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What Is Obesity?

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A general article concerning obesity ought to begin with a general definition of the concept in question.  For many lay people, the concept seems so common place as not to need any further discussion, but knowing exactly what we mean by obesity is important.  This is because our idea of obesity necessarily affects how we diagnose and address it.

A very common idea of obesity is that it simply means somebody who is very overweight.  Past a certain point, an overweight person is called obese.  There is some medical truth to this idea, but for purposes of this discussion, we will be using a slightly different definition.

According to the Medline Website (a creation of the United States National Library of Medicine), to be obese is to have too much fat in your body. This is not exactly the same as being overweight, as it is possible for a person to weigh too much because they have a lot of muscle mass, rather than fat. A bodybuilder, for instance, would be classed as overweight, even though he might weigh more than a slightly obese person of similar height and build.  This is how we might understand the distinction between the two terms.

Diagnosing Obesity

obesity Chart Of the diagnostic tools used to spot obesity, the Body Mass Index or BMI is one of the most popular.  It is used not only to determine whether or not a person is obese, but also the gravity of their obesity—or at the other extreme, degree of being underweight.  The BMI is derived using a person’s weight and height, and adjustments made according to the age of the patient.

For an example of the use of BMI, consider the following: a BMI of 30 is considered the threshold for people considering weight loss drugs.  Should the patient happen to have hypertension or other ailments associated with obesity, the threshold is lowered to 27.  A person with a lower BMI than that is more likely to be told to adhere to methods of diet and exercise, rather than being prescribed weight loss medication.

Then again, despite its popularity, BMI is not an infallible indicator.  For instance, it can be argued that the calculation does not make a distinction between weight due to muscle and weight due to fat.  Therefore, the use of BMI alone might cause heavily-muscled people (like professional athletes) to be categorized as obese, even though they are not.  Furthermore, the BMI calculation may have to be adjusted for people with different ethnicities or inherited body types.  It has been recognized that prevalent body types in Asia tend to differ from those in predominantly Caucasian populations, so one-size-fits-all calculation methods might give out inaccurate results depending on where they are used.

Making a Fuss

In the last few years, Western popular media has focused a great deal on cultural perceptions of obesity.  It is a curious fact that while "real"people in the West and Westernized countries generally are becoming fatter, the "ideal" body keeps shrinking.  For example, try comparing the very skinny, very young physique of model-of-the-moment Karli Kloss with those of the glamazons of yesteryear, such as Cindy Crawford.  Speaking of young models, obesity is also often associated with old age.  A slim figure can help a person appear younger.  Then again, one might go to extremes with this idea, slimming down to the point that they look old and withered, instead of young and active.

To some, being either slim or overweight seems merely a matter of vanity.  If your appearing thin does not matter much to you, why bother to lose weight?  Well, it cannot be denied that obesity poses far graver problems in addition to feeling unattractive, or being considered so by others.

As far as health risks go, fat in the abdomen region is a matter of especially serious concern.  A fatty abdomen can speed up or intensify ailments of the vital organs—though the nature of this mechanism is still being hotly debated within the global medical community.  Sadly, the abdomen is also one of the toughest areas in which to effect a change in body fat content--as opposed to, say, the face, where fat can be lost and gained relatively quickly.  A general rule of thumb for assessing abdominal fat is that a man with a waistline of at least 40 inches and a woman with a waistline of 37 inches or more would be facing significant health hazards.

The cardiovascular organs are also very sensitive to high fat content in the body.  For instance, the accumulation of fatty tissues or deposits along the insides of blood vessels can bring about atherosclerosis.  Here, blood cells will have to squeeze through much narrower pathways, which means that more strain is placed on the heart.  If blood vessels become too rigid or blocked, one of the more extreme consequences is gangrene, especially in the legs and feet.  The frequent remedy for gangrene is amputation.

Some types of cancer also seem to be connected to obesity.  Once more, we must say that the reason for this connection has not quite been explained.  Still, one possible explanation is that cancer cells can propagate faster if they have a lot of fat and sugar to feed on.  Another is that bodily hormones can somehow react with fatty cells, thus bringing about the onset of cancer.  People with a high incidence of cancer in their family tree had better pay particular attention to their weight.

Not a Small World After All

Obesity varies in prevalence throughout the world’s different ethnic and/or geographic populations.  Factors affecting obesity levels in this regard include the levels of material wealth, food culture, work atmosphere, etc. prevalent in a particular population.  According to many sources, the current "fattest nation" in the world is the United States of America.  Most other countries with a large rate of obesity tend to be European.  Mexico is an interesting exception, being a so-called Third World nation, but ranking right after (or, in other ranking lists, soon after) the United States.

Some research and analysis has also gone into investigating why some ethnic groups seem to have a larger tendency towards obesity.  This should not be interpreted as racial prejudice or bigotry on the part of the scientists.  Actually, it just means that, in settings where people of various ethnic backgrounds have similar lifestyles (as in multi-racial societies wherein racial equality is relatively high and segregation is low), individuals from certain ethnic groups have a higher likelihood of developing obesity.  As of now, some researchers say that people of African, Southeast Asian, or Pacific Islander extraction have stronger tendency to become obese.  This is probably because such populations, over many thousands of years, developed a "thrifty gene" since food was (and often still is) hard to come by in such parts of the world.  The gene caused its possessors to store up a lot of fat, despite eating relatively little.  However, once a person with the gene finds himself/herself in circumstances where it is easy to get a lot of food, obesity can be the result.  It should also be noted that not everybody from the abovementioned populations has the gene.

Interestingly, people from the Middle East tend to be on the opposite genetic extreme.  This may be because agriculture developed in the Middle East relatively early. (Mesopotamia, located mostly in present-day Iran, is called the Cradle of Civilization partly due to this historical fact.)

The idea that there is a connection between ethnicity and obesity should not be taken as a disparagement to any particular race or culture.  Rather, it is simply a reflection of the fact that populations in different parts of the world have diverged genetically. Different environments have favored the prevalence of different heritable characteristics.  It just so happens that many people with the thrifty gene now live in places or situations where food is much more easily procured, and therefore, the gene no longer has its former effect.  Instead of storing enough fat to last through hard times, people who have the activated gene end up storing too much fat and suffering the resultant ailments.  Again, this does not mean that certain groups have “better” genes than others.  It simply means that different genes are suited to different settings.

Nutrition and Weight

The fundamentals of nutrition have been getting so much media and academic focus that, in a way, they have become common knowledge.  Actually, we might say that there is an overload of information on this subject, some of it rather questionable.  This section of the article aims to clear up some of the confusion by stating the real basics of lean nutrition.

Much of the time, consumption of excess refined carbohydrates plays a major part in determining obesity.  Foods like white rice, white bread, and white pasta facilitate the onset of obesity, and can lead to diabetes, to boot--especially among populations that have these as their staple foods.  It is also important to pay attention to the manner in which food is cooked.  After all, even if the ingredients you use are very healthy and nutritious, you can still ruin your health if you constantly smother them in fat, processed sugar, etc.

Of course, you will find no shortage of fad diets claiming to be the answer to your weight loss prayers.  The Atkins and South Beach diets still have many adherents, even though one might argue that their popularity is somewhat past its peak.  However, these diets also have serious drawbacks.  The ruthless reduction of carbohydrates people face under the Atkins program can cause fatigue, especially if the dieter leads a lifestyle in which he/she must do a lot of physical work.

Various "fad diets" such as the Atkins or South Beach diet have tried to ride the diet wave.  However, these diets, particularly the Atkins diet with its merciless cutting of carbohydrates, often bring on major side effects, such as fatigue.  The South Beach diet, for its part, can be quite expensive, particularly in the latter stages.

For many people, the ideal approach is one of gradualism and moderation.  Rather than adopting drastic diets in order to lose weight quickly, it might be best to begin looking after your nutrition while you are still young. You might not be noticing any problems with fat and nutrition at this stage, but it is best to accustom your body to good nutrition early, and also to avoid the “delayed action” effects of a (nutritionally) misspent youth.

Then again, simply dieting is not a healthy way to lose weight in the long term.  Dieting without exercise is likely to make you lose muscle mass as well as fat, and any weight you regain is likely to be in the form of fat.  In other words, you could eventually end up with a body that has a higher fat content than the one you started with before your weight loss program.  Exercise is essential to maintaining appropriate muscle mass as you lose weight.

Physical Exercise

Physical exercise is an integral aspect of an effective weight-loss regimen.  Unfortunately, contemporary life--particularly during economic downturns--is by nature rather hectic, so many people who would like to exercise simply find a conventional exercise program unfeasible.  This is a major for people with families, for instance.  However, as we have already stated, trying to lose weight through diet alone can actually ultimately worsen one’s situation.

It is an unfortunate reality that certain dishonest salespeople try to take advantage of the widespread (and sometimes rather desperate) desire to avoid obesity.  These salespeople try to advertise ineffective or downright dangerous products that supposedly help you lose weight quickly.  This disturbing trend has given rise to many entertaining tall tales.  One of them concerns a woman who orders a mysterious weight loss pill.  She downs the single tablet she receives in the mail, and is pleasantly surprised to find that she is quickly losing weight.  Unfortunately, she starts to lose too much weight and becomes anxious.  Eventually, a tapeworm falls out of her nose while she sleeps.  In other words, the pill contained a tapeworm egg, and the worm “helped” her lose weight by feeding off her digestive system.

Severely obese people might be demoralized or daunted at the prospect of starting up an exercise regime. After all, they appear to have a much longer way to go than most people.  However, the "silver lining" to this situation is that, given the same intensity and duration of exercise, a very obese person will experience greater weight loss than a slimmer person.  A very obese person has to work harder to do the same exercises, which means that he/she actually burns more calories.

Still, there are also alternatives to conventional exercise regimens (i.e. the sort involving trips to an expensive gym), which may be too costly or too strenuous for certain patients.  One option is to incorporate physical exercise into everyday activities.  Simple adjustments such as fetching things for yourself or arranging your home to be slightly less physically convenient can be rather significant.  Take the stairs instead of the elevator.  In spare hours, take walks instead of playing computer games.  In short, a very small increase in your daily level of physical activity can do wonders, if you practice these tiny adjustments over a long period of time.  As with a healthy diet, exercise habits work best if you begin to use them early.

Prescription Drugs for Weight Loss

This section of the article concentrates on Xenical and Meridia, two widely-prescribed weight loss drugs.  We will cover both their intended affects and their side effects.

Xenical is interesting in that it is both a prescription drug and an over-the-counter product.  Weaker versions of the prescription medication can be purchased without doctors’ orders in certain parts of the world.  Still, even if you plan to buy the over-the-counter pill, you should make sure that you will not suffer adverse effects from Orlistat, which is the drug’s active ingredient.  Your doctor should be notified if you have issues with diabetes, your pancreas, or your thyroid glands.  Basically, Xenical works by blocking the absorption of fat from the food you consume.  You can eat more while not gaining much weight.  However, over-use can damage the digestive system.

Meridia, on the other hand, targets the brain instead of the digestive system.  Namely, its target is what we call the "satiety center" of the brain, the part that tells you when you are full.  As such, Meridia is an appetite suppressant.  You are supposed to find that you simply do not want to eat as much as you usually did.  This suppressant effect is combined with the function of increasing your metabolic rate, helping you "burn" fat faster.  If you have cardiovascular ailments or mental disorders, it is recommended that you not take this medication.  Also, make sure to tell your doctor about any medicines or supplements you took over the past two weeks, as Meridia can combine with the remnants of many other drugs to produce adverse effects.

We can wrap up this section with some general warnings, which apply not only to Xenical and Orlistat, but to the class of weight loss medicines as a whole.  These medicines are usually not prescribed unless obesity is quite serious, and the patient has already made game attempts at weight loss via the normal means of diet and exercise.  Furthermore, if you do get a prescription for them, make sure you do not share your medicines with others.  If there is a danger that a person with an eating disorder can access your medicines, you might consider locking them up.  Furthermore, you should be aware that prescription weight loss drugs are not meant to just make the pounds melt right off.  You are likely to lose only about 5% of your weight after a year’s use.  It might seem like very little, but this is often enough to significantly improve your health.  However, you should also be warned that the use of such medication is often long-term, or for the rest of a person’s life.

Notes on Herbal Supplements

Supplements play a huge role in the weight loss industry, particularly online.  These concentrated herbal substances can often be procured without a prescription.  Here is some information on the most popular ones.

Hoodia gordonii is a type of cactus found in the Kalahari Desert.  Historically, its appetite suppressant effects have been useful to Kalahari Bushmen for thousands of years.  It allows them to ignore hunger and keep up their energy on long hunting excursions.  Now, some people who want to lose weight also want to benefit from the effects of this cactus.  Researchers studying the cactus found that it contained a special molecule, which they named P57.  Like Meridia, it also targets the satiety center in a person’s brain.  Phytofarm, a drug manufacturing firm, developed a supplement.  Pfizer bought the rights, then dropped the product, as, later, did Unilever.  The fact that major development and marketing of this supplement did not push through should make potential users cautious about ordering hoodia gordonii supplements sold online.

Acai berry supplements are arguably much more high-profile compared to Hoodia Gordonii.  The grapelike berry has received a lot of media attention.  It supposedly contains very strong antioxidants.  The berry apparently can speed up metabolism, as well as preventing the onset of some cancers.  On the other hand, the product’s popularity has proven to be a double-edged sword, since many con men/women have decided to try to ride the Acai Berry gravy train.

Resveratrol is yet another supplement that has been getting some buzz recently.  Found in small amounts in red wine, it is claimed as the explanation to why the French, in general, do not suffer the negative health results that one might expect from their less-than-lean diet.  However, it can also be argued that red wine does not actually contain enough Resveratrol to make a big difference, so the explanation does not quite hold.

Either way, resveratrol is being touted as a supplement with multiple good effects.  Aside from helping people shed pounds, it is supposed to keep blood sugar levels to an acceptable level and strengthen one’s general immune system.  It is being strongly marketed to more mature potential buyers, since diabetes and weakened immunity are major concerns of old age.

Mature consumers might find human growth hormone (HGH) supplements even more interesting than Resveratrol.  HGH is a natural hormone produced by the body.  Though you might not think so, given the hormone’s name, it actually governs much more than growth.  Higher levels of HGH are connected to more youthful-looking hair and skin, more physical energy, better immunity, and even more positive effects.  As such, it is being sold as an anti-aging product, as well as a weight loss supplement.  This supplement might just be a great solution for people with multiple ailments.  Instead of taking several supplements that might interact badly with each other, they can take a single product.

If you prefer not to take pills or syrups, you might wish to make green tea part of your regular diet.  Green tea can slightly raise your body's metabolic rate, and can work as a weight loss aid, in addition to diet and exercise.  You might also try to look for green tea-based drinks (without too much added Starbucks-style cream and sugar) that include the ground-up leaves, which are an excellent source of fiber.

Weight Loss Operations

It is not news that some people end up turning to surgery in order to lose weight.  Two of the best-known are ones are common plastic/cosmetic surgery procedures: liposuction and lipectomy.  A liposuction is when fat is sucked out of the body via a cannula, a special tube.  The ideal candidate for liposuction has no diabetes, inelastic skin, or reduced immunity.  Sometimes, liposuction is only part of a package of surgical procedures performed at a single session in a plastic surgery clinic.  With a lipectomy, on the other hand, the fatty tissue is cut rather than sucked away.  A liposuction, in particular, is one of the less serious procedures available in many plastic surgery facilities.  However, it is still possible for complications or outright malpractice to occur, and patients do occasionally die on the table.

Other types of weight loss surgery are directed at the digestive tract.  As a whole, these procedures are called bariatric surgery.  This type of surgery is divided into two major categories: malabsorptive and restrictive.  The first reduces your body’s ability to absorb calories, and includes the gastric bypass.  The latter makes your stomach--or at least its active portion--smaller, which means that you feel full after eating less.  Gastric stapling is an example of restrictive surgery.

Of course, going under the knife should only be a final recourse, after you have tried different types of diet and exercise, and particularly if your weight causes health complications. 

Beware of Quackery

So high and widespread is the demand for weight loss aids that this market has attracted a large number of questionable or downright hazardous operators.  The desperation of some buyers and the sheer effrontery of some sellers have served as midwives to the birth of several urban legends about weight loss products.  One of these involves a woman who buys and swallows a weight loss pill that, unbeknownst to her, was made to contain a single tapeworm egg.  The tapeworm, which feeds off her digestive system, is indeed effective, but horrifies the woman when it slips out of her nostril one night while she sleeps.

Conclusively confirming or denying the abovementioned urban legend is next to impossible, but the realities of the weight loss market are more than disturbing enough.  In the following sections, we will investigate one of the most notorious weight-loss products, plus look through some general guidelines about how to avoid quackery.

The Bangkok Pill is a notorious example of what not to buy.  The Bangkok Pill is a tablet with two functions: firstly, lowering the cathecolamine and serotonin in one’s blood (thus suppressing appetite), and secondly, speeding up metabolism.  When these two functions combine, many consumers find that the pill really does help them lose weight quickly.  In other words, the problem with this pill is certainly not any lack of effectiveness.  Rather, health authorities believe that its dangerous side effects far outweigh its potential benefits.  Indeed, the pill has been banned in many countries, such as the Philippines, the United States, and even Thailand, its purported country of origin.

One of the active ingredients in Bangkok Pills is Lasix.  Unfortunately, besides helping in weight loss, this chemical also increases urination to the extent that a person might become dehydrated.  Other, scarier side effects include angina and other heart problems, stroke, vomiting, and death.  It is also alleged that at least some of these pills (there are multiple manufacturers, some more questionable than others) contain the street drug shabu.

You might also be surprised to find questionable weight loss methods in (supposedly) more legitimate establishments.  We speak here of methods such as body sculpting by special massage machines.  Some scientists say that these expensive procedures are not actually effective, even though they are offered by professional clinics.  Unlike Bangkok Pills, body sculpting is not hazardous to your health, but it might be a heinous waste of your cash.

In general, you are advised to stay away from products that advertise unbelievable results, or claim to work well without additional diet adjustments and exercise. Such claims are signs that the products are being presented to you by entities that either do not know about the workings of the body or are hoping to prey on consumer ignorance. Also, be careful about customer reviews or testimonies--you do not know how authentic these are.

Bibliography

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Mayo Clinic.  “Weight-loss drugs: Can a prescription help you lose weight?”  Health.  http://www.mayoclinic.com/health/weight-loss-drugs/wt00013 (accessed 26 May 2010).

MediResource, Inc.  Meridia (Sibutramine).”  Drug Factsheets.  <http://chealth.canoe.ca/drug_info_details.asp?brand_name_id=1445&rot=4> (accessed 26 May 2010).

NationMaster.com.  “Obesity (most recent) by country.”  Health Statistics.  http://www.nationmaster.com/graph/hea_obe-health-obesity (accessed 26 May 2010).

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Starling, Shane.  “Unilever drops hoodia.”  Nutraingredients.com.  http://www.nutraingredients.com/Industry/Unilever-drops-hoodia  (accessed 31 May 2010).

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