National Obesity Awareness Week

This week is National Obesity Awareness Week, so it seemed appropriate to talk a little about obesity and separate fact from fiction.  I’m probably going to be a little controversial here; as an obese person myself I’ve certainly had time and opportunity to formulate my own views.

What is Obesity?

The NHS defines an obese person as one who has a very high body weight, and a lot of excess body fat.

The most widely used way to measure obesity is the BMI, or body mass index.  This is a height:weight ratio measurement expressed as a number.  A BMI of 30 or more is usually classified as obese.  I say ‘usually’, because it’s possible for people with a high muscle mass, such as people who do a lot of strength training, to have a high BMI but not be obese.  They may weigh a lot, but most of that weight comes from muscle rather than fat.

What’s your BMI?

Measuring waist circumference rather than BMI is becoming a more popular way to measure obesity.  Evidence is mounting that this approach may be more useful in determining who is at risk from long-term health problems due to obesity.  That’s because fat around the middle (‘visceral fat’) is considered the most dangerous to health.  In men a waist circumference of more than 94cm (37 inches) is considered obese.  In women, it’s 80cm (31.5 inches) (1).

How many people are obese?

Obesity statistics & projections for the UK

The NHS estimates that 1 in 4 adults in the UK are obese.  It’s also a growing problem amongst children.  By the time children in the UK leave primary school, 1 in 5 may be obese.

Why does it matter?

Obesity can put you at greater risk of serious chronic diseases, such as diabetes, heart disease and some types of cancer, and can affect mobility, and ability to perform daily activities.

Larger children are frequent targets for bullies

Being obese can also make life harsh in other ways.  From being bullied in the playground to finding it more difficult to gain credibility in the workplace, obese people are subjected to prejudice wherever they go.  This is likely to affect their own esteem and self-image, and contribute to mental health problems.  I read one report which suggested that obese children are shunned by their peers as much as children who are undergoing chemotherapy.  Of course, it goes without saying that neither group of children should be shunned or shamed at all.

In many cases, adults aren’t much kinder.  Some of the remarks people make on social media under the cover of anonymity are beneath contempt.  As an obese person myself, I’ve found myself subject to a great deal of prejudice, not just from trolls, but from people who really ought to know better.

Why are people obese?

The truth is, we don’t entirely know what has led to the alarming rise in obesity in the last couple of decades.  Most people will say that more people are obese because, as a nation, we eat too much and move too little.  Of course, that can be a huge factor in some cases, but it’s not the only factor, and it’s not true in every case.  There are many other influences on a person’s weight as well, and each will be more or less important according to the individual.  These include, but are not limited to:

• Genetics; although the importance of a single ‘fat gene’ has probably been overestimated, there are likely to be a combination of genes which have a direct or indirect effect on weight. It’s possible that environmental factors in today’s world are more likely to ‘switch on’ these genes

• Ongoing stress, which can contribute to chronic inflammation

• Poverty; the inability to access fresh, healthy food due to cost or lack of access

• Medication use; in particular steroids and antidepressants often have weight gain as a side effect

• Imbalances of intestinal flora (gut bacteria)

• Suboptimal thyroid function

• Other hormonal imbalances (these may be more likely to maintain ongoing obesity than be the initial cause)

• Psychological issues or limiting beliefs around weight

What can be done about obesity?

Diets don’t work!

The best way to beat obesity is to prevent it in the first place.  According to Robert Lustig, author of ‘Fat Chance’, once a person has become obese, they have very little chance of achieving a healthy weight again in the long term.  They may lose weight for a time, but only a tiny proportion will maintain that weight loss for 5 years or more.

Despite the emphasis on calories in medical circles and in the press, calorie control diets have a very high failure rate (in studies, between 95 and 98% of people who follow these diets regain any weight they may have lost, and can even gain more weight).  Weight loss products appear to be similarly ineffective, and can have nasty side effects.  That’s why I will never be part of the weight loss industry, and am wary of anyone who is.  Who wants to be part of an industry with a 95% failure rate?  Having said that, a healthier diet will benefit everyone, including those with obesity-related concerns.  National Obesity Awareness week is about encouraging people to take small, achievable steps to improve their health.

Weight loss surgery can be very effective, but perhaps not as effective as some people think.  For example, only 54% of patients who have a gastric band fitted still have it in place 10 years later (2).  In fact, in several NHS trusts, gastric banding is no longer available because of the lower success rates. However, weight loss surgery is still much more successful than lifestyle measures.  Surprisingly, the reason for this may not be because the surgery restricts the amount of food you can eat, but because the surgery in some way alters the way that the patient’s hormones work.  How this happens is not fully understood.  When we have a better understanding, it may be possible to develop a treatment that is less drastic, and more effective.  Faecal (yes, poo) transplants look promising, but they’re not widely available, and many people are put off for obvious reasons.

Shouldn’t we be doing more to accept people as they are?

Lovlieness comes in many shapes and sizes

Of course we should!  Shaming or belittling anybody for the way they look should not be acceptable.  Prejudice related to size, whether the person is judged too fat or too thin, seems to be the last socially acceptable form of prejudice, and as such it’s rampant.  It makes for a nastier society, and if the aim is to encourage people to change their size, it’s a dismal failure, and rightly so.  Health comes in a range of shapes and sizes.

Obesity isn’t a choice; nobody would choose to be obese, because of all the negative things that come with obesity.  Nevertheless, many obese people accept and love themselves as they are.  In my opinion, everyone should be doing more of that, and directing less hatred at themselves, or others.

That said, obesity does put health and wellbeing at risk, and if people are unhappy with their weight, it’s important that they have tools and support available which are suited to their specific needs.  It’s also important that they are in a non-judgemental environment; believe me, an obese person has faced more negativity and judgement by the time they reach adulthood than many people will encounter in a lifetime.

If you want to improve any aspect of your health this year and obesity is one of your issues, I can help.  I promise that, unlike most other nutritional therapists, I’ve walked many miles in your shoes, and am still on my own journey.  I can help you identify what may be underpinning your issues, and together we can make a plan that suits your specific needs, and supports your overall health, whether or not weight loss is your goal.  If you’d like to know more, click here to access my calendar, and book a free, no-obligation chat with me.

Or if you’d like to get started with improving your health straight away, my online course, ‘Stronger Without Sugar’ may be perfect for you.  Find out more here.

I wish you a happy and healthy year, and look forward to helping you meet your health goals, whatever shape and size they are.

References

1. https://www.nhs.uk/conditions/obesity/ [Accesssed 11 January 2018].

2. Madura, J.A., & DiBaise, J.K., (2012). Quick fix or long-term cure? Pros and cons of bariatric surgery. F100 Medical Report, 4(19). Published online.  [Accessed 11 January 2018].