Diet and nutrition
Understanding adult obesity
Abdominal obesity: do more than loosen your belt
Understanding adult obesity
Most people believe obesity means being overweight. Health professionals,
however, define obesity as excess body weight that includes muscle,
bone, fat and water. More specifically, obesity refers to excessive
body fat. This is important to remember since athletes such as
bodybuilders, wrestlers, and weightlifters can have a lot of muscle
and can be overweight without being obese.
A certain amount of body fat is necessary. Fat acts as stored
energy and plays an important role in insulation and shock absorption,
among other functions. Generally speaking, women tend to have
more body fat than men. Health professionals generally agree,
however, that men with over 25 percent body fat and women with
over 30 percent body fat are obese.
Obesity may be difficult to measure accurately, but medical tests
do exist to accurately measure body fat. These tests include DEXA,
or dual energy x-ray absorptiometry, and measuring a person's
weight underwater. Such tests are usually conducted in specialized
facilities or research centers.
There are other tests which can help measure a person's body
fat. For example, the thickness of body fat just under the skin
can be measured at various locations throughout the body. Another
test sends a harmless amount of electricity through a person's
body. These tests are widely used in commercial weight loss programs
and at health clubs and gyms. If these tests are done by an inexperienced
person, results may be less than accurate. Remember too that test
results may also be inaccurate if the tests are conducted on a
severely obese individual.
Health professionals will often try to determine a person's healthy
or ideal weight in relation to his or her height, using tables
as a guide. One pitfall of such weight-for-height tables is that
they do not distinguish between excess fat and muscle. As mentioned
above, very muscular people may appear obese when in fact they
are not. The preferred diagnostic aid to measure overweight and
obesity is the Body Mass Index, or BMI.
BMI is closely associated with measures of body fat and helps
predict future weight-related health problems.
Body fat distribution
Not only is excess body fat important, but where that
body fat accumulates helps health professionals determine obesity.
For example, in women, body fat tends to accumulate in the hips
and buttocks, whereas in men, it generally accumulates in the
belly. You are more likely to develop weight-related health problems
if you carry your weight around your waist. While standing, have
someone measure your waist just above the hip bones. Women whose
waist measurement is more than 35 inches (89 cm) have increased
health risk because of their fat distribution.
What causes obesity?
Overweight and obesity occur when a person consumes more calories
than the body burns. The causes of this imbalance differ from
one person to the next and may be linked to any number of environmental,
genetic, psychological, or other factors.
Obesity occurs in families, supporting the theory that in may
be partly genetic.
Genetics alone do not predispose certain individuals to obesity.
Environmental factors such as lifestyle behaviors, food choices,
and level of physical activity also play a key role. Those who
consistently eat high-fat foods and those with a sedentary lifestyle
are more prone to obesity. Although you cannot change your genetic
makeup, you can make long-term changes in your eating habits and
in your lifestyle to help you effectively manage
Psychological factors have been shown to influence eating habits.
A small percentage of obese people suffer from binge
eating disorder. During a binge eating episode, a person feels
she has no control over her eating and will eat large quantities
of food in a relatively short span of time. This can lead to feelings
of extreme guilt and shame. Binge eating disorder, like other
eating disorders such as anorexia nervosa
and bulimia, is characterized by
depression and low self-esteem.
Those suffering from binge eating disorder have more trouble losing
weight and maintaining weight than those who do not suffer from
binge eating problems.
Other causes of obesity
Some illnesses such as hypothyroidism, Cushing's Syndrome, depression,
and certain neurological disorders can lead to obesity. Some steroids
and antidepressants and certain birth control pills have been
known to cause weight gain. Your doctor will be able to determine
whether underlying medical conditions or other ailments are causing
weight gain or impeding weight loss.
Health risks associated with obesity
Obesity can lead to the development of other diseases and medical
conditions, including Type II diabetes, heart disease, hypertension, high
blood pressure, heart
attack, and stroke.
Obesity is also linked to certain types of cancer. Obese women,
for example, are more likely to develop breast,
or ovarian cancer.
Other diseases linked to obesity include:
- Gallbladder disease and gallstones
- Liver disease
- Pulmonary problems including sleep apnea
- Irregular menstrual periods and infertility
Who should lose weight?
Those whose BMI is above 30 can improve their health through
weight loss. Those whose BMI is between 25 and 29.9 are strongly
encouraged to lose weight, unless they have risk factors as determined
by their doctor. Generally, you should try to lose weight if you
meet two or more of the following criteria:
- Family history of heart disease or diabetes
- Pre-existing medical conditions such as diabetes, high blood
pressure, high blood cholesterol, or high blood sugar
- Concentration of body fat around the waist
A weight loss of 5 to 10 percent can surely help improve overall
health and well-being by lowering blood pressure and blood cholesterol.
Weight loss can also help prevent Diabetes Melitus Type II in
those at high risk for the disease.
Treatment of obesity
Treatment of obesity depends on a person's level of obesity,
overall health condition, and motivation. Treatment may include
a combination of diet, exercise, cognitive behavior modification,
and weight loss drugs. In cases of severe obesity, gastrointestinal
surgery such as a gastric bypass may be necessary.
Abdominal obesity: do more than loosen your belt
(NC)-To you it might be a sign to lose a few pounds or to use
the next hole on your belt, but to healthcare professionals an
expanding waistline is a warning sign for a serious health condition.
Abdominal obesity, as it is known medically, is the
visible risk factor of the health condition metabolic syndrome.
Metabolic syndrome is comprised of independent risk factors including
abdominal obesity, insulin resistance, elevated triglycerides,
abnormal cholesterol profile and high
blood pressure. A diagnosis of metabolic syndrome occurs when
a patient has at least three of these risk factors.
Approximately 25 per cent of Canadians are affected by metabolic
syndrome. People with this condition are at increased risk of
developing heart disease,
stroke and diabetes.
In fact, they are nearly twice as likely to die from cardiovascular
disease, and their risk of heart
attack and stroke
It is important to visit your doctor regularly to have your cholesterol,
triglycerides and insulin levels tested and blood pressure measured.
By testing for these risk factors and measuring your abdominal
circumference your doctor can determine if you are at risk for
Together with your doctor you will be able to work to reduce
your risk factors. The risk factors can be controlled by making
healthy dietary choices, such as reducing intake of foods high
in saturated and trans fat, and through increased physical activity.
However, if lifestyle changes are not enough to reduce risk factors,
medication may be required. For example, statins may help lower
cholesterol levels. Reducing cholesterol may reduce one of the
risk factors leading to metabolic syndrome.