Obesity, or being overweight, is a condition characterized by excessive fat accumulation, which can pose health risks. It usually starts gradually and increases with time. Currently, more than 35% of Americans are obese, and more than 50% are overweight. Obesity is often caused by excessive caloric intake, consumption of calorie-dense foods, including ultra-processed foods, and a sedentary lifestyle.
BMI measures obesity. A BMI of 25-30 is overweight, 31-40 is obese, and 41+ is morbidly obese. Certain medical conditions can make it easier to gain weight and harder to lose it, with genetics playing a minor role. Additionally, some medications may contribute to weight gain. For reference, 3,500 calories are roughly equivalent to one pound of body fat.
Obesity often leads to illnesses and complications. The partial list includes coronary artery disease (heart attack), stroke, depression, low self-esteem and poor body image, infertility, sexual dysfunction, increased risk of cancers (especially endometrial, breast & colon), hypertension, dyslipidemia (high cholesterol), diabetes mellitus and fatty liver. Obesity can also cause substantial disability and premature death. Fat is pro-inflammatory, meaning that it increases chronic inflammation in the body, which can affect many organs adversely.
Losing weight has many benefits, including decreasing the risk of chronic disease (heart disease, stroke, fatty liver, diabetes mellitus, high blood pressure) and lowering the risk of endometrial, breast, and colon cancer. It also makes you feel physically better and improves your body image.
To evaluate your obesity risk, measure your height, weight, waist and hip circumference. You can calculate your BMI easily by searching Google or Microsoft for a BMI table. The waist-to-hip ratio for females should be 0.8 – 0.85. Waist circumference for males should be less than 40” and for females less than 35”. Waist circumference highlights intra-abdominal fat, which is correlated with a higher risk of coronary artery disease and other illnesses.
How to lose weight. Losing weight is not all that difficult. You just need a desire to lose weight, discipline, and persistence. Set realistic weight goals (not wishful thinking). Usually, 5% of the weight is recommended as a first step. Setting unrealistic goals and not being able to attain them will make you depressed and disheartened, and you may just quit the weight loss effort.
Plan your activities for the next four weeks and beyond. This planning should include nutrition, activity, and lifestyle changes.
Nutrition. Caloric restriction is the most essential factor. Usually, at 1,600-1,800 calories daily, you will start losing weight gradually. By removing 500 calories a day from your diet, you can lose approximately one pound per week. Avoid calorie-dense foods (e.g., cookies, chocolate, cheese), sugary drinks (e.g., soda, sports drinks, juices). Fats in oils are also calorie-dense. It is not that difficult to remove 500 calories a day from your diet. Remember, 3,500 calories equal roughly one pound of weight. You should avoid junk food, control portion size, and eat mindfully.
If you get hungry, increase the quantity of calorie-light foods (large volume with low calories). Increasing your protein (more than 60g daily) and water intake (more than 40oz daily) will also help keep you feeling full. Typical protein-rich foods include lentils, fish, eggs, yogurt, nuts, and seeds. Make sure that your daily caloric intake remains within the desired range. Less than 1,800 calories for females and less than 2,000 calories for males is standard, but it depends on your age and level of activity.
Activity. Set easily obtainable and verifiable goals. Then, gradually increase them. For example, walk 15 minutes and climb two flights of stairs daily, and then gradually double over the next few weeks.
Lifestyle changes. Changing habits is difficult and takes time. Get adequate sleep, 6-8 hours of restful sleep daily. Decrease social media and mindless TV watching or mindless internet scrolling. Start spending more time with family and friends. Start learning a new skill or improve an existing one.
Start gradually, taking baby steps on your weight loss journey. It may take time and effort, but you will see the results.
Obesity is a lengthy and complex topic. It isn’t easy to cover everything in one session. Next month, we will discuss medications used in obesity treatment. There have been medications to lose weight for many years, but recently, newer medications (GLP-1 agonists, Wegovy, Zepbound, etc.) have been added to this list. We will discuss these medications, their indications and uses, dosing, and side effects. We will also discuss the length of treatment (when and how to wean off these medications).
