Health Matters: Obesity

By Larry Aguirre, PA-C

Many of us need to lose weight, but dieting is no fun and life is stressful, so after eating salads for a week or two, we go back to old routines and gain back any weight we may have lost. If this sounds like you, you’re not alone. According to the American Heart Association, nearly 70 percent of American adults are either overweight or obese.

Obesity is commonly defined using the body mass index or “BMI,” measured by dividing a person’s weight in kilograms by their height in meters squared. (You can determine your BMI with online graphs or calculators.) By this measurement, a BMI over 30 is considered obese. This is frequently less weight than one might think; for instance, an adult who is 69 inches tall and weighs 205 pounds has a BMI of 30. The BMI measurement is not perfect: someone who is very athletic or pregnant can have a relatively high BMI without being overweight.

Causes

Obesity is a complex problem influenced by many factors, some of which are still unknown to us, but genetics, our environment, culture, and our behaviors all play a role. Genetic predispositions do not doom us to a life of obesity, but they can make it more difficult to lose weight. Genetics can affect our rates of metabolism and how easy it is for us to control our appetite, among other things. Our environment includes everything from our physical surroundings to our cultural practices around food. When we live in a place that makes it easy to walk or bike, we’re more likely to do so. When we are part of a culture that uses food to express love, it can be difficult to refuse that generosity.

And at the most basic level, when we take in more calories than we burn, we find ourselves at unhealthy weights. While the behaviors that lead to obesity may seem straightforward, they are sometimes influenced by more complicated psychological issues, like eating for emotional comfort or eating as a form of self-sabotage.

A common contributor of obesity is a combination of overeating and physical inactivity. Eating too much high-fat and/or sugary food is especially damaging. Interestingly, those who are mildly overweight in teen and early adult years are more likely to become obese in adulthood. When it comes to being overweight, the sooner it is addressed the better. Childhood obesity is on the rise and some experts think it will lead to a decline in life expectancy, in stark contrast to the last century.

Our hormones can also contribute to weight gain. Cortisol, which is elevated during times of stress, is a good example. Women tend to gain weight during pregnancy, menopause and sometimes when taking contraceptives.

Risks

Obesity is not just a cosmetic consideration; it is a chronic medical disease that contributes to a multitude of health problems, including:

• Hypertension
• Coronary Artery Disease
• Diabetes
• Cancer
• Gallstones
• Joint pain
• Back pain
• Gastroesophageal reflux disease (GERD)
• Decreased energy
• Obstructive sleep apnea
• Falls
• Psychiatric conditions
• Erectile dysfunction
• Skin infections

Small Changes Bring Big Rewards

The good news is that even modest weight loss (5-10 percent of a person’s overall weight) and the long-term maintenance of that weight loss can bring significant health benefits, including lower blood pressure and lower risk of diabetes and heart disease.

Sustainable weight loss is a life-long endeavor and understanding nutrition is essential. Working with a medical professional to lose weight is a far better choice than to go for extreme diets that put you at risk for relapse. A safe and effective long-term weight reduction and maintenance diet must contain balanced, nutritious foods to avoid vitamin deficiencies and other diseases of malnutrition. To figure out whether you’re getting the nutrition you need, read food labels carefully and learn to estimate calories and serving sizes.

A balanced diet combined with a consistent exercise routine is a great way to maintain a healthy weight. If you would like help overcoming obesity, talk to your medical provider. We’re here to help.

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Larry Aguirre is a physician assistant at MCHC Health Centers, a local, non-profit, federally qualified health center offering medical, dental and behavioral health care to people in Lake and Mendocino Counties.