What is Obesity?
Obesity is defined as having a Body Mass Index (BMI) of greater than 30 as measured by dividing your body weight in kilograms by your height in metres squared (wt/m2). That is; if you weigh 108 kg and stand 1.83m your BMI would be 108/(1.832) = 32.2. It should be remembered that the BMI is used to identify populations at risk for diseases related to an elevated BMI. That is; as a population, those with BMI’s greater than 30 will have a greater rate of certain diseases than those with BMIs less than 30. Individuals with a BMI of greater than 30, may have a reason that decreases their risk compared to the population group, (ie heavily muscled) however as a population group that is rare. Other measures such abdominal circumference (>90cm men and > 80cm in women), waist-hip ratios (>0.9 men and >0.8 women) and body fat percentage (25% for men and>35% for women) may be more accurate in describing an individual’s risk of developing a chronic disease compared to BMI.
The range of diseases that increase with obesity is varied. They include:
- Cardiovascular disease: heart attack, stroke, hypertension
- Metabolic disease: diabetes and elevated cholesterol
- Renal disease: kidney failure and cancer
- Neurological disease: increased rates of dementia
- Musculoskeletal disease: Osteoarthritis, lower back pain
- Mental Health: increased rates of depression and anxiety
How do I know if I have it?
Obesity is very common in Australia. One person in five is considered obese and nearly 60% of the population is overweight or obese.
There are many reasons that contribute to a person becoming obese. For the most part, while there are other contributing factors, such as medications, genetics and medical conditions, the underlying cause is the number of calories being consumed is more than the body requires. When the human body has an excess of calories, for whatever reason, the body stores these excess calories as fat. It is very important to address the reason for the intake of the excess calories. Is there a misunderstanding regarding how many calories in certain food, or the amount of certain food, not being active enough or do you eat because you feel better when you eat? Are you eating because you are sad, bored, lonely or are your drinking your calories in alcohol or in fizzy drinks?
Your GP will help you to identify where these additional calories are coming from.
How do I fix it?
If you are concerned about your weight, you should see your GP. They will discuss with you any previous medical history that may cause obesity, examine you, and arrange for several investigations to exclude some of the rarer contributors to obesity.
Following this, your GP should discuss with you various means to reduce the calories that are being consumed, via changes to your diet, increasing the calories being expended by increasing the amount of exercise you do (where possible) and most importantly, addressing the reasons that excess calories are being consumed (depression, boredom, alcohol consumption). On occasion medications may be prescribed to assist with the weight loss.
Your GP may recommend a referral to a dietician, to help develop a better understanding of the calories that are in food or a referral to a psychologist to assess for depression or anxiety. Other times a referral to community groups may help with boredom and social isolation.
Sometimes, surgery is a reasonable intervention that can be suggested. This is useful for people who have tried for a long time the above interventions and have not succeeded. There is a financial cost to such interventions.
Where can I get more information?
The following websites can assist with further information or see your GP.