Mark A. Mahoney
A past report by the Centers for Disease Prevention provided some sobering news that America’s obesity epidemic is far from under control with a startling revelation that over 40% of people in the United States are obese.
During the time period between 1999 and 2018, the prevalence of obesity increased about 12% — from 30.5% to 42.4% of Americans. Obesity — which means not merely overweight, but seriously overweight — is considered one of the nation’s leading public health problems.
The COVID-19 pandemic along with a less active population and an increase in the consumption of so-called “comfort foods” has contributed to the ever-increasing obesity epidemic.
I recently was speaking with some of my fellow gym-goers at Planet Fitness and a discussion ensued about the issue of body fat with a particular interest in the area of belly fat – both how to address the issue in terms of a reduction in size as well as how to go about focusing on flattening the abdomen. This prompted today’s column.
Obesity – a disease
The American Medical Association designated obesity a disease in 2013. According to the Obesity Medicine Association, obesity is defined 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.”
According to the U.S. National Institute for Diabetes and Digestive and Kidney Disease, NIDDK (part of the National Institutes of Health, NIH) obesity is associated with type 2 diabetes, heart disease, high blood pressure, stroke, fatty liver disease, sleep apnea, arthritis, gallbladder disease and more.”
Obesity is related to genetic, psychological, physical, metabolic, neurological, and hormonal impairments. Go to the Obesity Medical Association site for further explanation of obesity as a disease at obesitymedicine.org.
Body Mass Index and waist circumference
The BMI provides a good estimate of body fat. There are some flaws with this measurement but it serves as the standard way to diagnose overweight and obesity.
The designation for obesity is a BMI of 30 or more with severe obesity being a BMI of 40 or more.
One’s BMI is based upon a rough estimate of an individuals’ body fat based on their height and weight. A person who is 5-foot-4, the average height for U.S. women, is considered obese at a weight of 174 pounds and severely obese above 232 pounds. A person who is 5-foot-9, about the average height for men, is deemed obese at 203 pounds and severely obese at 270.
Probably the most important caveat is that the BMI reflects total body fat without regard to how the fat is distributed. And although no excess fat is good, one type of excess fat is much more dangerous than the others. Research shows that abdominal fat is the worst of the worst.
Waist circumference is considered a good estimate of your body fat, especially your internal fat deposits, and your likelihood of developing weight-related disease.
It is generally agreed that for better health your waist should be less than 40 inches around for men, and less than 35 inches for women.
Even at a healthy weight, excess fat carried around the waist can increase your risk of high blood pressure, high [blood] cholesterol, heart disease and type-2 diabetes
Additional information on the role of excess abdominal fat (in both men and women) with relation to one’s health can be accessed at health.harvard.edu.
Taking proactive measures
If your BMI (or other relevant indicators such as waist circumference) indicates you are getting close to being overweight (or obese) or if you have certain risk factors, your doctor may recommend you adopt healthy lifestyle changes to prevent you from becoming overweight and obese.
A potentially valuable resource may be a referral for counseling to a Registered Dietitian, the nutrition professional with the specific expertise in this area.
Changes include healthy eating, being physically active, aiming for a healthy weight, and getting healthy amounts of sleep.
One good resource titled Changing Your Habits for Better Health from the NIDDK can be found at niddk.nih.gov.
There needs to be a wake-up call which comes down to focusing on health promotion and being proactive with regards to living a healthy lifestyle. Obtaining appropriate evidence-based and best practices information can go a long way in assisting us in preventing becoming overweight or obese.
Additional resources on diet and physical activity information on the DASH eating plan is available at nhlbi.nih.gov.
A good resource from the American Heart Association on recommendations for physical activity is at heart.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 [email protected]
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