Global epidemics are defined as diseases affecting various individuals at the same time. They can spread from one person to another, especially in a place where the disease is not completely prevalent. Although many associate it with diseases that are often communicable such as HIV, pneumonia, or cholera, many lifestyle diseases or non-communicable diseases are now being considered as epidemics due to their sudden increase in number over the past few decades.
The World Health Organization defines obesity as abnormal or excessive fat accumulation that may impair health and is often determined based on the Body Mass Index or BMI of an individual. BMI uses a simple calculation based on a ratio of someone’s height and weight and is defined as a person’s weight in kilograms divided by the square of his height in meters. According to the Harvard School of Public Health, a person’s BMI correlates greatly with important health outcomes like heart disease, diabetes, cancer, and overall mortality. Sadly, this disease has now affected millions all over the world.
Recent numbers from the Center for Disease Control and Prevention indicates that more than 1.9 billion adults are overweight, with 650 million being obese and most suffering from its deleterious effects leading to death. Unfortunately, this condition affects not only adults but children as well. Currently, there are 41 million children under the age of five all over the world who now fall under the classification of being either overweight or obese. Numbers seem to be increasing likewise in the Philippines, with an overwhelming 400% rise in cases of overweight and obese children under five years old within the last decade. As for adults, an alarming 18 million Filipinos were noted to be overweight or obese.
The BMI is a ratio used to classify individuals based on their weight-for-height proportion. A healthy BMI is described as adult men and women with BMI between 18.5 and 24.9, while overweight individuals have a BMI between 25.0 and 29.9. A person with BMI of 30 or higher is considered obese. Obesity is further subdivided into categories:
- Class 1: BMI of 30 to 34.9
- Class 2: BMI of 35 to 39.9
- Class 3: BMI of 40 or higher, considered as severe obesity
Because this condition affects not only adults, the WHO came up with the criteria for children in order to determine how much of the population falls under this classification. For children under 5 years old, the weight-for-height growth chart is used as a standard. Overweight children are those who have a weight-for-height greater than 2 standard deviations above the normal, while obese children have a weight-for-height greater than 3 standard deviations above the WHO Child Growth Standards median. Children between the ages of 5 and 18 who have a BMI-for-age greater than one standard deviation above the Growth Reference median are considered overweight, while obese children are those who have greater than 2 standard deviations from the normal.
Another practical factor considered in obesity is that of one’s waist size. Abdominal obesity is defined as the extra fat that accumulates around the abdomen or middle area that is an important factor that helps determine health. This is more easily determined especially if weight and height cannot be measured. Abdominal obesity is defined as having a waist size of 35 inches or higher in women and a waist size of 40 inches or higher in men. Studies have also linked waist size with increased risk of illness, specifically cardiovascular diseases.
Risk factors for obesity
Obesity is a condition that is often attributed to several factors. Common causes include genetics, hormonal problems, and even lifestyle practices. The Mayo Clinic lists down some of the more common causes and risk factors for obesity.
- Sedentary lifestyle
- Diet. High-fat and high-calorie diets are often associated with being overweight or obese, more so if there is a very little or no physical activity at all.
- Genetics. A common genetic disorder associated with obesity is known as Prader-Willi syndrome and is characterized by weak muscles, poor feeding, and slow development. As the child grows, constant hunger is experienced which leads to obesity and eventually, type 2 diabetes.
- Existingmedical conditions associated with obesity are often hormonal. Common conditions include:
Cushing’s syndrome – a condition wherein the adrenal glands produce an excess amount of steroid hormone called cortisol, which leads to a buildup of fat in characteristic sites such as the face, upper back, and abdomen.
Hypothyroidism – a condition that affects the thyroid gland wherein too little thyroid hormone is produced. Because thyroid hormones are responsible for metabolism, having low levels of this hormone can lead to weight gain and eventually obesity.
Depression – Specifically, clinical depression. This mood disorder causes severe symptoms that affect how one feels, thinks, and handles daily activities. It also greatly affects sleeping and eating habits which can lead to weight gain.
- Certain medications. Such as steroids and anti-depressants have a side effect of increasing one’s appetite or experiencing a constant feeling of hunger that leads to increased frequency of feeding and weight gain.
- Socioeconomic factors
- Age. Although also found in children, obesity is often associated with increasing age as one’s metabolism slows down. Hormonal changes and a less active lifestyle associated with conditions like arthritis tend to lead to weight gain in the later stages of life.
- Pregnancy. Because adequate weight gain is advised in pregnancy, women often have a difficult time losing their weight and going back to their pre-pregnancy size even after the baby is born. If not addressed, this can lead to retained weight added by more weight gain leading to obesity.
- Smoking cessation. Nicotine is associated with decreased appetite and increased metabolism. Once a person stops smoking, the appetite goes back to normal, and in some cases increases markedly. Despite the weight gain early on, the benefits of quitting far outweigh the effects of weight gain later on.
- Lack of sleep. According to the Journal of Clinical Nutrition and Metabolic Care, sleep is an important modulator of neuroendocrine function and glucose metabolism. Sleep loss has been shown to result in metabolic and endocrine alterations including those that affect glucose metabolism and decreased levels of leptin, which are responsible for appetite and hunger suppression which then increase one’s risk for obesity.
Effects of obesity
Naturally, being overweight and obese comes with many health complications, which include:
High cholesterol levels, specifically triglycerides and low-density lipoprotein (LDL)
Type 2 diabetes
Cardiovascular diseases such as hypertension and other heart conditions
Metabolic syndrome which is a combination of high blood sugar, high blood pressure, high triglycerides, and LDL
Breathing disorders such as sleep apnea due to the narrowing of airways
Gynecologic problems that may lead to infertility and irregular menses
Fatty liver disease
Mental illnesses such as depression and anxiety brought about by a hormonal imbalance often associated with obesity
Cancer. In a large prospective study published in the Oncogene Journal, almost all forms of cancer were associated with increased risk of cancer, specifically those affecting the colon, breast, endometrium, kidney, esophagus, ovaries, and even the lungs. Although most are related to hormones, the inflammatory cells associated with obesity seem to play a major role in the expression of cancer cells as well as the progression of cancer to later stages.
Despite the increase in number of cases over the past few years, the good news is obesity can actually be prevented. With daily exercise, a healthy diet, and a proper lifestyle, weight gain and obesity can be avoided with the risk of developing health problems greatly decreased. Although seemingly redundant, it cannot be emphasized enough how much the following can decrease one’s likelihood of developing obesity.
Moderate exercise for at least 30 minutes daily can help prevent excessive weight gain. For weight loss purposes, intense exercise may be advised.
Low calorie diets rich in nutrients found in fruits, vegetables, and whole grains are best in preventing weight gain.
Depriving oneself of food that may be high in calories can sometimes have a rebound effect. Eating moderate amounts of these types of food will not only make one healthier but happier too. Similarly, crash and fad diets are best avoided since these do not seem to benefit one’s health in the long run. Some of these diets may also be harmful, so best to consult with a physician or specialist prior to getting into any diet.
- Monitor weight frequently
Weekly monitoring of weight can help one become more conscious of sudden weight changes. This can also be easily addressed by increasing physical activity or simply increasing healthy food intake for the next couple of days.
When it comes to weight loss and weight maintenance, surrounding oneself with support groups or people who practice healthy eating habits can help one achieve a healthier weight and a healthier and happier body free from disease or illness.