Obesity

Health Matters By Goke T. Akinrogunde

I have often reiterated that obesity is now widely considered a global epidemic and a public health problem as more nations become “Westernized” in the everyday lifestyle outlook. Many of us just find it difficult to stop adding weight; this being a factor of not just what we eat but more of what we are not doing.

Having a stable body weight, however, depends on an even balance between energy intake from food and energy expenditure. Energy is expended by the body during the day in three major ways: as resting energy expenditure (called basal metabolism); as energy used in process of food digestion/absorption and energy expended during physical activity.

However, when the energy (caloric) intake exceeds the energy expenditure, the body stores the extra calories in the fat cells present in fatty tissues in the body. These fat cells function as energy reservoirs, and they have the capacity to increase in size or the fat cells can reduce in size depending on how people use this reserve energy.

If we do not balance energy input and output by adopting healthy eating habits and regular exercise, then fat builds up, and no sooner we may become overweight.

Measurement of overweight/obesity
Obesity is determined by measurement of body fat, not merely body weight. For an example, people might be over the weight limit for normal standards, but not necessarily obese, if they are very muscular with low body fat as it is the case in some categories of athlete e.g. weightlifters. Similarly, some individuals might have normal weight for their height or might even be underweight but yet have excessive body fat.

However, modern day medical practice uses three key measures to determine whether or not a person is overweight and these are: body mass index (BMI) (a measure of body fat); waist circumference; and a patient’s risk factors for diseases and conditions associated with obesity.

Successful weight loss program is predicated on helping people make healthy lifestyle changes and reduce weight. The most important key to success is to approach the changes in diet and exercise not as punishment but to plan and implement pleasurable healthy substitutes for compulsive overeating and sedentary behavior.

Social Influence
Weight loss is, indeed, so difficult to battle alone against a constant barrage of advertising, discrimination, and the insidious opposition of the body itself, that no one should be faulted or socially ostracized for failing or for giving up the effort altogether.

Calorie Restriction
Calorie restriction has been the cornerstone of obesity treatment. Saturated fats should be avoided. The first step is to calculate the daily caloric need for maintaining a healthy weight. This usually calls for 12 to 15 calories for each pound of ideal body weight, but it varies depending on gender, age, and whether a person is active or sedentary.

For instance a 50-year old woman who wants to maintain a weight of 135 pounds and is mildly active might require only 1,650 calories a day, but a 25-year old female athlete who wants to maintain the same weight might require about 2,000 calories a day. As a rough rule of thumb, one pound of fat equals about 3,500 calories, so one could lose a pound a week by reducing daily caloric intake by about 500 calories. Naturally, the more severe the daily calorie restriction, the faster the weight loss.

Low-Fat and High-Fiber Diets
Recent studies have indicated that it is high fat intake, rather than high consumption of sugar, that is the primary culprit in dietary weight gain. Some studies suggest that replacing foods high in fats with low-fat complex carbohydrates (fruits, vegetables, and whole grains) may even be more effective than calorie counting, particularly in maintaining weight loss.

Counting only grams of fat, in fact, may be more effective than keeping a record of daily food intake. One gram of fat contains 9 calories while one gram of carbohydrates or protein has only 4 calories, and dietary fat converts more readily to fat in the body than carbohydrates or proteins.

Fiber – Important for effective weight control
All healthy diets should be high in fiber, which is an important weight loss-factor. It interferes with absorption of fat and protein and, along with the nutrients found in high-fiber foods, may reduce the risk for heart disease, diabetes, digestive disorders, and certain cancers. Fiber is found only in plants. For weight loss, insoluble fiber (found in wheat bran, whole grains, seeds, and fruit and vegetable peels) is most effective. .

Sugar and Sugar Substitutes
A number of artificial sweeteners are available, including saccharin, aspartame (Nutra-Sweet), acesulfame K (Sweet One), and sucralose (Splenda). Sucralose usually leaves no bitter aftertaste as others do, and unlike most other artificial sweeteners, it works well in baking. Although contrary to previous concerns, there appear to be no health hazards involved with artificial sugar, using these substances may give false comfort to some dieters who then increase their fat intake. Studies indicate that consuming some sugar is not a significant contributor to weight gain as long as the total caloric intake is under control.

High Protein Diets
High-protein low-carbohydrate diets have become popular again. Although a high-protein diet will lead to quick weight loss, its health benefits are dubious. One byproduct of this diet is the release of substances called ketones, which can cause nausea, lightheadedness, and bad breath. Such high-protein diets may also be high in fat and low in fiber-rich and healthful whole grains, fresh fruits, and vegetables.

Exercise
It needs be emphasised that the dangers from obesity are not simply from being overweight; being unfit increases the existing health hazards significantly. Exercise, which replaces fat with muscle, is the critical companion for any weight control program, but it is as hard to sustain as dieting. Because obesity is so often related to heart and other diseases, anyone who is overweight must discuss their exercise program with a physician before starting.

It is recommended building up to 45 to 60 minutes a day of mostly aerobic exercise, such as hiking, brisk walking, or energetic dancing. Some studies have suggested that for both exercise adherence and total weight loss, frequent exercise sessions as short as 10 minutes in duration may be the most successful program for obese people.

It should also be stressed that any regular exercise has value; even moderate regular exercise helps improve insulin sensitivity (which, in turn, helps prevent heart disease and diabetes). Exercising regularly is critical. In addition, exercise improves psychological well being and replaces the sedentary habits that usually lead to snacking i.e. just can’t stop eating something when doing no physical activity. Exercise may even act as a mild appetite suppressant.

However, it is important to realize that as people slim down, their initial level of physical activity becomes easier and they burn fewer calories per mile of walking or jogging. The rate of weight loss slows down, sometimes discouragingly so, after an initial dramatic head start using diet and exercise combinations.

People should be aware of this phenomenon and keep adding to their daily exercise regimen.