Ref: CHB/HB/025/15                                                                   


What is obesity?

The definition of obesity varies depending on what one reads. In general, overweight and obesity indicate a weight greater than what is considered healthy. Obesity is a chronic condition defined by an excess amount of body fat. A certain amount of body fat is necessary for storing energy, heat insulation, shock absorption, and other functions.

The main cause of obesity?
The balance between calorie intake and energy expenditure determines a person's weight. If a person eats more calories than he or she burns (metabolizes), the person gains weight (the body will store the excess energy as fat). If a person eats fewer calories than he or she metabolizes, he or she will lose weight. Therefore the most common causes of obesity are overeating and physical inactivity. Ultimately, body weight is the result of genetics, metabolism, environment, behavior, and culture. 

  • Genetics
  • Overeating
  • A diet high in simple carbohydrates
  • Frequency of eating
  • Slow metabolism
  • Physical inactivity
  • Medications
  • Psychological factors
  • Diseases such as hypothyroidism insulin resistance, polycystic ovary syndrome, and Cushing’s syndrome.

The statistic in Tanzania indicates 5-7% in general. And in our community up to 60% are overweight, while 20-30% are grossly overweight or obese.

What are the health risks associated with obesity?
Obesity is not just a cosmetic consideration; it is a dire dilemma directly harmful to one's health. In the United States for example, roughly 112,000 deaths per year are directly related to obesity, and most of these deaths are in patients with a BMI over 30. For patients with a BMI over 40, life expectancy is reduced significantly. Obesity also increases the risk of developing a number of chronic diseases, including the following: 

  • Insulin resistance
  • Type 2 (adult-onset) diabetes.
  • High blood pressure (hypertension).
  • High cholesterol
  • Stroke
  • Heart attack.
  • Congestive heart failure
  • Cancer
  • Gallstones
  • Gout and gouty arthritis
  • Osteoarthritis (degenerative arthritis) of the knees, hips, and the lower back
  • Sleep apnea

What are other factors associated with obesity?

·     Ethnicity. Ethnicity factors may influence the age of onset and the rapidity of weight gain. African-American women and Hispanic women tend to experience weight gain earlier in life than Caucasians and Asians, and age-adjusted obesity rates are higher in these groups. Non-Hispanic black men and Hispanic men have a higher obesity rate then non-Hispanic white men, but the difference in prevalence is significantly less than in women.
·      Childhood weight. A person's weight during childhood, the teenage years, and early adulthood may also influence the development of adult obesity. For example, 

  • being mildly overweight in the early 20s was linked to a substantial incidence of obesity by age 35;
  • being overweight during older childhood is highly predictive of adult obesity, especially if a parent is also obese;
  • Being overweight during the teenage years is even a greater predictor of adult obesity.

·       Hormones. Women tend to gain weight especially during certain events such as pregnancy, menopause, and in some cases, with the use of oral contraceptives. However, with the availability of the lower-dose estrogen pills, weight gain has not been as great a risk.

What can be done about obesity?

  • All too often, obesity prompts a strenuous diet in the hopes of reaching the "ideal body weight." Some amount of weight loss may be accomplished, but the lost weight usually quickly returns. Most people who lose weight regain the weight within five years. It is clear that a more effective, long-lasting treatment for obesity must be found.
  • The prevention would include changing dietary habits, to include fruits, vegetables and salad taken before every meal.
  • Obesity treatment must acknowledge that even modest weight loss can be beneficial. For example, a modest weight loss of 5%-10% of the initial weight and long-term maintenance of that weight loss can bring significant health gains, including:-
  • Lowered blood pressure.
  • Reduced blood levels of cholesterol.
  • Reduced risk of type 2 (adult-onset) diabetes (In the Nurses’ Health Study, women who lost 5 kilograms (11 pounds) of weight reduced their risk of diabetes by 50% or more)
  • Decreased chance of stroke. 
  • Decreased complications of heart disease.
  • Decreased overall mortality.

It is not necessary to achieve an "ideal weight" to derive health benefits from obesity treatment. Instead, the goal of treatment should be to reach and hold to a "healthier weight."

The emphasis of treatment should be to commit to the process of lifelong healthy living including eating more wisely and increasing physical activity.
In summary, the goal in dealing with obesity is to achieve and maintain a "healthier weight."

General exercise recommendations

  • Perform 20-30 minutes of moderate exercise five to seven days a week, preferably daily. Types of exercise include walking, stationary bicycling, walking or jogging on a treadmill, stair climbing machines, jogging, and swimming.
  • Exercise can be broken up into smaller 10-minute sessions.
  • Start slowly and progress gradually to avoid injury, excessive soreness, or fatigue. Over time, build up to 30 to 60 minutes of moderate to vigorous exercise every day.
  • People are never too old to start exercising. Even frail, elderly individuals (60-80 years of age) can improve their strength and balance.

Exercise precautions

The following people should consult a doctor before vigorous exercise:

  • Men over age 40 or women over age 50
  • Individuals with heart or lung disease, asthma, arthritis, or osteoporosis
  • Individuals who experience chest pressure or pain with exertion, or who develop fatigue or shortness of breath easily
  • Individuals with conditions or lifestyle factors that increase their risk of developing coronary heart disease, such as high blood pressure, diabetes, cigarette smoking, high blood cholesterol, or having family members with early onset heart attacks and coronary heart disease

Calculate Your Body Mass Index

Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women.



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