Obesity and Being Overweight

A simple way to assess whether a person may be overweight or living with obesity is to calculate the Body Mass Index, or BMI.

BMI is calculated by dividing body weight in kilograms by height in metres squared:

BMI = Weight (kg) ÷ Height² (m²)

A higher BMI generally indicates greater body weight in relation to height.

According to commonly used BMI classifications:

๐ A BMI above 30 is classified as obesity.

๐ A BMI above 25 but not exceeding 30 is classified as overweight.

BMI is a useful screening tool, but it does not directly measure body fat or distinguish fat from muscle. A healthcare professional may therefore consider waist circumference, body composition, medical history, and other health factors alongside BMI.

Health Effects of Obesity

Being overweight may not immediately cause noticeable health problems. However, obesity can significantly increase the risk of several diseases and may require medical management.

1. Bones and Joints

Excess body weight places additional pressure on the bones and joints.

This may lead to:

๐ Faster degeneration of the joints

๐ Knee, hip, ankle, or back pain

๐ Reduced mobility

๐ A higher risk of accidents and falls

๐ Joint deformity or disability in severe cases

2. Heart and Blood Vessels

Obesity increases the workload on the heart and may contribute to:

๐ High blood pressure

๐ High cholesterol and triglycerides

๐ Narrowing of the coronary arteries

๐ Heart disease

๐ Stroke

3. Respiratory System

Excess fat around the chest and abdomen may restrict lung expansion and make breathing more difficult.

Possible effects include:

๐ Shortness of breath

๐ Becoming tired easily

๐ Reduced exercise tolerance

๐ Snoring

๐ Low oxygen levels during sleep

๐ Obstructive sleep apnoea

Poor sleep and reduced oxygen levels may also affect concentration, learning, mood, and daytime performance.

4. Digestive System

People living with obesity may have a higher risk of developing gallstones and other digestive or liver-related conditions.

5. Endocrine and Metabolic System

Obesity can contribute to insulin resistance, in which the body does not respond to insulin effectively.

This significantly increases the risk of:

๐ Prediabetes

๐ Type 2 diabetes

๐ Abnormal blood lipid levels

๐ Metabolic syndrome

Obesity may also affect emotional well-being, social relationships, confidence, and work performance.

Causes of Obesity

Obesity usually results from several factors rather than a single cause. The two main categories are genetic and environmental factors.

1. Genetics

Genetic factors may influence:

๐ Feelings of hunger and fullness

๐ Appetite-regulating hormones

๐ Metabolic rate

๐ How the body stores fat

๐ Individual responses to food and physical activity

Having a genetic tendency does not mean that obesity is unavoidable, but it may make weight management more difficult for some people.

2. Environment and Lifestyle

Daily habits and the surrounding environment have a major effect on body weight.

Contributing factors may include:

๐ Eating high-calorie foods regularly

๐ Consuming sugary drinks

๐ Large portion sizes

๐ Frequent snacking

๐ Limited physical activity

๐ Spending long periods sitting

๐ Inadequate sleep

๐ Stress

๐ Easy access to highly processed food

Some medicines and medical conditions may also contribute to weight gain and should be assessed by a doctor when appropriate.

Treatment for Obesity

Effective long-term treatment requires more than temporary dieting. A sustainable weight-management programme generally combines dietary changes, physical activity, and behavioural modification.

1. Dietary Control

The main principle is to reduce foods that provide large amounts of energy while improving the nutritional quality of meals.

Foods to limit include:

๐ Deep-fried foods

๐ Fatty meat

๐ Animal skin and visible fat

๐ Coconut milk-based dishes

๐ Soft drinks

๐ Sweetened beverages

๐ Desserts

๐ Crisps and fried snacks

๐ Highly processed foods

Healthier Cooking Methods

Replace frying and excessive use of oil or coconut milk with methods such as:

๐ Steaming

๐ Boiling

๐ Stewing

๐ Baking

๐ Grilling

๐ Roasting

Choose water instead of soft drinks and replace frequent snacks with appropriate portions of fresh fruit that are not excessively sweet.

A balanced meal should include vegetables, suitable portions of whole grains or other carbohydrates, and lean protein.

2. Exercise and Daily Physical Activity

Exercise for weight control does not always need to be intense.

Brisk walking for approximately 30 minutes a day can support energy expenditure and cardiovascular health.

Daily activities can also make a difference. Helpful changes include:

๐ Standing more often instead of sitting for long periods

๐ Walking short distances instead of using a vehicle

๐ Taking the stairs when appropriate

๐ Doing household activities

๐ Taking movement breaks during work

๐ Reducing prolonged screen time

An appropriate exercise programme should match the individual’s health, fitness, joint condition, and physical ability.

3. Behavioural Modification

Changing eating and activity habits is essential for sustainable weight loss.

3.1 Keep a Food and Activity Record

Recording meals, drinks, snacks, exercise, sleep, and daily activities can help identify habits that contribute to weight gain.

It also makes it easier to monitor progress and recognise areas that need improvement.

3.2 Control Eating Triggers

Certain situations may encourage eating even when the body is not physically hungry.

Common triggers include:

๐ Eating snacks while watching television

๐ Drinking sweetened beverages during screen time

๐ Keeping large quantities of snacks at home

๐ Leaving food in visible and easily accessible places

๐ Eating because of boredom, stress, or habit

Helpful strategies include:

๐ Eating only at the dining table

๐ Avoiding food while watching television or using a phone

๐ Finding other activities to manage boredom or stress

๐ Keeping snacks out of sight

๐ Avoiding unnecessary food stockpiling

3.3 Change the Way You Eat

Practical eating strategies include:

๐ Eating more slowly

๐ Chewing food thoroughly

๐ Serving smaller portions

๐ Using a smaller plate

๐ Avoiding second servings

๐ Eating regular meals

๐ Paying attention to physical hunger and fullness

๐ Avoiding eating simply because food is available

Mindful eating can help people recognise the difference between genuine hunger and the desire to eat because of stress, habit, or emotion.

Long-Term Weight Management

Successful obesity treatment should focus on improving health rather than achieving rapid weight loss.

Important long-term goals include:

๐ Gradual and sustainable weight reduction

๐ Improved blood sugar control

๐ Better blood pressure and cholesterol levels

๐ Increased physical strength and mobility

๐ Improved sleep quality

๐ Reduced risk of chronic disease

๐ Better overall quality of life

People who have obesity, related medical conditions, or difficulty losing weight despite lifestyle changes should consult a healthcare professional for an individual assessment and appropriate treatment plan.

 

Reference :

Kasemrad Hospital Ramkhamhaeng Obesity and Being Overweight

ArokaGO Providers Kasemrad Hospital Ramkhamhaeng