WEIGHT CONTROL AND DIET
People in many cultures around the world are very “weight conscious”. Individuals often start being concerned about their weight in childhood, particularly if they are overweight and are teased and excluded from social groups. When children reach the teenage years, many become greatly preoccupied with their physical appearance and would like to change how they look. They frequently express concerns about skin problems and wanting to have a better figure or more athletic body, to be taller or shorter, and to be the “right” weight. People with less-than-ideal bodies are often thought of as lazy and self-indulgent, and many of them wish or strive for bodies they are biologically unable to achieve.
Whether individuals do anything about their weight and what they do can have important implications for their health.
Overweight and Obesity
No matter how fit we are, our bodies have some fat— and they should. Having fat is a problem only when we have too much. The question is, how much is too much? Determining how much fat a person’s body has is not as easy as it may seem. Bulk or stockiness alone can be misleading since some stocky people simply have larger skeletal frames than others, or their bodies are more muscular.
Today, 64.5 percent of adults in the U.S. are overweight or obese. How do you know if you are among them? Two simple measures, body mass index (BMI) and waist circumference, provide useful estimates of overweight, obesity, and body fat distribution.
Body Mass Index
Health care providers use body mass index (BMI) and waist circumference measures to assess a person’s risk of developing diabetes, heart disease, or other health problems. The following section describes how to measure your BMI and waist circumference, and what these measures mean for your health.
BMI measures your weight in relation to your height, and is closely associated with measures of body fat. You can calculate your BMI using this formula:
For example, for someone who is 5 feet, 7 inches tall and weighs 220 pounds, the calculation would look like this:
A BMI of 18.5 to 24.9 is considered healthy. A person with a BMI of 25 to 29.9 is considered overweight, and a person with a BMI of 30 or more is considered obese.
Because BMI does not show the difference between fat and muscle, it does not always accurately predict when weight could lead to health problems. For example, someone with a lot of muscle (such as a body builder) may have a BMI in the unhealthy range, but still be healthy and have little risk of developing diabetes or having a heart attack.
BMI also may not accurately reflect body fatness in people who are very short (under 5 feet) and in older people, who tend to lose muscle mass as they age. And it may not be the best predictor of weight-related health problems among some racial and ethnic groups such as African American and Hispanic/Latino American women. But for most people, BMI is a reliable way to tell if your weight is putting your health at risk.
Waist Circumference
Excess weight, as measured by BMI, is not the only risk to your health. So is the location of fat on your body. If you carry fat mainly around your waist, you are more likely to develop health problems than if you carry fat mainly in your hips and thighs. This is true even if your BMI falls within the normal range. Women with a waist measurement of more than 35 inches or men with a waist measurement of more than 40 inches may have a higher disease risk than people with smaller waist measurements because of where their fat lies.
To measure your waist circumference, place a tape measure around your bare abdomen just above your hip bone. Be sure that the tape is snug, but does not compress your skin, and is parallel to the floor. Relax, exhale and measure your waist.
How does overweight or obesity affect health?
Weighing too much may increase your risk for developing many health problems. If you are overweight or obese, you may be at risk for many health problems including:
- Type 2 diabetes
- Heart disease and stroke
- Cancer
- Sleep apnea
- Osteoarthritis
- Gallbladder disease
- Fatty liver disease
1. Type 2 diabetes
Type 2 diabetes used to be called adult-onset diabetes or noninsulin-dependent diabetes. It is the most common type of diabetes in the U.S. Type 2 diabetes is a disease in which blood sugar levels are above normal. High blood sugar is a major cause of early death, heart disease, kidney disease, stroke, and blindness.
How is it linked to overweight?
More than 80 percent of people with type 2 diabetes are overweight. It is not known exactly why people who are overweight are more likely to suffer from this disease. It may be that being overweight causes cells to change, making them less effective at using sugar from the blood. This then puts stress on the cells that produce insulin (a hormone that carries sugar from the blood to cells) and makes them gradually fail.
What can weight loss do?
You can lower your risk for developing type 2 diabetes by losing weight and increasing the amount of physical activity you do. If you have type 2 diabetes, losing weight and becoming more physically active can help you control your blood sugar levels. Losing weight and exercising more may also allow you to reduce the amount of diabetes medication you take.
2. Heart disease and stroke
Heart disease means that the heart and circulation (blood flow) are not functioning normally. If you have heart disease, you may suffer from a heart attack, congestive heart failure, sudden cardiac death, angina (chest pain), or abnormal heart rhythm. During a stroke, blood and oxygen do not flow normally to the brain, possibly causing paralysis or death. Heart disease is the leading cause of death in U.S. and stroke is the third leading cause.
How is it linked to overweight?
People who are overweight are more likely to suffer from high blood pressure, high levels of triglycerides (blood fats) and LDL cholesterol (a fat-like substance often called the “bad cholesterol”), and low levels of HDL cholesterol (the “good cholesterol”). These are all risk factors for heart disease and stroke. In addition, people with more body fat have higher blood levels of substances that cause inflammation. Inflammation in blood vessels and throughout the body may raise heart disease risk.
What can weight loss do?
Losing 5 to 15 percent of your weight can lower your chances for developing heart disease or having a stroke. If you weigh 200 pounds, this means losing as little as 10 pounds. Weight loss may improve your blood pressure, triglyceride, and cholesterol levels; improve how your heart works and your blood flows; and decrease inflammation throughout your body.
3. Cancer
Cancer occurs when cells in one part of the body, such as the colon, grow abnormally or out of control and possibly spread to other parts of the body, such as the liver. Cancer is the second leading cause of death in the U.S.
How is it linked to overweight?
Being overweight may increase the risk of developing several types of cancer, including cancers of the colon, esophagus, and kidney. Overweight is also linked with uterine and postmenopausal breast cancer in women. Gaining weight during adult life increases the risk for several of these cancers. Being overweight also may increase the risk of dying from some cancers. It is not known exactly how being overweight increases cancer risk. It may be that fat cells make hormones that affect cell growth and lead to cancer. Also, eating or physical activity habits that may lead to being overweight may also contribute to cancer risk.
What can weight loss do?
Avoiding weight gain may prevent a rise in cancer risk. Weight loss, and healthy eating and physical activity habits, may lower cancer risk.
4. Sleep Apnea
Sleep apnea is a condition in which a person stops breathing for short periods during the night. A person who has sleep apnea may suffer from daytime sleepiness, difficulty concentrating, and even heart failure.
How is it linked to overweight?
The risk for sleep apnea is higher for people who are overweight. A person who is overweight may have more fat stored around his or her neck. This may make the airway smaller. A smaller airway can make breathing difficult, loud (snoring), or stop altogether. In addition, fat stored in the neck and throughout the body can produce substances that cause inflammation. Inflammation in the neck may be a risk factor for sleep apnea.
What can weight loss do?
Weight loss usually improves sleep apnea. Weight loss may help to decrease neck size and lessen inflammation.
5. Osteoarthritis
Osteoarthritis is a common joint disorder. With osteoarthritis, the joint bone and cartilage (tissue that protects joints) wear away. Osteoarthritis most often affects the joints of the knees, hips, and lower back.
How is it linked to overweight?
Extra weight may place extra pressure on joints and cartilage, causing them to wear away. In addition, people with more body fat may have higher blood levels of substances that cause inflammation. Inflammation at the joints may raise the risk for osteoarthritis.
What can weight loss do?
Weight loss can decrease stress on your knees, hips, and lower back, and lessen inflammation in your body. If you have osteoarthritis, losing weight may help improve your symptoms.
6. Gallbladder Disease
Gallstones are clusters of solid material that form in the gallbladder. They are made mostly of cholesterol and can sometimes cause abdominal or back pain.
How is it linked to overweight?
People who are overweight have a higher risk for developing gallbladder disease and gallstones. They may produce more cholesterol, a risk factor for gallstones. Also, people who are overweight may have an enlarged gallbladder, which may not work properly.
What can weight loss do?
Weight loss — especially fast weight loss (more than 3 pounds per week) or loss of a large amount of weight — can actually increase your chance of developing gallstones. Modest, slow weight loss of about 1/2 to 2 pounds a week is less likely to cause gallstones.
7. Fatty liver disease
Fatty liver disease occurs when fat builds up in the liver cells and causes injury and inflammation in the liver. It can sometimes lead to severe liver damage, cirrhosis (build-up of scar tissue that blocks proper blood flow in the liver), or even liver failure. Fatty liver disease is like alcoholic liver damage, but it is not caused by alcohol and can occur in people who drink little or no alcohol.
How is it linked to overweight?
People who have diabetes or “pre-diabetes” (when blood sugar levels are higher than normal but not yet in the diabetic range) are more likely to have fatty liver disease than people without these conditions. And people who are overweight are more likely to have diabetes. It is not known why some people who are overweight or diabetic get fatty liver and others do not.
What can weight loss do?
Losing weight can help you control your blood sugar levels. It can also reduce the build-up of fat in your liver and prevent further injury. People with fatty liver disease should avoid drinking alcohol.
Losing Weight
People generally adopt different ways to reduce their weight. One popular and not-so-effective way is excessive dieting. Research as well as real life experiences of many obese people indicates that dieting is not the solution. Is causes more harm than good.
Similarly, many people go for fad diets to reduce their weight. Fad diets are not the best way to lose weight and keep it off. Fad diets often promise quick weight loss or tell you to cut certain foods out of your diet. You may lose weight at first on one of these diets. But diets that strictly limit calories or food choices are hard to follow. Most people quickly get tired of them and regain any lost weight.
Fad diets may be unhealthy because they may not provide all of the nutrients your body needs. Also, losing weight at a very rapid rate (more than 3 pounds a week after the first couple of weeks) may increase your risk for developing gallstones (clusters of solid material in the gallbladder that can be painful). Diets that provide less than 800 calories per day also could result in heart rhythm abnormalities, which can be fatal.
Tip:
Research suggests that losing ½ to 2 pounds a week by making healthy food choices, eating moderate portions, and building physical activity into your daily life is the best way to lose weight and keep it off. By adopting healthy eating and physical activity habits, you may also lower your risk for developing type 2 diabetes, heart disease, and high blood pressure.
Keeping in view the importance of weight control as a significant issue that concerns many of us, there are still many facts that need to be considered before we move on to our next topic. In our next lecture, we will discuss many popular and misleading ideas about weight control. Then we will move on to discuss the most important form of weight reduction i.e., exercise and physical activity.