Doctors now regard obesity as a global health threat

The West is experiencing an epidemic directly affecting a greater proportion of the population than did either the Black Death of the 14 century or the influenza epidemic that occured during and after the First World War.

For example, in Australia in 1983, about 40% of adults were above the normal weight range. By the year 2000, this number had increased to 60%. That is, in the space of just 17 years, Australia had gone from having a minority to a substantial majority of the adult population being overweight.

Research in Australia indicates that the country is on its way to overtaking the United States as the fattest nation in the world.

The image of Australia as a sporting nation populated by fit, healthy people has been dented by the latest statistics on obesity. Experts in Australia are warning
that unless urgent preventative programmes are taken, Australia will become the fattest nation in the world in as little as a generation.

Doctors now regard obesity as a global health threat, claiming it has raised the incidence of heart disease, stroke, breast cancer and colonic cancer.

Studies by a Washington-based Worldwatch Institute show that the number of those overfed and overweight around the world has risen to 1.1 billion. In the United States 61% of all adults are overweight compared to 54% in Russia, the UK has 51% and Germany 50%. Research has shown that about 18% of the Chinese population are overweight.

Although being slightly above normal weight poses only minimal health risks, carrying a lot of extra body fat significantly increases the risk of several common diseases, especially heart disease and diabetes. It is almost certainly not a coincidence that the rise in incidence of diabetes in Australia and other similar countries, parallels that of obesity.

Being obese also vastly increases the risk of conditions such as sleep apnoea, where people literally stop breathing for short periods during sleep. As a result, they have only broken sleep of poor quality, usually accompanied by episodes of loud snoring, and often feel exhausted during the day.

Obesity also exacerbates some existing conditions such as osteoarthritis, because the joints now have to carry a much greater load than usual.

Obesity can also lead to psychological problems through social ostracism, particularly for children, and can adversely affect self-esteem throughout life.

Did you know that besides feeling lousy, fatigued, and fuzzy minded, being overweight ages you faster than normal AND sets the stage for catastrophic health problems such as:

• High blood pressure and cardiovascular disease


• Diabetes


• Respiratory problems


• Gall stones


• Complicated pregnancies


• Arthritis


• Increased risk of cancer of the breast, uterus, gall bladder and bowel


• Hormonal and gynaecological disorders such as fibroids and heavy painful periods

Fat farms

Obesity among Australian children has doubled in the last 10 years hitting 20% and still growing fast.

Subsequently, fat farms, where children try to sweat off their excess weight, have done a roaring trade in recent years.

Between 5% and 10% of the Chinese youth are considered obese by World Health Organization Standards. Specialists believe that China’s young generation, often reared on a diet of junk food and little exercise, is particularly at risk. These figures are expected to double within a decade.

Yet the latest research by doctors from the Chinese Academy of Preventative Medicine suggests that the problem is affecting all age groups. And with more and more people, especially in the cities, eating greater quantities of meat, eggs and dairy products, and less vegetables, doctors warn that obesity could become China’s biggest health threat.

The nation already has a 100 million people suffering from high blood pressure and 26 million with diabetes.

What’s the cause?

A decade or two ago it was common to blame the individual for being overweight. ?Gluttony? and ?sloth?, two of the seven deadly sins, were often invoked as the causes. Today, a more enlightened approach is taken to the problems that people have with weight control. It?s now believed that there are very strong and complex, but often quite subtle factors involved in the tendency to increase body fat.

For example, over the past decade, the average weight of adult Australians has increased by about 2-3 kilograms. This corresponds to a daily increase of only about one gram in body fat, a miniscule amount. This means that adult Australians are balancing food intake with energy output to better than 99.5%. But that tiny imbalance, less than half of 1%, has led, in the last 15 years, to a doubling in the proportion of Australian adults who are obese.

So what is the case, or what are the causes, of these subtle, but in the long term, very significant effects?

If your food intake is greater than your energy output, then your body is stuck with that extra energy, it cannot make it miraculously disappear. Rather, the extra energy is converted into body fat.

Until a few thousand years ago, this was of great value to people. When the inevitable famine arrived, those who had built up a large reserve of energy, in the form of body fat, when food was plentiful, were better able to cope with the famine, and so were more likely to survive. This meant that they would pass their genes into the next generation, while many of their naturally slim relatives and other members of their group, would not survive the famine, and so could not reproduce.

It is believed that this strong evolutionary pressure has led to a substantial proportion of the present population having a tendency to put on weight when conditions are favourable, that is, during periods when plenty of food is available.

But in the developed, Western world, the feasting periods are no longer interspersed with famines. We live in an era when food is available all year round, and the food that is available isn?t wild berries, yams and low-fat game meat any more, it is food that has been made to appeal to taste buds as strongly as food manufacturers can make it, often by having added sugar and/or fat.

Compounding this is the reduction in the need to do physical work in both our jobs and in everyday life. Modern technology means that many people now drive or catch a train to work, take an elevator to the floor where their airconditioned office is located, and spend the rest of the day seated in front of the computer.

This combination of a genetic predisposition to put on weigh, ready availability of very tempting food, and diminishing physical work seems to be the major factor in the dramatic increase in overweight and obesity that is occurring in Australia and in other Western nations.

Which category do you fit into?

So how do you know which category you are in: ?underweight?, ?normal weight?, ?overweight? or ?obese??

Well, there is a simple test: your ?body mass index?, or BMI is a reasonable indication of which weight category you fit into. BMI is calculated as your weight in kilograms, divided by the square of your height, where your height is measured in metres. A BMI of less than 18.5 is defined as ?underweight?; from 20 to just below 25 is ?normal?; from 25 to just below 30 is ?overweight?; and having a BMI of 30 or above is defined as ?obese?.

To take a simple example, one that is simple enough for me to do by mental arithmetic: if a man, perhaps a Rugby forward or Australian Rules ruckman, is 2 metres tall and weighs 100 kilograms, his BMI is his weight (100 kilograms) divided by the square of his height (where his height is 2 metres). So his BMI is 100 divided by two-squared, which equals 25. That is, our hypothetical footballer has a BMI at the low end of the ?overweight? category.

Although BMI is useful, it does have limitations, because it doesn?t take into account body build. In fact, our hypothetical footballer, who may be very muscular, illustrates this problem. He is categorised as ?overweight? without actually being over fat.

Another problem with BMI is that it doesn?t determine where the excess fat lies on the body. Having a lot of fat in the abdominal area (that is, the ?beer gut? that many Australian men so fondly cultivate), is a much better predictor of diabetes and heart disease risk than is high fat in the area of the hips and thighs, for example.

The circumference of your body at the level of your waist is a reasonably good predictor of abdominal fat, and it will also indicate if your BMI is high because of excessive body fat, rather than unusually high muscularity. To measure your waist circumference, pass a tape measure horizontally around your body at the level of the navel. Breathe out and then measure the circumference before you breathe in again. The maximum recommended waist circumference for a man is about 100 centimetres, for a woman, 90 centimetres.

So if you have a BMI above 25 and a waist circumference of greater than about 100 centimetres, for a man, or 90 centimetres for a woman, you are almost certainly carrying more body fat than is good for you.

What can you do about this?

You need to reduce your total food intake slightly, a reduction of about 5% to 10% should be enough. And you can substantially increase your energy output, tipping the balance in favour of reducing body weight, by simply doing about 30 minutes of moderately vigorous activity each day. This activity should be in addition to any incidental activity that you do, such as walking to the train station rather than driving, taking the stairs rather than the elevator, or escalator, and so on.

The 30 minutes of extra activity can be virtually any form of moderately vigorous exercise. Walking is excellent, provided that it is brisk walking. So too are swimming, riding a bike, light weight training, playing tennis, or any other activity that uses up energy at a moderately vigorous, or greater rate.

Food for thought …

There are 300,000 American deaths a year linked to obesity. The healthcare costs of obesity is $US 117 billion ($A 204 billion) per annum, which is five times the health costs associated with tobacco.

According to a health warning about weight, issued by the US Surgeon General, obesity may soon overtake smoking as the leading cause of preventable deaths in the US.

Meanwhile, in the developing world, 815 million people live in hunger …

Unable to lose weight?

One of the chief issues raised by women visiting our website, and the cause of untold frustration and deminished self-esteem, is their inability to lose weight.

These women reach a point where, for the first time in their life, weight suddenly increases around the tummy, hips, and thighs. Breasts may increase in size, and they become quite flabby, gaining unsightly cellulite and a fatty (liver) roll around the midriff.

They might attend a gym and routinely exercise and yet cannot shift the excess pounds.

Alternatively, they many join a clinic offering weight control diets but fail to sustain their newfound svelte body shape once they abandon such control measures. The weight creeps back on. Unfortunately, these women ‘yoyo’ from one diet to the next, often growing fatter with each episode, causing enormous despair and suffering, and burdening their body further still.