eat. Model healthy choices for your child, and he or she will learn to embrace them too.”
Preventing obesity in adults is similar, but takes more self-motivation. The most critical aspect of prevention is a commitment to change. Changing eating habits and increasing physical activity requires consistency and hard work. Working with a dietician and/or physical trainer can be helpful in setting weight management goals and staying accountable to those goals.
If you are obese, there is no time like the present to begin taking steps towards health. It is possible to lose weight, but it’s important to realize that it can be a steady, grueling process. Start with trying to lose 1-2 pounds per week. This pace gives you time to integrate healthier lifestyle patterns and puts you on a track to keep the weight off. The reality is that those who lose weight too quickly tend to gain it back.
Forget fad diets and focus on creating a good balance between the amount of food you take in and the amount of energy you expend. This usually requires sticking to a strict diet and exercise plan and keeping close track of your progress.
If consistent attempts to lose weight fail, surgical intervention may be an option. The two most common bariatric surgeries are the laparoscopic Roux-en-Y gastric bypass and the laparoscopic gastric sleeve resection. Both procedures are very helpful in inducing changes to a person’s metabolism and hormonal response to food that favor weight loss. These changes can even directly treat some diseases such as diabetes. Some restriction of caloric intake is seen, but contrary to popular thought, the hormonal changes are believed to be chiefly responsible for the weight loss. Within two to three years after these surgeries, most people lose around 40-80% of their excess weight. Keep in mind, the National Institutes of Health (NIH) does have strict criteria to qualify for this surgery, including failed attempts at weight loss, no endocrine causes of obesity, and an absence of a drug or alcohol problem.
“Bariatric surgery candidates have a body mass index (BMI) that is 40 or greater or 35 to 40 with other diseases associated with obesity,” says Dr. Chris Sanborn, director of Metabolic and Bariatric Surgery at Erlanger Health System. “These diseases include diabetes, high blood pressure, high cholesterol, and many others. It is easy to find your BMI by using charts and calculators available on the internet or in your doctor’s office.”
To anyone considering bariatric surgery, doctors say it should be considered as one component of a weight-loss program rather than a stand-alone solution. “It is important to know that bariatric surgery is not a cure-all for obesity, but it is a powerful tool that can help you lose weight and regain your health,” Sanborn says. “It should be combined with a proper diet and exercise regimen.”
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With the country moving towards healthier eating habits, there is more hope in the battle against obesity than ever before. Research shows many adults can prevent certain chronic diseases by losing as little as 5-10% of their body weight. It’s never too late to take steps toward a healthier lifestyle. Why not start today?