Obesity & Diet
Carolyn Classick-Kohn,MS,RD

If you are overweight or obese, you are certainly not alone, in fact you are in the majority. 
In the United States, estimates as recent as 1999 show that 61 percent of adults are overweight or obese and 13% of the children and adolescents are overweight. And, obesity is becoming more prevalent in countries around the world, even in those that have a very low incidence of obesity like China.

Does it help to be in the majority? If you are overweight, what matters is not how many others have the same problem, but how your body weight affects your personal health and well-being. Fighting obesity is a personal challenge that is fought one pound at a time.

Measuring Obesity
Overweight has been defined in the United States as a body mass index of  between 25 and 29.9. If an individual's body mass index is 30 or greater, they are considered obese.   As an example:

If you are 5'2" tall and weigh 142 pounds, your body mass index is 26 and would be considered overweight and at greater health risk. This applies to both men and women in the same way because this measurement is simply a comparison of weight for height. 


An Old Condition
Obesity is not a new condition.  Anthropologists tell us that the problem is more than 20,000 years old.  Obesity has always existed in segments of societies when abundant food supplies removed the threat of starvation.  But it has become a major public health problem in this country, a state of affairs which worries the medical community.

Why are People Obese?
In this area, the results of recent studies raise many questions.  While controversy exists and there are no definite answers, scientists are investigating the following as the most likely causes of obesity:

• Overeating

• Lack of exercise

• Metabolic changes which trigger a higher than normal level of lipoprotein lipase, the enzyme which directs the fat cells to store fat; or a faulty response to nerve impulses which instructs the cells to break down their fat stores.

• Psychological problems.

• An environment where food is increasingly plentiful and available.

• Genetic predisposition.

• A Malfunction of "brown fat." While white fat cells store calories, brown fat gives off calories as heat so that they are not stored.  Normal weight individuals may burn extra calories as heat when they overheat while obese people may not.  This notion is only tentative.

• Too high a "Set Point" The set point determines a certain biological weight for each individual .  It could be lowered through exercise and a lower fat diet.

The Risks of Being Overweight
People in this country tend to focus on the cosmetic and "esthetical " facets of "fatness."  Often overlooked are the health related risks of being overweight.  These are real and should be a strong incentive for people to lose weight.

Can you be Fat and Fit?
According to the U.S. Surgeon's Report on Overweight and Obesity, obesity and overweight conditions are associated with increased risk of serious diseases and even premature death. For example, even a small amount of weight gain (11 to 18 pounds) increases a person's risk of developing Type II diabetes. While one person may be obese and have no serious health problems, the evidence shows that weight gain (fat not the fit athletic muscle weight) is a serious health risk:    

• Any level of obesity is a health risk factor, but a body weight of 20% or more above desirable weight constitutes a definite health hazard.

• Obesity is associated with a reduced life expectancy.

• General risk factors for heart disease such as high blood pressure and high blood cholesterol are also associated with being overweight.

• A weight gain of 10 to 20 pounds is associated with increased risk of coronary heart disease in both men and women.

• The prevalence of diabetes is nearly 3 times higher in overweight persons than in normal weight people.

• Being overweight also is a risk factor for cancer of the breast, the uterus, the colon, the rectum and the prostate.

• Obesity increases stress on the body joints.

• It heightens the risk of surgery.

The Bright Side
The experts also agreed, that ALL the previous risk factors can be improved by a reduction in weight.
For example, some scientists have indicated that a 10% weight loss can result in a 20% reduction in the risks for heart disease. And while it can be very hard to lose and maintain a large weight loss, the greatest health benefits seem to occur with the first 10 to 20 pounds of lost weight. This should be a great incentive for everyone who thinks "it's not worth it!" You don't have to lose every extra pound to gain the benefits of better health and improved energy levels.

Taking Action
If you have decided that it's time to lose weight, and you have your own personal reasons that make this important to you, then it's important to choose a weight loss method that meets your needs - no program is perfect for everyone! In evaluating diets and weight control programs there are some basic recommended strategies: 

• A reasonable initial weight loss goal is to lose about 10% of your current body weight, if you are overweight.

• A reasonable amount of time to expect to lose 10% of your body weight is about six months.

• A reasonable weekly goal for weight loss is about 1/2 to 2 pounds a week.

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