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01.12.2017 Feature Article

Understanding The Implications Of Being Overweight And Obese

Understanding The Implications Of Being Overweight And Obese
01.12.2017 LISTEN

OBESITY, BARE FACTS
One sensitive topic, that many Ghanaians do not want to hear about it is Obesity.

Obesity is the term used for people with greater than average proportion of body-fat content.

Excess body Fat is usually deposited in the upper thighs, buttocks, Neck, chest wall, Breast and the abdomen

Of these areas, the most dangerous, in terms of health and diseases, is the fat deposited in our belly region, (known as Visceral fat).

The simplest way to know if one has excess visceral fat is to measure their Waist Circumference.

MEASURING WEIGHT CIRCUMFERENCE:
Here is how we do it:
Stand upright, with bare feet together.
Place a Cloth Measuring Tape, at the Belly button, making sure the tape is parallel to the floor, and measure the waist circumference (at the level of the belly button.)

Record the measurement in Inches or Centimeters, whichever you prefer.

One is at risk when their waist circumference is greater than 102cm (>40inches) for Men, and 88cm (>35inches) for Women.

Obese persons are at risk for several preventable chronic diseases. The following are examples of such diseases.

OBESITY AND TYPE 2 DIABETES:
Fat cells bind to Insulin readily, and these cells compete with the rest of the body tissues for insulin. Insulin is the hormone, released by the pancreas to facilitate sugar entry into Muscles Fatty and other body tissues. The higher the proportion of one's body fat, the less is the amount of insulin, available for the rest of the body tissues. People who are obese, therefore have less of insulin available for use by the rest of the body, and as a result, sugars (the end product of ingested Starchy food, after digestion) remain and pile up and circulate in the blood. Persistent elevation of sugars in the circulating blood stream is known as Diabetes Mellitus

OBESITY AND HIGH BLOOD PRESSURE
Blood Pressure increases directly, in proportion with one's Body Mass. Some cases of hypertension, could be reversed when one sheds their excess weight.

OBESITY AND SLEEP APNEA
Those who are overweight and having Neck circumference, greater than 17 inches, are at risk for Sleep Apnea. Sleep Apnea is a condition in which during sleep, obese persons snore a lot and they stop breathing for about 20 seconds. These pauses in breathing can occur many times during sleep and these breathing pauses, disrupt sleep. If these pauses in breathing are not treated, Sleep Apnea leads to excessive daytime sleepiness. Car drivers with this condition fall asleep while operating their vehicles, leading to vehicular accidents. Another condition frequently associated with sleep apnea is sexual weakness/Erectile dysfunction

OBESITY AND KNEE ARTHRITIS
The knee joints bear the brunt of the total body weight, in the standing position. The extra weight in the obese, places so much stress on the knee joint leading to gradual destruction of the knee joint structures. Those affected usually, complain of pain the knees, in the early morning. Pain normally last less than 30 minutes and improves with activity. Most of the knee pain is reversible with adequate weight loss.

KIDNEY DISEASES Diabetes and high blood pressure are the primary causes of kidney injury and both conditions are related to Obesity

Several other diseases are associated with Obesity and these include the following Cancers:

1.) Breast cancer (especially women who have had their menopause)

2.) Cancers of the large intestines,
3.) Cancers of the Uterus,
4.) Kidney cancers.
Other chronic diseases associated with excess body weight include

1.) Erectile Dysfunction,
2.) Chronic Depression,
3.) Abnormal blood Cholesterol and lipid levels
5.) Stroke and Heart attacks are caused by a.) chronic Hypertension, b.) Uncontrolled Diabetes and c.) elevated bad Cholesterol level, all these are conditions associated with Obesity.

EVALUATION OF ABDOMINAL OBESITY
We can know if one is at risk of developing the above-mentioned chronic diseases by determining their weights and heights

WEIGHT/HEIGHT RATIO:
The slogan is: ENSURE YOUR WAIST CIRCUMFERENCE IS LESS THAN HALF YOUR HEIGHT

A Waist to Height ratio of 0.4 to 0.5 is the Ideal
Consider weight loss for Ratios between 0.5-0.6
A Weight/ Height ratio, greater than 0.6 requires intervention, since persons involved are at risk for developing Obesity related diseases including Diabetes, Hypertension and high cholesterol

HOW TO PREVENT, AND MANAGE OBESITY
We must know about the causes of Obesity
There are many factors which lead to Obesity. Among the tall list are Physiological, Social, Behavioral factors.

Physiological Factors: When you eat more food than your body requires, you gain weight. You lose weight when you burn more energy than you consume. You maintain your weight when there is a balance between the amount of food energy consumed and energy the body burns, each day

Social Factors: The advent of modern technology has led to a decrease in physical activities. Gone are the days when people walked several miles a day for their daily activities. Nowadays, Computers at workplaces have led to more sedentary jobs and lifestyle.

Behavioral: Business travels and lack of Family dinners have led to poor eating habits. Some are in hurry to eat any food, available to them at fast food restaurants. Most of these foods are higher in calories and fatty.

There are several other factors including ones Family history of being overweight and obese, Endocrine abnormalities including Thyroid gland abnormalities, and medications including some depression medications, could lead to Obesity.

OVERCOMING OBESITY
For the average person, Obesity is Preventable and Reversible

Let us start with diet.
When we talk about dietary control, we are referring to

1.) The type of food,
2.) the amount of food ingested and
3.) Timing of meals, all these can affect your weight

FOOD TYPE
Vegetables and fruits, on the whole do have low calories, and increase blood sugars slowly when consumed. One may feel full, after eating vegetables yet their blood sugar increases very little.

Replacing sugary and Starchy foods with Vegetables (vegetables have low glycemic index) is great. The following foodstuff help one to lose weight

Yam
Corn
Plantain
Beans and Nuts:
Beans, Legumes Groundnuts have lower glycemic index, and so do most fruits, Carrots, and nonstarchy, green leafy vegetables

AVOID OR LIMIT THE FOLLOWING FOODSTUFF:
White Rice has less fiber and raises blood sugars quickly when eating, so leave rice for the children who are always actively moving around.

Cut down on Pastries, including Bread, Pie, Cakes, these are high in Calories

Avoid adding sugar to oatmeal and tea; your taste buds can adapt easily.

Avoid sugary drinks: Sodas, Fruit juices
Timing of Meals/14 Hour Overnight Fast:
Regarding Timing of meals, it is very helpful, for one to lose weight if they could fast 12-14 hours overnight.

Example: Do not eat between the hours of 6pm and 8am. (or a bit earlier like, 5pm to 7am.) This helps with glucose control, improve sleep duration, and eventual weight loss.

This means you can only have your daily meals within the 8-10 hours daytime window.

BURN THE CALORIES:
Once you have consumed the calories, you either have to burn them with increased physical activities (or you pile on the weight.) Weight gain is usually subtle, but as the positive caloric balance persists, the number of pounds gained become obvious, over time. Our culture is pro-obese, so beware when you hear comments like: "You look fine", "you look great". React to these comments, by Checking your waist line, first.

PHYSICAL ACTIVITIES
All physical activities burn calories. Walking, running, jogging, step-climbing, boxing, playing football/soccer, dancing. Chose the activities that you are comfortable with and do 1-2 hours daily. If weight loss is not appreciable, prolong the duration of these activities. The worst activity is sitting in a chair, watching television and doing nothing, and sleeping more than 8 hours per day.

Overcoming Obesity requires a determined effort, "When the heart decides, there is no turning back"

AVOIDING EXCUSES:
The excuses given by most people include the following: "Obesity runs in my family". The answer to this excuse is: No matter your family history and background, you can lose weight if you prolong your workouts, watch your diet and avoid over-eating, and adhere to 14-16 hours of overnight fast

Another excuse is: The more I exercise, the more I gain weight. In this case, Overeating is the culprit.

Some severely overweight persons undergo stomach restriction Surgeries. These surgical procedures would be helpful, if one adopts, healthy lifestyles, post-surgery.

EQUIPMENTS REQUIRED
You need a bathroom type of Weighing Scale, and cloth measuring tape at home, to monitor your weight and also to monitor your progress.

So, in summary, the power to control your weight, lies with you only. Yes, you can do it, if you really want

ALEX SARKODIE, MD
Email: [email protected]

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