Diet and nutrition

Adult obesity

Understanding adult obesity
Abdominal obesity: do more than loosen your belt

Understanding adult obesity

The following information is adapted from the Weight-Control Information Center.

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 your weight.

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, cervical, uterine, or ovarian cancer. Other diseases linked to obesity include:

• Gallbladder disease and gallstones
• Liver disease
• Osteoarthritis
• Gout
• 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 is tripled.

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 metabolic syndrome.

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.

Courtesy NewsCanada