Weight

The great misconception about being overweight is that it’s all about poor diet and other lifestyle factors. If that were true, it could be resolved simply by fixing these things.

Unfortunately, that’s not the case. Weight is a complex, multi-factorial chronic condition; focusing solely on diet and lifestyle will not always get you the results you want.

What are the signs of being overweight?

Medical practitioners use Body Mass Index (BMI, a calculation based on weight and height) to determine whether a person is overweight. A BMI between 18.5 and 24.9 is considered normal; over 30 is considered as being obese. There are, however, some problems with this calculation. BMI does not measure fat directly, and someone with high muscle mass can be categorized as obese when in fact they are muscular.

Waist circumference is another marker used to identify obesity: a circumference of over 40 inches (102 cm) for men and 35 inches (89cm) for women is considered to be someone who has obesity. Ultrasound can also be used to measure the thickness of fat tissue, and the skin fold test can be used to measure the amount of fat in various regions of the body.

Additional measurements – including blood pressure, blood glucose and cholesterol – may also be considered along with BMI and waist circumference.

What risks are associated with overweight?

Being overweight comes with a number of risks: type 2 diabetes, high blood pressure, cardiovascular disease, dementia, sleep apnoea, osteoarthritis, gut issues, increased infections, non-alcoholic fatty acid disease (NAFLD), polycystic ovarian syndrome (PCOS), some types of cancer as well as chronic inflammation – to name a few.

Quality of life is also affected. An overweight person may experience shortness of breath, constant fatigue, depression, poor self-esteem, disability, social isolation, shame and discrimination.

What are the causes of overweight?

There is no single cause for being overweight. As more research is conducted, researchers are discovering that there may be many factors and mechanisms involved.

Some of the simpler explanations include:

1. Poor nutrition: consuming too much highly processed food, sugar and/or alcohol;
2. Lack of exercise;
3. Poor sleep;
4. Stress;
5. Environmental and social challenges;
6. Genetic or medical conditions; and
7. Food addictions and other eating disorders.

Researchers are now considering the possibility of additional factors involved in increased weight, such as:

1. The type of excess fat: It seems that certain fat, especially fat that accumulates around the liver, is detrimental to health. The presence of this fat is a strong predictor of both cardiovascular disease and type 2 diabetes.
2. The role of hormones and receptors: A number of highly regulated and controlled physiological processes depend on hormones and their receptors. Imbalances can alter things like energy balance, hunger (and therefore food intake), fat storage, and glucose regulation.
3. The gut microbiome: We host a large number of bacteria, viruses, and fungi in our gastrointestinal systems; these microorganisms play an essential role in our health. Imbalances can lead to (or increase) obesity.
4. Fetal origins: Whilst obesity can develop at any age, aspects of the in-utero environment may increase our susceptibility to gaining weight. Poor nutrition and/or exposure to obesogens in the womb could lead to obesity in childhood or even later in life.
5. Obesogens are chemicals that may disrupt the way our bodies use and store fat. They are found in our environment, our homes, our food and its packaging, cleaning materials, pollution… the list goes on and on. They contribute to both obesity and a higher incidence of metabolic disease.

As you can see, there’s often a lot more to losing weight than eating right and following a healthy lifestyle. If you want to reach a healthy weight and address chronic health issues, you need a personalized, holistic assessment for long-term success.