Obesity

One of the modern preoccupations of people in the Western world is weight. Sometimes it seems as if everyone is trying to get thin. Magazines and newspapers expend inordinate amounts of paper and effort on the latest diet, and readers eagerly devour the hundreds of thousands of words that regularly make their appearance on the news stands. For many people, their concerns are more a matter of fashion and whim than a real need to lose weight. Weight, however, is a health problem for some people.

Obesity is a condition in which an excessive amount of fat is stored in the body. The fat accumulates in all parts of the body, but usually excessive amounts are deposited in certain areas, such as the abdomen. Obesity is very common. Many people more than 30 years old weigh from 10 to 15 percent more than they should and are considered to be slightly obese.

Generally speaking, there is a range of weight according to age, sex and height, within which you should be to be healthy. Anyone who is more than 20% above their ideal weight is termed obese. At least 20 million Americans exceed their ideal weight by 20 percent or more. Obesity causes:

• increased risk of heart attack,
  
• liver deterioration,
  
• worsening of arthritis,
  
• poor circulation,
  
• strain on the lungs and joints,
  
• increased risk of diabetes,
  
• reduced ability to tolerate exercise or exertion,
  
• rashes in skin folds,
  
• gynaecological problems,
  
• increased risk of hernias,
  
• indigestion,
  
• increased risk from surgery and post-operative complications.

The more overweight you are, the greater the risk. A person who is more than 40% overweight is twice as likely to die from coronary artery disease as a person who is not overweight.

Mostly, obesity is caused by eating too much and exercising too little. The reason we eat is to get energy to maintain body temperature and to provide fuel so that our organs can function. Food also provides the raw material for building and repairing body tissues. If we eat more food than we need for the energy we expend, the surplus is stored as fat. How little 'too much' consists of is often not fully realised. If you eat one slice of bread more than you need every day, after ten years the stored food will weigh roughly 18 kg, and you will be that much over your ideal weight.

Obviously food requirements vary from individual to individual. A professional athlete or a manual labourer may need twice as much fuel as an office worker. Maintaining a healthy weight is simply a matter of balancing your particular fuel requirements with the amount you eat. There is no point in comparing the minuscule amount you eat with the huge amount consumed by your slender gluttonous neighbour, since your neighbour is different from you.

There are two ways of balancing your food and energy requirements. One is to reduce the amount you eat, and the other is to exercise more. A combination of both is probably ideal, but generally exercise on its own will not contribute too much to weight reduction since it is very much quicker to eat the food and take in kilojoules than it is to do sufficient exercise to burn the kilojoules up.

Obesity, if it is considerable, is a serious condition. The extra fat in the body puts a strain on the heart and other organs and on the skeletal system, which must support the weight of the body. Obese people also have a tendency to develop at relatively young ages the diseases that commonly occur with old age. Such diseases include hardening of the arteries, high blood pressure, diabetes, and arthritis. Statistics show that people who are obese do not have as long a life span as do people who are thin.

Occasionally, obesity is due to a disorder of an endocrine gland, such as the thyroid or the pituitary, or to a disorder of the part of the brain called the hypo-thalamus. In most cases, however, there is no physiological reason for the excess fat, and people are obese simply because they consistently eat too much. As a result, more calories are taken in than are required by the individual for energy and the excess food is stored by the body as fat.

Exercise also plays an important role in obesity. The less active a person is the less food he requires. People who get little exercise may eat only moderate amounts of food, but they will still gain weight if their food contains more calories than are needed.

There are many reasons why people overeat. Eating habits are established during childhood, and the pattern of overeating is sometimes related to family or cultural background. Overeating may also have psychological causes. For example, a person may eat more than he needs because he is nervous, insecure, upset, frustrated, or unhappy.

If obesity is caused by a physiological disorder, the disorder should be corrected. Generally, however, the only treatment for obesity is to reduce the number of calories taken in. When more calories are burned during a day than are taken in, the body will start to burn its stored fat and the person will lose weight. To avoid regaining the lost weight, it is important to maintain new eating habits.

For many reasons, it may not be easy for obese people to lose weight. However, it is important for them to do so, since the consequences of obesity may be dangerous.

There are drugs that can combat obesity, but most doctors are reluctant to prescribe them since they can have major side effects. Furthermore, most such drugs are appetite suppressants and most obese people eat for reasons other than hunger alone.

In extreme cases of obesity, where the person's health is suffering and there seems no other solution, drastic treatments are sometimes tried. This includes wiring the person's jaw so they cannot open it and can fit only tiny amounts of food in, and so-called stomach stapling. This literally staples the walls of the stomach together, reducing it in size so that the amount of food that can be ingested is limited. Similarly, it is possible for an operation to be performed to by-pass part of the small intestine so that the area through which food can be absorbed is reduced. It also diminishes appetite. These operations are risky and meet with mixed success since the person's eating habits are not easily changed.

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