Obesity is a disease which involves excessive body fat that increases the risk of additional diseases and health issues, such as cardiovascular disease, diabetes, hypertension, and cancer. Metabolic syndrome is closely linked to obesity and inactivity, as well as insulin resistance.
Obesity
Obesity is “a chronic relapsing progressive disease progress” (Bray et al., 2017). It is determined by the following factors:
- Energy Balance
- Obesogenic Environment
- Nature VS Nurture
eNERGY BALANCE
Energy In (dietary intake) VS Energy Out (physical activity)
Obesogenic Environment
An environment that promotes weight gain and is not conducive to weight loss.
Nature vs Nurture
Genes affect the metabolic rate, fuel use, brain chemistry, and body shape. Over-eating is learned earlier on in childhood eg. encouraging child to eat whatever is on the plate. Environmental factors add to weight gain influences. Social status affects weight status eg. poverty may lead to unhealthy food choices.
Nutrition Assessment of Obesity
Obesity is characterised by excessive body fat: women with >35% body fat and men with >25% body fat. Excessive body fat puts the individual at increased risk for health problems. Body fat is calculated by measuring skin folds using calipers.
BMI calculation = weight (kg) / height (m2). BMI should ideally be between 18.5 and 24.9kg/m2
Obesity Health Risks
Android vs Gynoid Body Fat Distribution
ANDROID
- obesity centered in the upper-body area – apple shape
- abdominal fat is released into the liver
- associated with cardiovascular disease, hypertension and type 2 diabetes
- related hormone at play – testosterone
GYNOID
- obesity centered in the lower-body area – pear shape
- not as risky as android
- related hormones at play – estrogen and progesterone
Health Problems Associated with Obesity
- cardiovascular disease
- hypertension
- type 2 diabetes
- pulmonary disease
- cancer of the breast,colon, pancreas and gallbladder
- sleep apnea
- gallstones
- bone/joint disorders
- infertility
- difficult delivery following pregnancy
- increased surgical risk
- reduced agility
- poor quality of life
- early death
Weight Loss Benefits & Guidelines
Adult Weight Loss…
- total energy intake should be less than energy expenditure
- consider diets with 600kcal/day deficit
- consider low-fat diets alongside expert support and follow-ups for sustainable weight loss
- keep in mind that low-calorie diets may not provide all nutritional requirements
- include behaviour change strategies using a biopsychosocial approach and history in relation to past diet experiences as well as comorbidities
Metabolic Syndrome
Metabolic syndrome is a worldwide growing epidemic, affecting about 1 of every 4 or 5 adults in every country. Its incidence increases with age.
The term Metabolic Syndrome refers to a group of risk factors which increase the risk for cardiovascular disease, diabetes, stroke, and other health-related problems.
Metabolic Syndrome Risk Factors
- hyperglycaemia
- hypertension
- abdominal obesity a.k.a. android obesity
- low HDL cholesterol level
- high triglyceride level (including individuals on treatment for high triglyceride level)
WHO Recommendations
Insulin Resistance
While a third of all individuals with Metabolic Syndrome have normal insulin sensitivity, the two are still associated with each other. Insulin resistance features high plasma insulin concentration which fails to suppress plasma glucose as normally happens. Contributing factors include unresponsiveness to insulin at a cellular level due to receptor-based mechanisms.
Hypertension
Insulin resistance and hyperinsulinaemia may cause hypertension due to an increase in catecholamine activity, as happens with increased insulin concentration through insulin-mediated renal tubular reabsorption of sodium. Weight loss helps in improving both hypertension and hyperinsulinaemia.
Dyslipidaemia
High trygliceride and low HDL cholesterol levels are key factors for metabolic syndrome, both commonly leading to cardiovascular disease. The term dyslipidemia refers to an increase in plasma cholesterol, triglycerides, both, or low HDL cholesterol level which leads to atherosclerosis development.
Preventing or Reversing Metabolic Syndrome
- weight loss through healthy eating
- regular exercise
- smoking cessation
- alcohol cessation
- pharmacological interventions
Reference
Bray, G.A., Kim, K.K., & Wilding, J.P.H. (2017). Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obesity Reviews, 18: 715-723.
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Claire is keen about public education on health-related subjects as well as holistic patient-centered care. She is also passionate about spreading awareness on the negative effects that domestic abuse leaves on its victims’ mental, emotional, social and physical wellbeing.
Claire aspires to continue studying following completion of her Nursing Degree, because she truly believes in lifelong education.
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