Obesity as a Silent Killer

By definition "Obesity is a label for ranges of weight that are greater than what is generally considered healthy for a given height." The term also identifies ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems. For adults, these ranges are determined by using weight and height to calculate a number called body mass index (BMI), where normal BMI is in a range from 18.5-24.9.

BMI =Weight [In Pounds] X 704.5 / (Height [In Inches]) ²

Another important number to consider is waist circumference, where high risk is considered a waist greater than 40 inches for men and greater than 35 inches in women. Prevalence of obesity (BMI >30) in Canada for 2004 was 23.1% for those aged 18 years or older, but the prevalence of childhood obesity has increased as well. The reason for this problem is in the positive energy balance where the energy input (i.e. calories from food) is bigger than the energy output. This increases with age, lifestyle, and drugs, and endocrine disorders like Cushing's, polycystic ovarian syndrome (PCOS) and hypothyroidism.

Complications from Obesity Are Plenty and Include:

• Cardiovascular-like hypertension, coronary artery disease, chronic heart failure, varicose veins or sudden death from arrhythmia.
• Respiratory dyspnea, sleep apnea, pulmonary embolus.
• Gastrointestinal effects including gallbladder disease, gastroesophageal reflux disease.
• Endocrine disorders such as Type 2 Diabetes mellitus, hyperlipidemia, PCOS, hirsutism, irregular menses, and infertility.
• Increased risk of neoplastic diseases like endometrial post-menopausal breast cancer, and prostate and colorectal cancers.

So if BMI>30, or BMI 25-29.9 and a person has more than two risk factors (listed above as complications), weight loss is recommended. The recommended rate of weight loss is approximately 1kg a week. The goal is a 10% weight loss over 6 months.

Diet, Exercise and Behavioural Changes Are Important

Dietary therapy involves reducing caloric intake by 500-1000 kcal/day, physical activity for at least 30 minutes most days of the week, behavioural therapy, and pharmacotherapy and surgery if lifestyle changes are unsuccessful after 6 months.
Before starting an exercise program, please be aware of one very important thing: let a professional assess your current level of fitness. Warm up and cool down to allow your body to adjust between rest and activity to avoid injuries, with special precautions for patients with coronary artery disease, diabetes or exercise-induced asthma. And at the end I want to remind you of other benefits of weight control as an increased feeling of well-being with an improved quality of sleep, and a longer lifespan.

Jovanka Ristovski is qualified as a Medical Doctor in Macedonia.