The prevalence of overweight and obesity among adults and children is on the rise and shows no sign of abating in the near future. There are some groups of people in whom the incidence is higher than the norm:
• Women in lower social and economic classes
• Black women (more than 80% of black women are overweight)
• Age over 55
This is a serious situation because as weight increases, so does the incidence of heart disease, diabetes, arthritis, cancer, sleep disorders, fatty liver disease, and depression.
In the United States, complications from obesity account for 300,000 deaths per year.
The BMI (Body Mass Index) is commonly used as one of the screening tools for diagnosing overweight and obesity. It is generally accepted as a reliable tool even though it is not foolproof in a variety of situations (this is why it should be only one of several diagnostic methods used).
For example, its usefulness is diminished when used in children, the elderly, the very muscular, and individuals with diseases such as those which cause muscle-wasting (ALS, polio).
The evaluation of obesity will most likely also include an analysis of risk factors, waist circumference, fats in the blood, skin-fold thickness measurement, body composition, and numerous other methods.
Whether or not we understand these diagnostic tools, it is important to know that the evaluator does understand them. The appropriate management of obesity requires permanent lifestyle changes. It is important to understand that obesity is a chronic disease and must be taken seriously and treated effectively in order to reduce the incidence of complications. Obesity will not “go away” on its own.
There are several approaches that may be required in order to lose weight. The most common, and logical, of these is nutritional management. Often the dietary culprits in weight gain are irregular meals, mindless eating, immoderate use of sugar (think of the sugar-sweetened beverages you drink), patterns of constant eating or munching, loss of awareness of “hunger-full” triggers, poor food choices…and on and on the list goes.
Sometimes…very occasionally…there is a chemical cause for excessive weight gain. For most of us however,the “simple” cause is an out-of-balance proportion of calories consumed and calories used up.
An increase in exercise and movement is essential in order to increase the “burning up” of calories. Calories taken in amounts that are excessive compared to need are stored as fat, unless they are used up in energy expenditure, (which is called “exercise”).
In addition to burning the calories, exercise brings other benefits:
– increase the rate at which food is burned
– reduces appetite so that there is a lower tendency to over-eat
– improves insulin regulation
– regulates blood fats
– lowers blood pressure
– improves mood and general outlook in life
– increases muscle to fat ratio
Changes in lifestyle which will bring about weight management include:
– limiting daily calories to amount set by physician taking into account health, age, height, activity, and station in life.
– reduction of portion sizes
– elimination of excess sugar
– healthful snacks in place of high-calorie, high-fat food items
– regular meals with mid-meal healthful snacks
– increase in water intake
– a moderate, sustainable exercise program