Doctors Say Obesity Should Be Treated as Disease

By Dr. Magdy Badran

CAIRO, Dec. 4 (SEE) - Obesity is one of the greatest public health challenges of the 21st century. Globally, there are 1.5 billion adults who are either overweight or obese, a number expected to increase to 3 billion by 2030.

Overweight and obesity are defined as an abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI), a person’s weight in kilograms pided by the square of his or her height in meters.

Overweight is defined as a BMI between 25.0 and 29.9. A person with a BMI of 30 or more is considered obese.

In addition to causing various physical disabilities and psychological problems, excess weight drastically increases a person’s risk of developing a number of noncommunicable diseases, including an increase in the risk of asthma, impaired immune response, type-2 diabetes, musculoskeletal disorders, diabetes, cardiovascular diseases, sleep apnea, and fatty liver disease.

There are many causes of obesity. Multiple factors act upon a genetic background cause weight gain and obesity. The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended.

Globally, there has been an increased intake of energy-dense foods that are high in fat; and an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.

One important category of obesity not captured by BMI is so-called “abdominal obesity”-the extra fat found around your belly, that is an important factor in health, even independent of BMI. Frequently consuming foods and beverages high in sugar or high-fructose corn syrup may cause belly fat gain.

Genes appear to play a role in high waist-to-hip ratios and storage of excess calories as belly fat. Trans fats increase inflammation that may drive insulin resistance and the accumulation of belly fat. Inactivity may promote an increase in belly fat. Low protein intake may drive hunger and belly fat gain.

Hormonal changes at menopause result in a shift in fat storage from the hips and thighs to visceral fat in the abdomen. Having an imbalance of gut bacteria may cause weight gain, including belly fat.

The hormone cortisol, which is secreted in response to stress, may lead to increased abdominal fat. A diet that is low in fiber and high in refined grains may lead to increased amounts of belly fat. Short sleep or poor-quality sleep may lead to weight gain, including belly fat accumulation.

Food can sometimes be relied upon for non-nutritional purposes; inpiduals may be prompted to eat by their emotions rather than actual feelings of hunger. This type of behavior is often referred to as ‘emotional eating’.

Emotional triggers for unhealthy eating habits include low mood, anxiety, frustration, loneliness, stress, abuse, neglect, trauma and anger. This can lead to a dependence on food for emotional support which in turn can lead to weight gain.

Highly palatable foods such as those high in sugar, salt, and fat have been linked to chemical reactions in the brain related to pleasure. It is possible for people to become addicted to the feeling experienced when dopamine, the ‘feel-good’ chemical, is released by the brain. The reward signals experienced when eating these types of food can result in overeating and weight gain.

Some medications can lead to weight gain if you don't compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids, and beta blockers.

Obesity is preventable, record your meals and snacks in a diary, what are you eating and when? Focus on the reasons behind your eating habits and reduce portion sizes and address stress. Support from the people around you is important as they can help to remove temptations and be there for you if you’re having a bad day. Seek treatment when necessary.

If you are affected by obesity, decrease your calories to help facilitate weight-loss. Decrease simple carbohydrates such as sweets, goodies, baked goods, sugar-sweetened beverages, sugar, honey, jams, jelly, etc.

Decrease excess “bad” (saturated or trans) fats commonly found in: commercial baked goods, processed or fried foods, ice cream, fatty meats, butter, margarine, and palm oil. Eat two cups of whole fruit per day and at least three cups of vegetables per day.

Water is a natural appetite suppressant, it is 100% calorie-free and helps you burn more calories. Drinking 0.5 liters of water may increase the number of calories burned for at least an hour. Drinking of at least 2 liters of water per day may assist with weight loss, especially when consumed before meals.

Prevention of childhood obesity focuses on Parent Education. Parents' education should center on the promotion of breastfeeding, recognizing when the baby is full, delaying the introduction of solid foods, proper nutrition, selection of low-fat snacks and monitoring of television viewing. Encourage the kids for good exercise/activity habits, playing outside, walking or riding bikes

Family behaviors must change, the first rule of change is to not make changes too quickly. Examples include turning off the TV during dinner, switching from sugar-sweetened drinks to milk or water, making sure healthy foods are readily available, serving fruits and vegetables with meals, removing high-calorie, high-fat foods from the home, and buying them just occasionally.

Offer more whole-grain foods with meals and snacks. Reduce the number of meals eaten out at fast-food restaurants. Sit down together for family meals and eat slowly.