Obesity
By Dr. Kent Niss
Discussing the topic of weight is something that is very frustrating and always stressful in our lives. However, it is quite possibly one of the single most important controllable risk factors for multiple health conditions.
I think it is always important to define a topic that were discussing. To define obesity and overweight we used the BMI scale. BMI is calculated utilizing your height and your weight. This is a much more accurate analysis of body mass rather than just looking at weight alone. A BMI greater than 25 falls into an overweight range and a BMI of greater than 30 falls within and obesity range. For instance, for a 5’9” individual a BMI of 27 (overweight) would mean weighing approximately 185lbs, or a BMI of 30 would mean weighing approximately 210 lbs. As you can see this is much more different than what most of us would typically classify overweight and obesity. Over the years there has been some slight discussion that overweight classification would be a BMI of greater than 27-28 rather than 25. However, the same principle applies. Today I’d like to talk about obesity and the risks that increase with it as well as simple steps to help manage it.
We do know that obesity is directly related to several different very common conditions such as diabetes, heart disease, heart attacks, congestive heart failure, stroke as well as chronic kidney disease. This is a very wide range of conditions but also very common conditions. Hypertension, chronic kidney disease, coronary artery disease and diabetes are in the top 5 most common conditions in the United States. We do know from research in subgroups within the United States as well as in other countries that that people with a BMI of less than 25 have a much smaller risk of even developing these conditions in the first place. Certainly, there are many other factors that come into play including genetics, smoking, and your environment. However, repeatedly, obesity is the greatest risk factor for all of these conditions.
There are so many ways to discuss/approach managing obesity, however, there are two general strategies: exercise and dietary intake. Notice that this is not exclusively saying “high intensity exercise and strict dieting”, but more importantly balancing energy. Calories is the most common measure for energy consumption and burning. Energy balance can be boiled down to the simple concept of “more energy out than energy in will equal to weight loss”. However, the inverse is equally true. Now there are many small details that we could also discuss, but I think it is very important to start with the big picture.
Calorie intake: The average adult requires around 2000 calories per day for regular daily needs. This includes our normal metabolic demands as well as very minimal exercise. However, the average calorie intake that we have is far greater than that and usually around 3000 calories per day. This is an excellent place to start to monitor and manage weight control. By paying attention to the foods that you are eating and how many calories they have you will be more aware of this calorie intake and how to monitor it and adjusted to help fit your energy balance requirements. A simple way to start this process is looking at your nutrition labels on the foods that you eat. Some foods do not come with nutrition labels particularly whole foods like steak, chicken, apples, and broccoli. The nutritional facts on these can be easily obtained by going too myplate.gov.
Calorie output (burning): As discussed balancing calorie intake and output is a two-sided equation. Therefore, monitoring how many calories you’re burning each day is also important. On average a person who is not actively exercising will burn somewhere between 1000 and 2000 calories per day depending on their other metabolic demands. As I mentioned earlier having excess calorie output (burning calories) over calorie input will result in weight loss. Therefore, increasing activity which will increase your metabolic demand resulting in more calories out and calories in. This is not something that requires training for a marathon or high intensity workouts or even daily workouts. However, this can be obtained by simply walking for 30 minutes a day 5 days a week. Certainly, higher intensity exercise will increase calorie output, but this is not always achievable, at least not right away. I would always encourage starting an exercise plan that is attainable and something that can be continued for long periods of time.
Battling obesity can start with simple tasks such as monitoring what you are eating and how much you are moving. Then making small changes to these two factors can yield big results over time. There is a significant amount of evidence stating that a weight loss of 8% can result in dramatic risk reduction for cardiovascular disease, diabetes and congestive heart failure complications.
