Obesity

Obesity is a chronic health condition characterised by excess body fat (adipose tissue) accumulation that can adversely affect health over time. Body mass index (BMI), calculated based on a person’s weight and height, is a common tool for assessing obesity. According to the Centers for Disease Control and Prevention (CDC), obesity in adults is typically defined as having a BMI of 30 or higher. Obesity is associated with an increased risk of developing several serious diseases, including type 2 diabetes, heart disease, and certain types of cancer.

While BMI provides a general indication of body fat levels, it does have limitations as a measurement tool. These limitations stem from the fact that BMI does not differentiate between fat mass and muscle mass, nor does it account for factors like body composition or fat distribution. Despite its drawbacks, BMI remains a widely used screening tool in clinical settings due to its simplicity and ability to assess potential health risks associated with excess body weight quickly.

What causes obesity?

Obesity can result from consistently consuming more calories than you expend through daily activities and exercise. This imbalance leads to weight gain over time. While calorie intake and sedentary lifestyles are primary factors contributing to obesity, several other causes may not be entirely within an individual’s control:

• Genetics: Genetic factors affect how the body metabolises food for energy and stores fat. People with a family history of obesity may be more likely to gain weight.
• Ageing: As individuals age, they typically experience a decline in muscle mass and a slower metabolic rate, which makes weight gain more likely and weight loss more challenging.
• Sleep Deprivation: Insufficient sleep disrupts hormonal balance, increasing appetite and craving calorie-dense foods. This can contribute to gradual weight gain.
• Stress: Elevated stress levels can stimulate the release of cortisol and other hormones that promote fat storage, particularly in the abdominal area, and increase overall food intake.
• Pregnancy: Weight gain during pregnancy can persist after childbirth, making long-term weight management more difficult and potentially leading to obesity over time.
• Health Conditions: Certain medical conditions can predispose individuals to weight gain and obesity:
  • Metabolic Syndrome: A cluster of conditions including high blood pressure, high blood sugar, abnormal cholesterol levels, and excess abdominal fat.
  • Polycystic Ovary Syndrome (PCOS): A hormonal disorder that can cause weight gain due to insulin resistance and hormonal imbalances.
  • Prader-Willi Syndrome: A rare genetic disorder characterised by insatiable hunger and a tendency to overeat.
  • Cushing Syndrome: Occurs when the body is exposed to high levels of cortisol over an extended period, leading to weight gain, particularly around the face, upper back, and abdomen.
  • Hypothyroidism: A condition where the thyroid gland does not produce enough thyroid hormones, which can slow down metabolism and lead to weight gain.
• Osteoarthritis and Painful Conditions: Chronic pain from conditions like osteoarthritis can limit physical activity, contributing to weight gain.

Who is at risk of obesity?

Obesity is influenced by a complex interplay of various factors that can increase an individual’s risk. Here are some key contributors:

• Genetics: Genetic predisposition plays a significant role in determining how the body processes and stores fat. Some individuals may inherit genes that make them more prone to weight gain and obesity.
• Environment and Community: Surroundings, where individuals live, work, and socialise, have a profound impact on their eating habits and physical activity levels:
  • Food Environment: Living in neighbourhoods with limited access to nutritious foods but abundant availability of high-calorie options (e.g., fast-food restaurants) can contribute to the overconsumption of unhealthy foods.
  • Cooking Skills and Nutrition Knowledge: Lack of knowledge about balanced meals and cooking skills can lead to reliance on processed or fast foods, often high in calories and low in nutritional value.
  • Physical Activity Environment: Limited access to safe and inviting spaces for physical activity, such as parks or sidewalks, can discourage regular exercise.
    
• Psychological and Emotional Factors: Emotional states and psychological conditions can influence eating behaviours and weight:
  • Depression: Some individuals may turn to food as a coping mechanism for emotional distress, leading to overeating and weight gain.
  • Sleep Patterns: Disrupted sleep patterns, such as insufficient sleep or sleep disorders, can disrupt hormonal balance and increase appetite, particularly for high-fat and high-carbohydrate foods.
  • Smoking Cessation: Quitting smoking is beneficial for overall health but can lead to weight gain in some individuals. Managing diet and exercise during the quitting process can help mitigate this risk.
    
• Medications: Certain medications are known to contribute to weight gain as a side effect:
  • Corticosteroids: Used to treat conditions like autoimmune diseases, corticosteroids can increase appetite and lead to weight gain.
  • Antidepressants and Antipsychotics: These medications may alter metabolism or increase appetite, contributing to weight gain over time.
  • Beta-blockers: Prescribed for conditions like high blood pressure, beta-blockers can slow down metabolism and decrease calorie expenditure.

What are the complications of obesity?

Obesity not only results in weight gain but also poses significant health risks due to the high ratio of body fat to muscle. This imbalance places strain on bones and internal organs, contributing to various health complications:

• Increased Inflammation: Obesity is associated with higher levels of inflammation in the body, which can elevate the risk of developing chronic diseases, including certain types of cancer.
• Type 2 Diabetes: Obesity is a significant risk factor for insulin resistance, and type 2 diabetes is when the body becomes less responsive to insulin, leading to elevated blood sugar levels.
• Cardiovascular Diseases: Obesity is linked to an increased risk of heart disease and high blood pressure (hypertension), both of which can lead to severe cardiovascular events such as heart attacks and strokes.
• Cancer: Certain types of cancer, including breast, colon, and endometrial cancers, are more prevalent in individuals who are obese.
• Gallbladder Disease: Obesity can contribute to the formation of gallstones and increase the likelihood of developing gallbladder disease.
• Fatty Liver Disease: Non-alcoholic fatty liver disease (NAFLD) is common in obese individuals and can progress to more severe forms of liver disease.
• High Cholesterol: Obesity is associated with elevated levels of cholesterol and triglycerides in the blood, increasing the risk of atherosclerosis (narrowing of the arteries).
• Sleep Apnea and Respiratory Issues: Excess weight can lead to obstructive sleep apnea and other breathing problems, impacting sleep quality and overall health.
• Joint Problems: Obesity contributes to joint wear and tear, increasing the risk of osteoarthritis and joint pain.
• Infertility: Obesity can affect hormonal balance and reproductive function, leading to fertility issues in both men and women.

These health complications underscore the importance of maintaining a healthy weight through a balanced diet, regular physical activity, and lifestyle modifications.

How is obesity treated?

A structured exercise program and increased daily activity — between 150 and 300 minutes will help build your strength, endurance, and metabolism. Cutting down on fatty foods and carbohydrates, as well as following a well-structured diet with meals easily found in the environment, aids in weight loss. If you are obese and would like to lose weight but have been unable to do so on your own, medical help is available.