Board-certified urologist and a fellow of the American College of Surgeons
Obesity is a worldwide problem that is as great as hunger. (Shutterstock/File)
Obesity is the physical condition of excess fat tissue caused by a complex interaction of eating habits, environmental factors and genetic factors. In simpler terms, an obese person consumes more calories than they expend.
While obesity in itself is not an illness, obesity can lead to health issues if it is not managed. Here are five things to know about obesity:
1. Nature and nurture
Genetic factors are significantly involved in obesity in terms of how energy is stored as either fat or lean tissue. Extra-genetic factors that influence individual habits in terms of eating and physical activity also play a role in obesity. This is evidenced by the prevalence of obesity associated with environmental factors, such as aggressive marketing of fast foods and sodas, oversized food portions, lack of access to healthy foods, lack of neighborhood sidewalks and work schedules.
A number of physiological and environmental factors can help explain our eating habits. Eating may be based on mealtimes, a special occasion or a holiday. We may eat more or eat less based on our mood: happy, sad, bored or stressed. We may be triggered by environmental factors like free food offers, advertisement campaigns or business occasions. In addition, an unintended cause of obesity is the information gap on the proper nutritional and caloric value of our food choices.
2. Links to eating disorders
Some obese people may have an eating disorder, such as binge eating, bulimia nervosa or night eating syndrome (NES).
Binge eating is defined as frequent consumption of large amounts of food at least once a week for a period of 3 months. This disorder may occur in 50 percent of patients with severe obesity. Bulimia nervosa is an eating disorder that is characterized by compulsive overeating followed by self-induced vomiting or the abuse of laxatives or diuretics, and is often accompanied by feelings of guilt and depression. It occurs in about 1 percent of adults, mostly women.
Meanwhile, night eating syndrome is when at least 25 percent of a person's daily food consumption occurs after consuming the evening meal and is often associated with sleeping disorders. For example, a person with NES may require additional food intake to get back to sleep after recurrent awakenings, but the amount of food consumed is not necessarily excessive.
3. Fat is not dead weight
Fat cells release substances that increase inflammation, promote insulin resistance and contribute to atherosclerosis, or hardening of the arteries. This is why obesity is the leading cause of heart disease, diabetes, high blood pressure and related mortality. This is especially the case for people who have a lot of visceral fat, the type of fat that accumulates deep inside your abdomen around your internal organs.
Visceral fat is much more dangerous than the subcutaneous fat, or fat that accumulates just below the skin. (You can pinch your subcutaneous fat with your fingers.) Visceral fat acts as an active gland that produces hormones and pro-inflammatory cytokines, which in turn have a direct impact on insulin sensitivity and increased risk for type 2 diabetes, inflammation and cardiovascular disease.
4. Measuring risk
The most widely used method to gauge obesity is the Body Mass Index (BMI), but keep in mind that BMI is not necessarily the best parameter. People who have a lot of muscle mass, for example, might have a BMI of over 25, even if they have a low body fat percentage. On the other hand, people who are thin but have a lot of visceral fat might have a BMI under 25, even though they are technically high risk.
According to Harvard Medical School and other expert sources, the easiest way to get an idea of the amount of visceral fat you have, as well as your health risk for cardiovascular disease, high blood pressure, high blood sugar and dyslipidemia (high lipid/cholesterol), is to measure the circumference of your waist. A waist circumference over 40 inches (102 cm) for men and over 35 inches (88 cm) for women indicate a high presence of abdominal fat.
5. Can you be fit, healthy and overweight?
It would be great if you could be overweight without the condition affecting your health, but such people are rare. A recent article in the Journal of American College of Cardiology, based on a broad study at the University of Birmingham, concluded that even when overweight or obese individuals were free of health complications, they were still more likely to develop heart disease than their peers who were not overweight.
The study was conducted by reviewing the electronic health records of 3.5 million British patients from 1995 to 2015. (dev/kes)
Agustinus Rushanaedy is an Indonesian diaspora and obtained his medical degree at the Katholieke Universiteit Leuven in Belgium. A board-certified urologist and a fellow of the American College of Surgeons, he has been practicing medicine for 30 years, during which he has maintained a holistic approach to healthcare that emphasizes patient education and preventive medicine.
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