Obesity, which is defined by the World Health Organization as having a Body Mass Index (BMI) of more than 30, is currently increasing worldwide. Worldwide, the rate of obesity has more than doubled since 1980 and in 2014, about 40% of the world adult population over 18 years was overweight and 15% was obese. Most importantly of all, obesity is completely preventable.
In Australia, more than 60% of adults and around 25% of children are classified as being overweight or obese. Compared with 1995, 10% more adults are overweight or obese and 15% more people living in regional and remote areas of the country are overweight or obese than people living in major cities. In Australia, obesity is the second highest contributor to the burden of disease – higher than smoking.
The basic cause of obesity and being overweight is an imbalance between calories consumed and calories expended. Put simply, if you consume more calories than you burn you will gain weight. Worldwide, energy-dense foods are far more prevalent and easy to obtain than they were 30 years ago. These foods tend to be high in fat and sugar (carbohydrate), both of which are energy dense for a given weight of food. In addition to this, there has been a marked decrease in physical activity, related to communities becoming more and more urbanised, changing types of transport (cars instead of bicycles for example) and an increase in sedentary (seated) work such as office-based work.
The dangers of obesity are well researched and documented. Raised BMI (remember that obesity is defined as a BMI over 30) is a major risk factor for a number of non-communicable diseases.
Some people claim that BMI is not necessarily a good indicator of obesity and the example often given is professional footballers, many of whom would have BMIs above 30 due to their high level of muscle development. For the large majority of the population, BMI is still a good basic indicator and can be used to prompt you and your health care provider to consider whether dietary and other lifestyle factor adjustments are needed.
In particular, risk for heart disease and stroke increase (cardiovascular diseases) and these were the leading cause of death in 2012. People with raised BMI are also at increased risk for Diabetes, disorders like Osteoarthritis and cancers such as breast cancer and colon cancer.
Furthermore, people with BMIs in the obese range often report increased difficulty with mobility and flexibility and an increase in joint pain, further reducing levels of activity. This can lead to a deepening of the risks associated with being obese.
In Australia, childhood obesity is becoming a significant challenge to our population health. We know that childhood obesity also carries many health risks, including adult obesity and premature death and disability. Obese children often experience breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance and psychological effects (such as reduced self-esteem and self-efficacy).
Some people are at risk of being both undernourished and obese. The consumption of nutrient poor, high fat and high sugar foods can lead to people not receiving a proper balance of micronutrients and at the same time , becoming obese from the imbalance of macronutrients.
Any attempts to manage obesity should be done in consultation with your primary health provider – usually your local GP.
Taking straightforward steps to plan your goals with respect to weight, then track your progress closely as you go is a good way to start. For people with chronic obesity, medical practitioners might discus with you pharmacological treatments and possibly surgical treatments also.
If you recognize that you are overweight or obese, start by recording everything you eat for a two to three week period. Do it honestly. It’s not an exercise in shaming or embarrassing – it’s a way of getting accurate data about what you might need to change. Then chat with your GP about it.
If you think perhaps you just don’t understand enough about food and nutrition and what constitutes a balanced and healthy diet, chat with your GP again and ask about referral to a Dietitian and if you’ve noticed that you’re struggling with the psychological impact of being overweight or obese, ask your GP for a referral to a Psychologist who can help you manage some of these difficulties.