OBESITY: A RISK FACTOR FOR OTHER DEGENERATIVE DISEASES

Obesity can be a serious health problem and is ultimately no laughing matter. Obesity is a risk factor for other generative diseases, such as diabetes mellitus (type 2 adult onset), diseases of heart and circulation, and certain cancers. Obesity is defined as an excess of body fat. By using body weight as an index, obesity is a weight greater than 20% more than the average desirable weight for men and women of a given height. Obesity results when there is an imbalance between energy intake and energy expenditure.
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CAUSES

Over Eating

This may result from primary failure in the regulation of ingesting behavior at the cognitive level. This usually results in excessive caloric intake that exceeds energy needs of the individual. Why do people over eat? Set points are only one piece in a complex puzzle that scientists are still trying to solve. Their search is fueled by the fact that obesity is a major health risk and, for many, a source of social stigma and low self-esteem. If eating were controlled only by internal needs, fewer people would overeat. The sight or aroma of food often makes people want to eat, even when they do not feel hungry. It seems that many people are sensitive to external cues (signs and signal linked with food). If you are sensitive to external cues, you are most likely to eat when food is attractive, highly visible, and easy to obtain. People of all weights can be found who are unusually sensitive to external eating cues. Placing animals on a supermarket diet, for instance, can lead to gross obesity. In one experiment, rats were given meals of chocolate chip cookies, salami, cheese, bananas, marshmallows, milk, chocolate, peanut butter, and fat. Rats on this diet gained almost three times as much weight as control animals that ate only laboratory rat chow (rat chow is a dry mixture of several bland grains. If you were a rat, you’d probably eat more cookies than a rat chow too!) We humans also appear to be sensitive to dietary content. In general, sweetness, high fat content, and variety tend to encourage overeating.

Age

As a general rule, as you grow older, your metabolic rate slow down and you do not require as many calories to maintain your weight. Do people have different set points? YES, set points appear to be partly inherited and partly affected by childhood feeding pattern. If a child’s birth parents are overweight, the child is likely to become obese too. This suggested that genes greatly influence adult weight. Also, the set point tends to be higher for people who were overfed as children. Adults whose weight problems began in childhood tend to have more fat cells and larger fat cells in the body. What about a person who does not become overweight until childhood? In that case, the fat cells grow larger, but they usually do not increase in number. Thus, weight problems that began in childhood are much more difficult to control.

Emotional factors

Many people overeat when they are stressed, bored or angry. Overtime, the association between emotion and food can become firmly fixed. Depression or stress are also causes of obesity and other patterns of disordered eating. A cursory observation reveals that people with weight problems are just as likely to eat when they are anxious, angry or sad, as when hungry. Furthermore, unhappiness often accompanies obesity in our fat-conscious culture. The result is a pattern of overeating that leads to emotional distress and still more overeating.

Sex

It is common in women in whom it is liable to occur after pregnancy, especially repeated pregnancies. A woman may gain as much as 12.5kg during pregnancy. Most of this will be in form of adipose store mainly for the demand of lactation. However many women gain more weight and retain part of this weight becoming progressively obese with each succeeding child. Males have a higher resting metabolic rate than females, so males require more calories to maintain their body weight.

Environment/culture: An environment where people eat high fat and high sugar diets and take little exercise, causes more problems with excess weight and obesity than one where people eat low fat diets and regular exercise. Cultural belief also contributes to the development of obesity. It seems that our culture may provide the worst possible kinds of foods for those with a tendency toward obesity.
Lack of physical activity: lack of physical exercise are key factors in the increase of obesity and other metabolic disease. The more you move your body the more calories you burn.

TECHNIQUES AND STANDARD FOR MEASURING OBESITY

Body mass index (BMI):

This is calculated by dividing the body mass in kg by square of height in meters (BMI = kg/m2). The BMI is used to define underweight, overweight and obese individuals.
BMI Categories:

Underweight = <18.5
Normal weight = 18.5-24.9
Over weight = 25-29.9
Obesity = BMI of 30 or greater
Skinfold thickness
Waist/hip-ratios
Body fat distribution: Pear vs Apples

CASE STUDY

A 25 year old female weighing 68kg, height of 167cm and of moderate physical activity has a BMI 29. Healthy BMI ranges from 18.5-24.9, therefore healthy weight range is 43.3-58.5kg. Based on the current weight, height and activity level, daily calories requirement is 2291 calories. This is what is needed by this person to maintain the current weight. However, food is not the only thing that affects weight management; exercise or lack of it will impact of amount of calories burned and therefore the net caloric intake. To change your weight by 0.5kg or 1lb in one week, you must increase or reduce your net caloric intake by 500 calories per day or 3500 calories per week.

WHAT CAN BE DONE TO CONTROL WEIGHT

What is really needed if one wishes to lose weight is to overhaul eating habits and to control cues for eating. The person who succeeds in changing eating habits can expect a permanent weight reduction. This approach, called behavioural dieting, is greatly superior to simple dieting for weight control.
The following list summarizes several behavioural techniques that have proved helpful.

Learn your eating habits by observing yourself and keeping a “diet diary”. Begin by making a complete record of your eating habits for two weeks. Record when and where you eat, what you eat, and the feelings and events that occur just before and after eating.
Count calories, but don’t starve yourself. To lose, you must eat less, and calories allow you to keep an accurate record of your food intake. If you have trouble eating less every day, try dieting four days a week. People who diet intensely every other day lose as much as those who diet moderately every day.
Develop techniques to control the act of eating. Begin by taking smaller portions. Carry to the table only what you plan to eat. Pull all other food away before leaving the kitchen. Eat slowly, finish one mouthful before taking another, sip water between bites of food, count your mouthfuls, and leave food on your plate. Generally, avoid eating alone, since you are less likely to overeat in front of others. (One exception is eating at social events where food is plentiful and you are urged to eat. Another is eating with someone else who is overeating. In either case, eating may be facilitated).
Try to base eating on hunger, not on taste, or learned habits that dictate leaving a clean plate. When you see something really appealing, ask yourself. Am I hungry? Do I need to eat? Or do I just want a good taste? If your desire to eat is based on taste, turn the food down. Also, during meals pause for a minute or two and then ask yourself. “Am I full”. If the answer is yes, stop eating.
Learn to weaken your personal eating cues. When you have learned when and where you do most of your eating, avoid these situations. Try to restrict your eating to one room, and do not read, watch Tv, study, or talk on the phone while eating. Require yourself to interrupt what you are doing in order to eat. Be especially aware of the “night eating syndrome”. Most calories are consumed late in the day or at night. Keep food out of sight and find things to do to keep yourself busy during this dangerous period.

TREATMENT

A poor diet and lack of exercise are the most common causes of obesity, there are some fairly simple treatment for obesity.

Incorporating more natural foods into your diet
Drinking more water
Cutting out junk food and getting into the habit of exercising several times every week.

CONCLUSION

Excessive body fat resulting from an imbalance between energy intake and expenditure is the most important nutritional problem in developed countries and is rapidly becoming a global epidemic; a definition of a healthy diet that fails to address this problem would be deficient. Some well-intended guideline are highly prescriptive in terms of energy intake or servings per day of each food group. A fundamental problem is that even the healthiest combination of foods consumed in sight excess, by only a percentage or two, over an extended period will lead to overweight. It is a fact now that optimal health is linked to good nutrition. The importance of good nutrition is the main preventive measure against a high number of human diseases. The importance of good nutrition to achieve optimal health is unquestionable.

References

Lifestyle disease
Obesity and overweight
Journal of the ASEAN Federation of Endocrine Societies
Adult Obesity Causes & Consequences
Obesity Health Risk