Chronic obesity is on the rise, becoming significant health issue | Mark Mahoney

As we progress into the latter part of National Nutrition Month the issue of obesity is one that should not be discounted.

According to the World Obesity Atlas (March 2022) by 2030 it is predicted that 1 in 5 women and 1 in 7 men will be living with obesity equating to over 1 billion people globally. Four in 10 American adults have obesity, and obesity rates continue to climb nationwide and within population groups, according to a report, State of Obesity 2022: Better Policies for a Healthier America.

Obesity is associated with decreased life expectancy of 5–20 years depending upon its duration, the magnitude of excess weight and the emergence of associated comorbid diseases.

Definition and adverse health consequences of obesity

Obesity is recognized as a significant public health hazard and was so designated in 2013 as a chronic disease condition by the American Medical Association as it increases the risks for multiple diseases, such as type II diabetes, cardiovascular disease, hyperlipidemia (an abnormally high concentration of fats or lipids in the blood), hypertension (high blood pressure), stroke, breast and colon cancer, and degenerative arthritis.

Obesity is defined by the Obesity Medical Association as a “chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.”

Individuals with obesity have an increased accumulation of fat not always attributable to eating too many calories or lacking physical activity. Individuals with obesity experience impaired metabolic pathways along with disordered signaling for hunger, satiety (the feeling of fullness), and fullness (the state of fullness).

Diagnosing obesity

Weight and height can be used to determine Body Mass index (BMI). BMI is a tool used to “screen for weight categories that may lead to health problems.” It is calculated as weight (kg.) divided by height (m2) The Centers for Disease Control and Prevention note that BMI is a potential “indicator of high body fatness.” A measurement of over 30 is classified as obese when employing this method.

Waist circumference can also be used to measure the distribution of fat and is therefore a marker of disease risk.

Individuals who carry excess visceral fat in their abdominal region can experience metabolic changes leading to a higher risk for many chronic diseases. According to the National Institutes of Health (NIH), a healthy waist measurement is less than 35 in. for a woman and less than 40 for a man.

A calculator from the Mayo Clinic to calculate your BMI and waist circumference is accessible at: mayoclinic.org.

Some tools for addressing obesity

The relationship between diabetes and overweight/obese individuals is striking with about 80% of adults with type 2 diabetes also being overweight or obese. Greater levels of obesity confer higher risk for the disease.

Weight loss can prevent, delay, or reverse type 2 diabetes, but it can be very hard to achieve and maintain. That’s why the approval of semaglutide (a GLP-1 receptor agonist) to treat obesity is causing such excitement.

At the dosage approved for diabetes, GLP-1 receptor agonists not only lower blood glucose, but also reduce weight by about 3-5% of initial weight. Scientists believe this occurs because the medications reduce appetite and they slow down gastric emptying, which can increase a sense of fullness and decrease hunger.

According to the PBS podcast (see link under resources at the end of the column) the GLP-1 agonists can also assist with helping you to want to stay on a diet and exercise program as part of an approach to weight loss. Furthermore the podcast participants noted that the new medications are a resource to weight loss and form part of a comprehensive approach to include diet and exercise.

A select trial is underway which should shed light on the drug’s potential for a decrease in mortality as a lifesaving intervention.

Other issues remain besides the efficacy of the long-term use of the drug which includes access/availability(to who and for what reason) and costs.

A final note

It is important to note that a healthy diet and physical activity remain key components of a healthy lifestyle and possibilities for experiencing a better quality of life. Preventing and/or addressing obesity should be an important focus to improve our individual and collective health status. Be proactive by staying informed. Good luck.

Additional resources

Check out the podcast on the Public Broadcast Service’s (PBS) 1-A program for a more in-depth discussion by qualified specialist on some controversy over diabetic medicines showing potentially promising results for weight loss at the1a.org.

A Q&A on medications for weight management for individuals with diabetes iddk.nih.gov/health-information

ReferencesSports Nutrition (6th Edition). Academy of Nutrition and Dietetics

Obesity Medicine Association (obesitymedicine.org)

World Obesity Atlas (worldobesity.org)

Mark A. Mahoney, Ph.D. has been a Registered Dietitian/Nutritionist for over 35 years and completed graduate studies in Nutrition & Public Health at Columbia University. He can be reached at marqos69@hotmail.com.

This article originally appeared on Tallahassee Democrat: Chronic disease of obesity is a complicated public health issue