Obesity

Obesity is clinically defined as present when a person’s body weight exceeds by 20 percent or more of the standard weight listed in common height-weight tables.

Obesity is several times more common among lower socioeconomic status individuals than those of higher socioeconomic status. Age is a second major influence on obesity. Demographic studies indicate that as one’s age increases, the chance of obesity also increases up to age 50. After that, the obese people apparently begin dying of cardiovascular disease, so the relationship between age and obesity is difficult to determine. Women are also more likely to be obese than men.

How and when a person eats is almost as important as what. Obese people have difficulty recognizing somatic signals that tell them their hunger is satiated. They often confuse hunger with other negative emotional states, such as depression. Not surprisingly, studies have linked this sort of confusion to severe deficits in one’s self-identity and to feelings of personal ineffectiveness.

I recommend to my clients both drinking heavily of noncaloric beverages before and during meals and, most importantly, eating slowly. This is because gastric filling (more commonly known as a full stomach) has been shown to be the major determinant of satiety in single-meal experiments. Eating slowly also gives the hypothalamic satiety center more time to process incoming information on metabolites carried by the blood, such as fat, protein, and carbohydrates.

Interestingly, the average non-obese man consumes about a million calories a year. However, his amount of body fat remains the same because he expends an equal number of calories. A change of no more than ten percent in either intake or uptake leads to a 30-pound body weight change within a single year.

There are two different ways that the body increases adipose tissue (fat cells). The individual fat cell itself can increase in size, which is called hypertropic obesity. When they lose weight, they do not lose fat cells. Thus, those fat cells are lurking around the corner, just waiting (weighting?) for an incoming chocolate cream pie or a strawberry malted milk before they balloon forth again.

Most people who are chubby from childhood have hypertrophic-hyperplastic obesity, resulting from endocrinological or other medical causes. They may have five times as many fat cells as normal weight persons or those with only hypertrophic obesity. Prognosis for obese children controlling their weight later in life is poor. Usually, emotional difficulties accompany what is clinically termed juvenile onset obesity. Thus, prevention of obesity in childhood is very important.

I believe in two “treatments” for obesity. Most importantly, physical activity should be increased. There is no way around it, unless, you want to undergo a surgical procedure. Caloric expenditure is directly proportional to body weight, thus obese people expend more calories doing the same exercise than non-obese persons. Secondly, physical activity helps to curb one’s appetite, i.e. the more you exercise, the less your appetite, believe it or not.

I also believe in using social reinforcement or “emotional goodies as a support or reward for dieting activities. By that I mean I have had a good success when non-obese spouses have supported their obese loved ones’ efforts to lose weight by either carefully monitoring caloric intake or, better yet, actually joining them in dieting. For a relationship in which the couple is not communicating well with each other, this joint project has potent ancillary benefits.

TOPS (Take Off Pounds Sensibly), Weight Watchers, and Overeaters Anonymous are support groups I highly recommended for obese individuals. Weight Watchers is somewhat expensive, while TOPS and OA are nonprofit organizations.

I am against any form of pills or surgery for weight loss. It is much healthier to change your body by changing your lifestyle. Both pills and surgery have tremendous potential for creating other problems and may not even alleviate the weight difficulty in the long run.