What Is Obesity?

What Is Obesity?

When your body carries more fat than is defined as healthy for your age and sex,

you are said to meet criteria the for obesity. In simple terms, obesity occurs when there is an abnormal or excess amount of body fat, which is known as adipose tissue.

A fat cell is an endocrine cell (a hormone-producing part of your body), and adipose tissue is an endocrine organ. Detailed scientific research has demonstrated that this extra fat in the body produces several “bad chemicals,” known as metabolites or cytokines, which have negative influences on health and that ultimately lead to multiple medical problems. Fat produces inflammation (i.e., a fundamental way in which your body reacts to infection, irritation, or any other form of injury), which reinforces the fact that this extra adipose tissue in the body causes various disease processes. Excessive fat can eventually lead to your body becoming resistant to a hormone called insulin, which tries to keep your blood sugar (glucose) in a normal range and ultimately paves the way for development of type 2 diabetes.

How Common Is Obesity?

Obesity is one of the most universal chronic diseases. However, there is a pressing need for new guidelines for its medical prevention and treatment.

According to the 14th Annual State of Obesity: Better Policies for a Healthier America report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF), roughly one in three Americans battle with obesity.

This year, obesity rates among adults topped 35% in five states in the United States (West Virginia led the way at 37.7% followed by Mississippi, 37.3%; Alabama and Arkansas, 35.7%; and Louisiana 35.5%), 30% in 25 states, and 25% in 46 states (California, 25%; Hawaii, 23.8%; Massachusetts, 23.6%; Washington, DC, 22.6%; and Colorado, 22.3% had the lowest rates). This is a substantial increase from the year 2000, when no state exceeded 25% (Fryar et al, 2017). (https://healthyamericans.org/assets/files/TFAH-2017-ObesityReport- FINAL.pdf)

With regard to rates of obesity in children, childhood obesity rates hover around 17%, with nearly one-third (31.3%) of children ages 10 to 17 being overweight or obese. Among high school students, 13.9% are obese. These statistics mean that more than 100 million people in the United States are directly affected by the obesity epidemic, and even more struggle with their weight. These statistics imply that if you look around your workplace and your home, you will see the dramatic impact of the obesity epidemic.

Do I Weigh Too Much?

You can calculate whether you meet the criteria for overweight or obesity by using a simple mathematical formula involving height and weight; it is called the Body Mass Index (BMI). The numbers derived from this calculation will help you to categorize your weight, as described in just a moment.

First calculate your BMI by dividing your body weight (in kilograms) by your height (in meters squared [(weight [kg]/height [m]2 = BMI]) or by using the conversion with pounds (lbs) and inches (in) [Weight (lbs) ÷ height (in)2] × 704.5 = BMI 

(https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm).

It is important to remember that this number can be misleading; it can place some people (e.g., those who are very muscular or who are pregnant or lactating) in a category that does not accurately reflect their disease state.

The BMI cutoffs are as follows:

  • Below 18.5: Underweight
  • 18.5–24.9: Normal weight
  • 24.5–29.9: Overweight
  • 30 and above: Mild to moderate obesity 
  • 40 and above: Severe or extreme obesity

If your BMI falls between 18.5 and 24.9, you are considered to have a normal weight. However, if your BMI is equal to or greater than 30, you have obesity (Duerenberg et al, 1991).

BMI is the most commonly used tool to assess someone’s weight status, and this is what your doctor will commonly use, as well. However, other indicators of excess fat tissue, such as waist circumference, waist-to-hip ratio, and other measures are also used. Waist circumference is used to determine the fat content around your waistline. An excess of abdominal fat or “belly fat” is considered a predictor of risk factors, such as a predisposition to heart disease and type 2 diabetes.

Now, let’s talk about how to measure your waist circumference.

  1. First, remove any clothing from your waistline.
  2. Stand with your feet shoulders’ width apart, and make sure to keep your back straight.
  3. Locate the top of your hip bone. This is the part of the hip bone at the side of the waist, not at the front of your body. Use the area between the thumb and index finger to feel for the hip bone at the side of your waist.
  4. Align the bottom edge of the measuring tape with the top of your hipbone. Wrap the tape measure all the way around your waist. Ensure that the tape measure is parallel (even) with the floor and is not twisted.
  5. Take two normal breaths, and as you exhale the second breath, tighten the tape measure so that it is snug, but not digging into the skin.
  6. Take the measure of your waist.

Now, all of these steps might seem very complicated. A very easy and accurate way to measure waist circumference is to take the measurement at the belly button or navel. This location often captures the widest circumference, and it is directly related to your risk of metabolic diseases, such as type 2 diabetes and heart disease.

The number obtained is your waist circumference. Men with a waist measurement greater than or equal to 40 inches (102 cm) are at risk for multiple health-related problems. Women with a waist measurement of greater than or equal to 35 inches (88 cm) are also at risk for these disorders (Jensen et al, 2014).

Why Do I Continue to Gain Weight?

Your body sets its own target, or set point, for fat (Schwartz et al, 2000). Fat is our body’s fuel supply, the body’s gas tank. There are complex signals and mechanisms that regulate the amount of fat in your “tank.” Unfortunately, we do not have complete control of the amount of fat in our tank, and there is a common belief in our society that we are able to voluntarily control the balance of fat in our body by counting calories and burning them with exercise. 

This is far from true. The body’s fat mass goal is determined by a variety of factors, including our genetics, age, race/ethnicity, and environment. The body’s fat mass is strongly protected. That is why when someone loses weight by reducing calorie intake, they almost always gain it back (eventually); the body fights to return to its set point—the weight it wants to be at (even if we want it to be otherwise).

Why Do I Have Trouble Losing Weight?

Many people still believe that obesity is caused simply by eating too many calories and exercising too little. Unfortunately, that’s a mistaken belief. How the body regulates weight is similar to how it regulates your water balance. If you need water, your brain makes you thirsty, and you drink. If you drink more than you need, your body gets rid of the excess water. It’s the same with calories and body fat. You can control it for a short time by eating less, and you might lose weight. But if all you do is eat less, your body will eventually fight back. 

You’ll stop losing weight and ultimately your body will push you to regain all of what you have lost. The same principle allows your body to have a certain set point for fat content; it fights to stay there. It is very frustrating!

Can I Lose Weight?

The first step in weight loss is identifying the key contributing factors that are involved in causing obesity, which varies from person to person. There is not a “one size fits all” approach. 

The reason behind this is that there are many types of obesity and, as a result, it is necessary to try multiple therapies and combinations of therapies to help different people achieve a healthy weight. Dietary changes might work well for one person, whereas another person might lose weight by improving their sleep habits. 

We should not expect that there’s a simple solution for how you can achieve and maintain a healthy weight. It is critical to understand that obesity is caused by varied biological and physiological disruptions in different people, and it is important to match every person to their ideal weight with an individualized treatment approach through exposure to several different methods. Through this strategy, you are most likely to achieve beneficial results and to lose weight. 

Although interventions (such as engaging in consistent exercise, eating a high-quality diet, practicing stress reduction, and developing good sleep patterns) are at the cornerstone of efforts to achieve and maintain a healthy weight, other individuals might need more invasive interventions (such as medical and surgical interventions) to achieve weight loss. 

There are multiple medical options available for the treatment of obesity (Apovian et al, 2015). You should talk to your doctor about an appropriate referral to a practitioner trained in obesity medicine, who will complete an interview and a physical examination to decide on the best line of treatment for you.

In conclusion, because obesity is a complex disease, it often needs multiple methods to achieve the desired result of weight loss.

Should I Try Weight Loss Supplements?

Certainly, a person cannot rely on a single food or supplement to burn fat. They should also decrease their calorie intake and increase physical activity. However, when used as part of a healthy diet and lifestyle, natural fat burners may accelerate weight loss by either increasing metabolism or decreasing appetite.

Traditional approaches to weight loss cannot be substituted by natural supplements. That said, they may help people burn slightly more calories every day, gradually increasing weight loss.

Resurge is of the most popular weight loss supplements that promise to help you shed pounds and sleep better. Because studies have shown that sleep deprivation is associated with deficiencies of growth hormone and elevated levels of cortisol, both of which contribute to obesity.

While other supplements promote nutritional factors, meal replacement forms, appetite suppression, or similar effects, Resurge boosts your body’s metabolism by increasing your core temperature. However, before making any purchases, you might want to read some Resurge reviews because the supplement industry is rife with scams.

It should be noted that pills or supplements are usually not recommended for children, pregnant and breastfeeding women because some of their ingredients e.g. caffeine can have serious side effects when consumed in large amounts. For example, if a pregnant woman consumes over 200 mg of caffeine per day, her baby is at an increased risk of fetal growth restriction and/or miscarriage, though caffeine can boost your weight-loss efforts.

Although the formula of Resurge doesn’t have any stimulants, you should still talk with your doctor before you start taking the supplement, especially if you have health concerns.

Can Obesity Be Prevented?

Considering the current obesity epidemic, policy makers and national agencies are evaluating various methods and designing programs to help build an environment that can support a healthy lifestyle and ultimately prevent obesity. However, considering the complex and multidimensional etiologies of obesity, it remains a public-health problem.

From an individual perspective, incorporating healthy eating habits (such as eating more fruits, vegetables, and whole grains, and by avoiding processed foods, by cooking meals at home, and by finding healthy recipes) is certainly helpful. Regular physical activity is vital for your overall health and well-being. The amount of exercise needed depends on your age. 

Most adults need at least 2 hours and 30 minutes (150 minutes) of moderately intense aerobic activity (e.g., brisk walking) every week and muscle-strengthening exercises that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms) on two or more days per week (WHO, 2004). The exercise doesn’t need to be planned. 

You can find your own ways to incorporate exercise into work (such as taking small breaks for a brief walk, stretching near your computer desk, parking far from the main building so that you get in more steps into your daily step count [approximately 10,000 steps are our daily target]). It is important for you to adopt some consistent form of exercise that you enjoy (such as dancing, walking with friends, playing a game). Find what works for you!

Apart from this, avoiding and finding ways to relieve stress, which is part of our modern lives, plays an immensely important part in achieving and maintaining a healthy weight. In addition, it is important to get an adequate amount of sleep, typically 7 to 8 hours for most adults.

How Does My Body Process and Store Fat?

Regulation of body weight and fat tissue appears to be coordinated primarily by our brains. A small area within our brain called the hypothalamus receives information from a variety of sources in our body. A hormone, called leptin, provides information to the brain about the body’s energy stores (Friedman and Halaas,1998). 

Signals also reach the brain from other organs of your body, such as the pancreas and the liver, which give information about the energy demands and nutrients availability for the resting energy expenditure and communicates this information to the brain. In terms of food intake, signals about the type, smell, taste, and texture of food are sent to the higher brain centers; these signals along with the others from various organs direct you to start or to stop eating. 

Overall, the hypothalamus integrates and orchestrates this mass of information and works to achieve a fat set point, which it views as normal for one’s body. The storage of fat happens in alignment with this principle, with a constant need to maintain and to achieve that physiological set point.

Where on My Body Is Fat Likely to Develop?

There are different kinds of fat in our body: brown, white, subcutaneous (mostly concentrated in your hips, butt, and thighs), and visceral (mostly in your mid- section). Depending on your gender, race, age, and ethnicity, you might have a predisposition to accumulate different kinds of fat in various parts of your body.

For example, women tend to accumulate more fat around their hips and thighs, whereas men are likely to accumulate it around their bellies (so-called abdominal fat). Abdominal fat conveys a greater health risk than does hip or thigh fat. This translates to a greater impact on insulin resistance, which increases the risk of diabetes, increases your total cholesterol levels, and predisposes you to an increased risk of stroke and heart disease (Schneider et al, 2010).

How Does Being Overweight Jeopardize My Health and Well-Being?

Obesity is now known to have caused or exacerbated more than 40 distinct disorders that lead to poor health and an overall decreased quality of life (Cummings et al, 2002). The medical complications (or co-morbidities) range from metabolic problems (such as type 2 diabetes mellitus, high cholesterol levels), to high blood pressure, gallstones, fatty liver disease, pancreatitis, obstructive sleep apnea, and even reproductive dysfunction. 

Other diseases that are often associated with obesity include stress incontinence (an inability to control your urination), increased pressure within your brain (idiopathic intracranial hypertension), which leads to headaches, degenerative joint disease (also known as arthritis), and vertebral disc disease. Scientific research has also provided evidence of a strong association between obesity and many cancers.

Is Obesity Inherited?

So far, we have learned that obesity is a complex condition that results from multiple interactions with hereditary and environmental factors. It is now well established that different forms of obesity tend to concentrate within families. Obesity risk is two to eight times greater for someone with a family history, as opposed to a person with no family history of obesity; there is an even higher risk observed in those with severe obesity (Zlot et al, 2007).

Studies on twins have compared those who were raised together to those who were raised in a different environment; these investigators have affirmed that genetic influences on BMI are substantial (Stunkard et al, 1990).

There are other rare causes of genetic obesity in which a single gene is affected and leads to more severe forms of obesity; these forms of obesity are seen most often in early childhood. In summary, in most cases, genetic variation influences a person’s predisposition for developing obesity, but environmental and psychological factors contribute significantly to the manifestation. Our understanding of how genes that contribute to weight and to energy regulation continues to advance rapidly.

Am I More Likely to Gain Weight as I Age?

Aging is characterized by changes in body composition. Imaging studies demonstrate that as we age, subcutaneous fat (the fat below the skin) decreases and the visceral fat (fat in the abdominal region) increases. Visceral fat is not a good thing to have, as we have discussed previously. It is associated with systemic inflammation, and it continues to increase the risk for coronary artery disease, stroke, and death. Another important age-related change along with altered body composition is loss of muscle mass. Muscle helps us maintain a high metabolic rate and an increased resting energy expenditure. Therefore, its loss is associated with a reduction in the total energy expenditure. The altered body composition and loss of muscle mass leads to fat gain.

Both increases in visceral fat and decreases in muscle mass are linked to a loss of sensitivity to insulin. The lower the sensitivity to insulin, the more the body secretes insulin. This metabolic hormone causes a torrent of problems, given that it’s a storage hormone. It helps to increase the uptake of glucose and fat production while decreasing the burning of fat and stored glucose (glycogen).

What Can I Do About My Excess Weight?

There are multiple effective treatment options available to lose weight. To decide which type of treatment will be best suited for your needs, you will need a comprehensive evaluation completed by a physician trained in obesity medicine. In addition, consultation with a nutritionist as well as a psychologist is also of vital importance. After you have obtained a thorough evaluation, which can include blood testing, your doctor and the entire team will decide on a management plan with you.

The various treatment options available include behavioral, medical, and surgical options. Behavioral treatment involves making lifestyle modifications (such as making better food choices, incorporating more hours of exercise in your routine, and maintaining a healthy and consistent sleep schedule).

If your doctor thinks that making lifestyle modifications will not be helpful by themselves (which is often related to a history of consistent lifestyle changes, severe obesity, or moderate obesity with many obesity co-morbidities (e.g., high blood pressure, type 2 diabetes, obstructive sleep apnea), he or she might choose to prescribe a medicine. There are various weight-loss medicines available that might be used to lose weight; however, only a doctor may prescribe these for you. After you start on a medication, you need to be followed to assess the benefits and side effects of the medicine. These medications are prescribed for long-term use, as discontinuing these medications often leads to weight gain.

If you are suffering from severe obesity, your obesity-medicine doctor might recommend weight-loss surgery, which is also known as bariatric surgery. Several weight-loss operations have been devised over the past 40 to 50 years. The operations performed by such surgeons includes Roux-en-Y gastric bypass, gastric banding (adjustable or non-adjustable), sleeve gastrectomy, biliopancreatic diversion, or duodenal switch. If surgery is the preferred therapy for you, this will be a joint decision made by you and your medical team; your surgeon will inform you about the various forms of surgery best suited for your needs. To date, surgery is the most effective treatment for those with severe obesity. Overall, it is important to utilize the appropriate tools for the best outcomes in obesity treatment.

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