Let's understand obesity

Obesity is a genuine medical condition

We now understand obesity to be a genuine medical condition- it is not a lifestyle choice or a weakness. Several genes have now been discovered that predispose a person toward developing obesity (read below), which explains why obesity often runs in families, and why some people really have to struggle with their weight whilst others seem to remain thin inspite of poor eating habits. Just like any other chronic medical condition such as epilepsy or asthma, obesity results from a complex interaction between a persons genetic makeup and their surrounding environment and lifestyle influences. 

Many people with a weight problem feel guilty and blame themselves for their situation. These feelings are inappropriate and cruel, and are often fuelled from misunderstanding and prejudice in the community. Lets get over this ignorance, and recognise obesity for what it is- a medical problem that can and should be treated.
 

Obesity is common.

In Australia 1 in every 5 adults have obesity, meaning, they have a body mass index (BMI) of 30 or more. It is more common than asthma. Morbid obesity refers to a BMI over 40. Childhood obesity is also emerging as a common disorder, with 1 in 6 primary school children having a BMI over 30. 

Obesity is genetic.

Leading researchers believe that our genes determine our susceptibility to develop obesity. Whilst it is true that unhealthy eating and lack of exercise also contribute to weight gain, the full story of obesity is more complex than that. We all know people who never seem to have a problem with their weight even though they don’t exercise much and make poor food choices. Conversely, others eat healthy foods and yet still face a constant struggle controlling their weight.

The evidence pointing to a genetic basis for obesity comes from a number of studies conducted over the past 30 years. Many of these studies have centered on looking for gene similarities among obese people. Other studies have looked for differences in the genetic make-up between family members who have obesity compared with those who don’t. Through this research a number of genes have now been discovered that are associated with obesity. These include the FTO gene, PCSK1 gene, and the ENPP1 gene. We are still a long way from unlocking the whole genetic basis for obesity, but it is now clear that a genuine genetic basis does exist.

Obesity is a disorder of appetite regulation.

Patients with obesity frequently report being hungry all the time. Hunger is regulated by the Hypothalamus- the part of the brain that controls the body’s metabolic mechanisms. It controls body temperature, thirst, fatigue, our sleep/awake cycle and other functions. It receives inputs from a variety of sources- one important source is the Vagus nerve which brings information back to the brain from the stomach and gastro-intestinal tract.

It is thought that the hunger-regulating part of the hypothalamus does not function correctly in people with obesity- it continues to stimulate hunger and food desire all the time, even when your body has plenty of energy reserves. Perhaps it is like the low-fuel warning light in a car constantly flickering on even though you’ve just filled the tank. This promotes both overeating and poor food choices, and over time leads to obesity

Another important observation is that people who are constantly hungry often seem drawn toward foods that are rich in calories. Such foods are often high in sugar and fat, such as chocolate, fried foods, and sweets.

The vagus nerves bring back information to the brain's hunger centre that influences how hungry we feel. It is believed that the gastric band alters these signals.

Weight loss surgery such as gastric banding can help correct this appetite imbalance. After surgery most patients notice a dramatic reduction in hunger, and feel full with less food. Being free of constant hunger can be very liberating, allowing sufferers to gain a sense of control. 

Health Risks

Why obesity is so dangerous

Obesity is associated with a huge number of other medical problems. It adversely affects every body system, and has become one of the leading causes of preventable death in Australia.

The extra fat tissue is metabolically active and interferes with the proper function of many organs. It interferes with the way the hormone Insulin works, leading to a condition known as ‘insulin resistance’, which can lead to diabetes and polycystic ovary syndrome. It also distorts the blood lipid profile, which can lead to fatty deposits in arteries causing heart disease. Deposits of fatty tissue around the neck and airway lead to snoring and obstructive sleep apnoea, whilst fat deposits within the liver (fatty liver disease) can cause liver inflammation and ultimately liver failure. These and many other reasons explain why being overweight is such a risk to your health.





The 'Metabolic Syndrome' is a collection of medical problems that is strongly associated with obesity which threatens both lifespan and quality of life






The following medical problems are also associated with obesity:

The risk of developing these problems increases dramatically once a person’s body mass index is more than 30. In fact a person with a BMI of 40 has ten times the risk of developing diabetes. At least 80% of people with obesity will develop at least one of these conditions, and 60% will develop at least three.

Obesity and life expectancy

As might be expected, obesity also reduces life expectancy. Data from Western Australia has revealed that obesity shortens average life expectancy by 4 years, whilst an American study has found that people aged 25–35 years who are severely obese are 12 times more likely to die early than those of a healthy weight. Click here for the report

Obesity and quality of life

Aside from the negative impact obesity has on medical health, obesity also significantly impairs quality of life. Reduced mobility, daily joint and back pain, constant fatigue, poor sleep, excessive perspiration, difficulty finding properly fitting clothes, and difficulty fitting into seats are just some of the constant struggles facing people suffering from this disease. Social isolation, prejudice and reduced employment opportunities also confront many obese people. 

 

Treatment Options

Obesity can be treated. A wide range of diets, exercise plans, and even medications exist and many are effective in the short term. However only weightloss surgery has been shown to provide effective long term weight control for people suffering from morbid obesity.

Weightloss surgery used to be regarded by some people as a cosmetic 'quick fix', or taking the easy way out. These views are totally wrong- unlike cosmetic surgery, weightloss procedures have their own Medicare item number, and are partially covered by all major Australian health funds. Weightloss surgery has been subjected to intensive scrutiny and study over the past 50 years- time and time again it has  proven to be effective in not only treating obesity, but also improving related medical conditions, quality of life, and survival. Surgery for obesity is now widely embraced by the medical community as a life-saving treatment for a genuine medical disorder.

Click here to read more about weightloss procedures.
 

Gastric band		Sleeve Gastrectomy		Gastric Balloon

Why does the weight seem to always come back after dieting?

Virtually all people with a weight problem will have tried diets and weight-loss programs. An almost universal characteristic of these attempts is that some weight is lost at first, only to be completely regained a few weeks later. This often leads to feelings of guilt and failure- however you have not failed at all- instead diets have failed you. When dietary programs are studied, over 97% of people have regained the lost weight within 2 years (and often with interest!). 

One explanation for this phenomenon is that the body’s homeostasis mechanisms kick in to restore the original weight. In general the body tries to resist change- it vigorously defends the status quo, even though losing weight is healthy. It reflects back to our earliest beginnings as humans, when food was scarce and unpredictable. Professor John Dixon from Monash University in Melbourne calls this the “spring theory”- the more the spring is compressed, the stronger the recoil force driving body weight back up again to its original level.

Weightloss itself appears to stimulate increased hunger. Just remember the last time you lost weight on a diet and how you gradually became more and more hungry. As a person’s weight falls, levels of the hunger hormone Grehlin increase, as if to restore weight to its original level. Weightloss surgery however leads to sustained control, as it appears to recalibrate the body’s weight set-point. In other words the spring is replaced with a shorter one. That is why it is so effective and permanent.

Click here to go back to the homepage and check your Body Mass Index to see if you are a candidate for weightloss surgery.