Global Health Asia-Pacific September 2020 September 2020 | Page 54

Feature
Worldwide
obesity has
tripled since
1975, with over
650 million
obese and
1.9 billion
overweight
people in 2016,
according to the
World Health
Organization
(WHO).
added, is that these highly restrictive approaches
eventually fail because you have a strong metabolic
pushback towards the set point � the more drastic
the diet the more intense the pushback � and many
people are simply not able to stick to the strict
regimen for long periods.
Regardless of the type of diet, non-compliance is
often driven by tough life events, stressed Dr Michael
D. �ensen, an obesity expert at the Mayo Clinic. �My
patients often fail to achieve their goal for weight-loss
because of life problems,” he told Global Health Asia-
�aci�c. �I’m not saying it’s their fault, they try to lose
weight and then their partner gets cancer, they get
stressed out from work, or something else happens
that disrupts their plans to lose weight.�
Poor socio-economic conditions are also strong
predictors of obesity.
Not everyone has the same degree of food security
or can afford to buy and prepare healthy food, so
these are extra challenges on top of the biological
pushback that make long-term weight loss even
harder, said Dr Dushay.
Coupled with the globalisation of unhealthy
lifestyles, all these factors have contributed to soaring
rates of excess weight gain. Worldwide obesity has
tripled since 1975, with over 650 million obese and
1.9 billion overweight people in 2016, according to the
World Health Organization (WHO).
Over the same period, the prevalence of overweight
and obesity in children and adolescents more than
quadrupled and stood at �40 million in 2016. �ids and
teenagers in low- and middle-income countries are
the most vulnerable because they’re more exposed
to high-fat, high-sugar, and high-salt foods that are
cheap but promote weight gain and lack essential
nutrients, highlighted the WHO.
This explosive rise has been described by the WHO
as an obesity epidemic, meaning the condition can’t
simply be blamed on people’s choices.
“Obesity is not a temporary condition where people
can easily lose significant amounts of weight and
keep it off over time,� stressed Dr �uhl. �And that’s
one of the reasons we’ve seen the American Medical
Association classify obesity as a chronic disease.�
Well-being isn’t the result of body size
Despite the strong biological and environmental
headwinds, people who are committed to eating
wholesome foods and doing physical activity on a
regular basis can definitely lose weight.
“Those people are much more likely to succeed
than people who say, ‘for the next two months I’m only
going to have a liquid diet or cut cheese out,’” said Dr
�ensen.
“I actually don’t use the term ‘diet’ when I talk to
my patients because it implies something temporary.
I prefer the term �changing eating habits,’� he said.
“I usually tell my patients: are you willing to make
permanent changes to your eating habits? Even one
small thing at a time you’re willing to change forever
can reduce your weight and improve your health.�
A comprehensive healthy lifestyle, including not
only a high quality diet and exercise but also good
sleep and stress management habits, can help even
very large-size people improve quality of life and lose
a significant amount of weight, said Dr Dushay, but
that doesn’t necessarily mean everyone will slim down
to their ideal body size.
“The scale moves in very frustrating and
individualised ways that we don’t totally understand,
but if people focus on improving their diet, exercise,
sleep, and stress levels, they could feel significantly
better without having to rely solely on a number on
the scale to tell them that they are healthier,” she said,
noting that many of her patients are surprised by how
empowered they feel when they improve their health
to the point that they can go up a �ight of stairs, walk
a mile, or play with their children or grandchildren
without being out of breath.
The bottom line is that the goal is to feel better
rather than chase a number on a scale because
excess weight doesn’t always equate to poor health.
Despite what many think, the body mass index
(�MI), the measure used to establish whether you’re
overweight or obese by dividing your weight by the
square of your height, isn’t an accurate metric of
overall health.
�Obesity is a very heterogeneous disease. �ou can
find 10 people with the exact same �MI and they can
be in 10 different states of health, from very poor to
very good,” explained Dr Dushay, noting that someone
who is slim but totally stressed out with terrible eating
and sleeping habits is less healthy than another with
a higher �MI who follows a good diet, does regular
physical activity, and sleeps well.
People with obesity who exercise can be in good health even if
they don’t lose a lot of weight
52 SEPTEMBER-OCTOBER 2020 GlobalHealthAsiaPacific.com