Thursday, January 25, 2007

Obesity - a public health timebomb

Obesity can be defined as "The condition of being overweight", or more specifically "having excessive storage of fat in the body".

A simple way to decide if one is obese is by working out your body mass index or BMI. This is your weight in kg divided by your height in metres squared (multiplied by itself eg if one is 1.7m, 1.7 x 1.7 = 2.89). A BMI of 20-25 is desireable, 25-30 is overweight and 30 upwards is considered obese or worse. This is only accurate for people of normal muscularity. Most rugby players would be obese under these calculations due to their strong bodies - muscle is heavier than fat.

Obesity can cause many health problems. These include:

  • hypertension (or high blood pressure)
  • type 2 diabetes
  • cardiovascular disease
  • gallbladder disease
  • certain types of cancer and
  • psychosocial problems

According to government HSE figures in 2003, 35% of men had a BMI of desireable or underwight. 43% were overwight and the remaining 22% were classed as obese. For women the equivalent figures were 44% desireable or underweight, 33% overweight and 23% obese. To simplify this 1 in every 4 of the population were obese in 2003.

What makes this more alarming is the rate of increase. One study I found shows that obesity in Americans had risen from 12% in 1991 to 18% in 1998. This is a 50% increase. The data in my previous paragraph puts present UK obesity at 22%. This proportion is rising at a serious rate and some action needs to be taken to control it.

The first step I would propose is educating people. One's fat creeps on slowly and most obese people probably don't realise how serious the situation is. GPs should bring the subject up when they see patients about other issues. I know some GPs do this at present.

The cause of the increase is obvious. With more TV channels and the popularity of video games today's children are less active. Teenagers are mouse potatos (too much time at a computer) or coach potatos (too much time watching TV). Also the rise in popularity of fast food (pizza and burgers) and microwave ready meals consumed by a population that are working longer hours and have less time to prepare healthy meals. This hard working population also get home later so have less time for physical recreation, relaxation and hobbies.

Once a person decides to tackle their own obesity there are two paths of action. One is to diet or consume less calories. Also the amount of calories from fat should be watched as fat in foods is very hard to convert to energy compared to carbohydrates and protein. I will discuss food composition in another article later. The main failure of people trying to diet is to allow themselves a 'treat' whenever they fancy. No treats until you have achieved some target! Otherwise you will still eat as much chocolate and cake as before which means you are not actually on a diet!

The second is to exercise to burn off calories. Any exercise is better than none. People who don't exercise often say they don't because they don't enjoy it. To this I say keep trying different activities in different places. I wouldn't enjoy jogging on a cold winter evening along city centre streets. Visit the gyms and health clubs in your area to find one with an atmosphere you like. Consider using some form of personal stereo when exercising - listening to lively music can help motivate you and relieve bordom. Most gyms have televisions so you can ride an exercise bike slowly for 30 minutes while you enjoy Coronation Street. Consider getting a pet dog. They are great companions and will remind you each day when its time for a walk! After a few weeks using a gym I guarantee you will feel much better in yourself. I love the buzz I feel after a thorough session. Did you know if you use weights in the gym to increase your muscle size you will actually burn more calories at times when you are inactive?

Talk to your friends about what they enjoy and ask if you can join them next time.

Dieting is not a substitute for exercise and vice versa. These two are not short term changes that you can do for 6 months to loose weight then get back to normal. Permanent changes need to be made to keep you healthy. Loosing weight takes a long time so don't give up if you havn't seen results in the first few weeks.

I don't recommend any of these 'fad diets', the most famous of which was the recent Atkin's diet. While most professionals will agree they work to some extent it is argued that it is not natural to starve your body of carbohydrates. It's odd that Dr Atkins was rushed to hospital in April 2002 with an unexplained cardiac arrest. The only scientificly recommended way is less calories, more exercise.

One idea for the government to tackle this issue and encourage more activity within the population would be to subsidise the up-market health clubs. How about some form of tax relief on gym membership subscriptions??


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