Obesity is spiralling and was the cause of premature death for an estimated 4.7 million people in 2017 – that’s three and four times higher than deaths from road accidents and HIV/AIDS respectively.
World Obesity Day will be observed globally on March 4 at a time when 13% of all adults are considered obese. But, even though it is such a problem, there are still many misconceptions around obesity.
But first, what is obesity?
Obesity is when you carry excess weight or body fat that may hamper your health. The best way to know if someone is obese is to use Body Mass Index (BMI) as a tool. Your BMI is your weight in kilograms divided by the square of your height in metres. A BMI between 25 and 29.9 means you are carrying excess weight and a BMI of 30 or over indicates you may have obesity.
What causes obesity?
The most common misconception about obesity is that it is purely because of a lack of physical activity and an unhealthy diet. Yes, eating more calories than you burn is a major cause, but other factors can affect obesity, including lack of sleep and the so-called obesity gene.
Research has shown that sleep deprivation significantly affects weight gain and obesity in both children and adults because it leads to hormonal changes that stimulate appetite. A lack of sleep causes the body to produce more of the ‘hunger’ hormone ghrelin, resulting in an increased appetite.
At the same time a lack of sleep also decreases the production of leptin, the hormone that suppresses the appetite. The imbalance in these hormones could cause people to eat more, resulting in increased weight gain.
A faulty gene called the fat-mass and obesity-associated gene (FTO) is also responsible for some cases of obesity. FTO affects the amount of ghrelin (hunger hormone) a person produces and this might affect their chances of having obesity. Ghrelin affects how the body stores fat and could play a role in practices like binge eating and emotional eating, further impacting a person’s predisposition towards obesity. The FTO gene can also affect eating habits, leading people to prefer high-calorie foods, having a higher intake of food and an impaired ability to feel full.
Complications around obesity
Overweight and obesity are major risk factors for a number of chronic diseases, including heart disease and stroke which are leading causes of death worldwide. Obesity can also lead to diabetes, and the conditions associated with diabetes complications such as blindness, limb amputations and the need for dialysis.
Stigmatisation can have a negative impact on people struggling with obesity and weight loss, leading to internalised weight bias and potentially disordered eating behaviours. Understanding the psychological reactions to weight and stigma could play a big role in treating obesity.
There are various methods that can help treat obesity, from changing diets and increasing physical activity to using weight loss medications prescribed by a medical professional. It is important to consult a healthcare professional as each person requires a different approach based on their condition.
A National Institutes of Health study in 2016 found that people with obesity who lose between 5 and 10% of their body weight, and maintain that weight loss, improve their health and reduce their chance of suffering from any of the diseases or conditions associated with obesity and overweight.
This can be used as an initial target for weight loss when treating obesity and shows that even a small amount of weight loss can be beneficial.
Dieting and physical exercise are the most common ways to lose weight, but should be done carefully. Crash diets cause new health problems or vitamin deficiencies, and can even make achieving weight loss more difficult.
Weight-loss medications can also play a role in losing weight and will be prescribed by healthcare professionals if diet and exercise have not resulted in weight loss, or a person’s weight poses a significant health risk. Medications are not meant to replace lifestyle changes, but can supplement weight loss by aiding dietary changes and exercise.
Weight-loss medications focus on the hormones that control hunger and the feeling of fullness. For example, GLP-1 (glucagon-like peptide-1) molecules are naturally occurring and can affect the body’s feeling of hunger after eating. Synthetic GLP-1 molecules can potentially be used to suppress appetite and kickstart weight loss.
Why you often end up regaining lost weight
One key point to remember when it comes to treating obesity is that the body reacts to losing weight by trying to regain weight. Once you start losing weight, hormonal changes lead to increased feelings of hunger and decreased feelings of fullness as the levels of satiety hormones decrease and the levels of hunger hormones increase.
The Set Point Theory states that every person has a certain ‘set’ weight that their body accepts and is genetically disposed to, so any attempts to lose weight results in the body’s survival instincts kicking in to regain weight to stay at that ‘set’ weight. These hormonal changes may last for up to three years and may be why most people end up regaining lost weight in the long run.
Obesity is a complex medical condition. Understanding the factors that lead to it is an important step in tackling the disease and the misconceptions around it. Seeking the help of a health-care professional and creating a treatment plan tailored to individual needs is an important step.
To help raise awareness and break down misconceptions about obesity and weight loss, Danish health-care company Novo Nordisk created the Truth About Weight website. The website provides information on obesity and weight loss, including information on why losing weight can be so challenging.