Article of the Month:
OBESITY
What is obesity?
The definition of obesity varies depending on what one reads, but in general, it is a chronic condition defined by an excess amount body fat. A certain amount of body fat is necessary for storing energy, heat insulation, shock absorption, and other functions. The normal amount of body fat (expressed as percentage of body fat) is between 25%-30% in women and 18%-23% in men. Women with over 30% body fat and men with over 25% body fat are considered obese.
The calculation of body mass index (BMI) has also been used in the definition of obesity. The body mass index (BMI) equals a person's weight in kilograms (kg) divided by their height in meters (m) squared. Since BMI describes body weight relative to height, it is strongly correlated with total body fat content in adults. "Obesity" is defined as a BMI of 30 and above.
How common is obesity?
Obesity has reached epidemic proportions all over the world. One in three persons is obese. The prevalence of obesity in children has increased markedly, with approximately 20%-25 % of children either overweight or obese. Obesity is also increasing rapidly throughout the world, and the incidence of obesity nearly doubled form 1991 to 1998.
Being Overweight Doesn't Mean You're Unhealthy!
The results of a study published in the Archives of Internal Medicine should not come as a shock to most people. Being overweight doesn't necessarily make you unhealthy, according to researchers in both the United States and Germany. Sports fans have known this forever; elite athletes can have an appearance ranging from tiny Olympic gymnasts to massive NFL linemen. Athletes at both extremes- and all those in between- are in shape and trained to perform at high levels. The new research confirmed this.
People who are overweight have a fifty-fifty chance of having high cholesterol, high blood pressure, or elevated blood sugar levels. Pretty good odds, but not as good as those for people who are within the normal weight range. They have a 75% chance of having normal results on blood tests for cholesterol and blood sugar. And for those who are obese, the chance of having normal results falls to one-third.
The definition of "ideal body weight" has been a thorn in the side of many people. Perceptions of how people appear, how their clothes fit, and how fat they are have permitted whole industries to flourish. Weight loss clinics, gyms and fitness centers, liposuction, and gastric bypass surgeries all were based at least partly on the presumption that being overweight equaled being at risk for heart disease and diabetes. The studies in the Archives of Internal Medicine found that there may be more to health than meets the eye.
What are the health risks associated with obesity?
Obesity is not just a cosmetic consideration; it is a dire health dilemma directly harmful to one's health. In the United States, roughly 300,000 deaths per year are directly related to obesity, and more than 80% of these deaths are in patients with a BMI over 30. For patients with a BMI over 40, life expectancy is reduces significantly (as much as 20 years for men and 5 years for women). Obesity also increases the risk of developing a number of chronic diseases including:
Insulin Resistance.
Insulin is necessary for the transport of blood glucose (sugar) into the cells of muscle and fat (which is then used for energy). By transporting glucose into cells, insulin keeps the blood glucose levels in the normal range. Insulin resistance (IR) is the condition whereby the effectiveness of insulin in transporting glucose (sugar) into cells is diminished. Fat cells are more insulin resistant than muscle cells; therefore, one important cause of insulin resistance is obesity. The pancreas initially responds to insulin resistance by producing more insulin. As long as the pancreas can produce enough insulin to overcome this resistance, blood glucose levels remain normal. This insulin resistance state (characterized by normal blood glucose levels and high insulin levels) can last for years. Once the pancreas can no longer keep up with producing high levels of insulin, blood glucose levels begin to rise, resulting in type 2 diabetes, thus insulin resistance is a pre-diabetes condition. In fact scientists now believe that the atherosclerosis (hardening of the arteries) associated with diabetes likely develops during this insulin resistance period.
Type 2 (adult-onset) diabetes. The risk of type 2 diabetes increases with the degree and duration of obesity. Type 2 diabetes is associated with central obesity; a person with central obesity has excess fat around his/her waist, so that the body is shaped like an apple.
High blood pressure (hypertension). Hypertension is common among obese adults. A Norwegian study showed that weight gain tended to increase blood pressure in women more significantly than in men. The risk of developing high blood pressure is also higher in obese people who are apple shaped (central obesity) than in people who are pear shaped (fat distribution mainly in hips and thighs).
High cholesterol (hypercholesterolemia).This is a major risk factor for heart disease. When there is too much cholesterol in your blood, it builds up in the walls of your arteries. Over time, this build up causes hardening of the arteries so that the arteries become narrowed and blood flow to the heart is slowed down or blocked.
Stroke (cerebrovascular accident or CVA).This is a life threatening condition when a part of the brain is deprived of adequate oxygen.
Heart attack. A prospective study found that the risk of developing coronary artery disease increased three to four times in women who had a BMI greater than 29. A Finnish study showed that for every one kilogram (2.2 pounds) increase in body weight, the risk of death from coronary artery disease increased by one percent. In patients who have already had a heart attack, obesity is associated with an increased likelihood of a second heart attack.
Congestive heart failure. This is a condition in which there is an imbalance in the pump function of the heart in which it fails to adequately circulate blood to the body organs.
Cancer. While not conclusively proven, some observational studies have linked obesity to cancer of the colon in men and women, cancer of the rectum and prostate in men, and cancer of the gallbladder and uterus in women. Obesity may also be associated with breast cancer, particularly in postmenopausal women. Fat tissue is important in the production of estrogen, and prolonged exposure to high levels of estrogen increases the risk of breast cancer.
Gallstones. These are pebble-like substances that develop in the gallbladder which can block the normal flow of bile.
Gout and gouty arthritis. This condition is as a result of overload of uric acid which leads to the formation of tiny crystals of urate that deposits in the tissues around the body especially the joints.
Osteoarthritis (degenerative arthritis) of the knees, hips, and the lower back.
Sleep apnea. This is when you have one or more pauses in breathing or shallow breaths while you sleep.
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