- Obesity has nearly tripled worldwide in the past 2 decades
- Fat around the middle may carry an increased risk of illness
- There are psychological, behavioural and medical treatments available from your doctor
Being far over your ideal weight can bring feelings of helplessness. Your decision to take action is a deeply personal one. When you are ready, help is at hand.
In the UK, more than 60% of adults are deemed overweight or obese. Over the past two decades, obesity has nearly tripled worldwide.
What do the words ‘overweight’ and ‘obesity’ mean?
The World Health Organization describes being overweight or obese as ‘abnormal or excessive fat accumulation that may impair health’. The term ‘obese’ generally means a much higher amount of body fat than ‘overweight’. We use body mass index (BMI) to distinguish between the two.
The World Health Organization (WHO) classifies the result for adults as:
- Underweight <18.5
- Healthy weight 18.5-24.9
- Overweight 25-29.9
- Obese >30
Be aware, though, that a BMI score might not always mean the equivalent degree of fatness. For example, heavier muscular athletes with minimal body fat might have a high BMI but not carry the same health risks as less muscular people with the equivalent BMI.
What’s the difference between being overweight and obesity?
Being overweight is a signal that you need to take action. A doctor will assess the risk presented by being overweight as more important if other risk factors are present. These include a larger waist size (see below), high blood pressure and family history of disease as well as lifestyle factors such as poor diet and smoking.
Obesity is associated with an increased risk of disease, which seems most evident when the BMI score is above 35. This is related not only to the amplified physical effects on our breathing and movement of carrying excess fats, but also to the metabolic effects on our body’s function and internal organs. All of these can potentially lead to illness. Some of these effects might also be present if you are overweight, but to a lesser degree - and your doctor will assess this.
What are some of the benefits of losing weight?
- Reduced risk of disease
Whether you’re classified as overweight or obese, losing just 5-10% of your weight could reduce your risk of developing the following:
Cardiovascular disease and heart attack
Type 2 diabetes
Joint and muscle problems
Sleep disorders, such as sleep apnoea.
Losing excess body weight increases your chances of being successful if you are trying for a baby. It also reduces your risks of miscarriage . It is important to note that being underweight also negatively affects fertility. The key is to be in a healthy weight range (see above).
- Reduced risk of disease
Not everyone’s confidence is impacted by being overweight - but if your weight affects you emotionally, your self-esteem might be low. Losing weight may increase your physical confidence and encourage more activity and socialising.
- Reduced risk of Covid-19 complications
Mounting evidence suggests that obesity can increase the risk of suffering potentially fatal complications if you contract Covid-19. Losing weight could lower this risk.
Does it matter where most of my body fat is located?
Excessive tummy fat is an indicator of fat around your internal organs. This is called ‘visceral fat’, and it secretes a protein that increases resistance to insulin – the hormone that your pancreas makes to process glucose – putting you more at risk of long-term health problems such as type 2 diabetes.
Fats around the middle of your tummy also produce inflammatory proteins that can trigger heart disease and cause blood pressure to rise. Fat on our arms and legs do not have this effect.
Sometimes doctors look at waist size in conjunction with BMI when they are assessing a patient’s risk of disease from being overweight or obese.
Waist circumferences larger than 88cm for women and 102cm for men are linked with a higher risk of serious medical conditions. In fact, a large amount of fat around the middle may put you at more risk of heart disease, breast cancer, colorectal cancer and Alzheimer’s disease.
What causes overweight and obesity?
It’s easy to assume that too many calories in and not enough burned off is the prime reason you’re overweight or obese. But many other – sometimes insidious – factors can contribute which make it more difficult to maintain a healthy weight. These are just some:
- Easy access to high-calorie foods
Energy-dense foods and drinks high in fats and sugars are everywhere we turn. Marketing for such foods is aggressive and targets consumers from an early age. Moreover, average portion sizes have increased over the past decade, so you might not even be aware of how much more you’re eating.
- Low protein content in unhealthy foods
Healthy protein leads to more satiety after eating, so we feel the need to eat less. Processed and junk foods often contain little of these healthy proteins, so your system doesn’t always register feeling full.
- Moving less
This has been exacerbated by coronavirus-related social restrictions worldwide, with more hours spent on laptops, phones and watching TV.
- Genetic factors
People’s metabolisms respond in different ways to diets and lifestyles because genes play a role in our shapes, sizes and weight fluctuations.
- Binge eating disorder
Binge eating disorder is the most common eating disorder, and is characterised both by eating an unusually large amount of food over a short duration of time, and feeling a sense of loss of control over one’s eating during this time. Studies have shown that people suffering from Binge Eating disorder are 3-6 times more likely to be obese than the general population. This disorder is often accompanied by feelings of sadness, anxiety or guilt. It can be effectively treated with a course of cognitive behavioural therapy (CBT) to help break this pattern. Talk to your Livi doctor for further advice regarding this...
Steroid medications, anticonvulsants, some diabetes medicines, antidepressants and antihistamines are all linked with weight gain. But before you make any changes to your medication, please talk to your doctor.
Certain illnesses can play a part in weight gain, such as polycystic ovary syndrome (PCOS), Cushing’s disease and an underactive thyroid.
What works for weight loss?
Slow weight loss is more likely to stay off, research has found. So, aim to lose no more than 1-2lb (0.5-1kg) a week.
Crash diets do not generally work. Initial weight loss is usually fluid and the weight is often regained when you start eating normally again.
These are some simple things you can do today to start your journey:
- Eat well Eat a balanced calorie-controlled diet that is high in nutrients. For more information and ideas on a balanced diet visit NHS Eat Well. Your GP may also be able to advise.
- Move more Make time for 2.5-5 hours’ weekly activity such as jogging, aerobics or dancing or low-impact exercise such as walking, swimming, yoga, cycling or Pilates.
- Get connected Slimming groups can be useful to help you get motivated and stay connected to others on the same journey.
What else can my doctor offer?
If your BMI measurement suggests you’re either overweight or obese, a good starting point is your Livi doctor. He/she is well equipped with psychological, behavioural and even medical solutions to help improve your quality of life, health and wellbeing.
It’s useful to keep a food and exercise diary in the 2 weeks leading up to your appointment, if you can.
Your Livi GP can:
- Listen to your weight concerns.
- Examine your food and exercise diary.
- Explain the benefits of losing weight and the risks of not doing anything.
- Do blood tests to check for medical causes, and check your blood sugar and cholesterol levels.
- Help you set achievable goals, plan for a start date and set review dates to track your progress.
- Discuss the options of speaking to a psychologist if it appears that a condition such as low mood, anxiety or binge eating is affecting your eating patterns (a course of talking therapy such as CBT can help change the way you think about food and eating).
- In some areas of the UK, and depending on your weight and other factors such as whether you have high blood pressure or diabetes, your doctor can also refer you to a weight loss and exercise programme. Check with your doctor if this is something that is available in your area.
- If needed — usually as a last resort — they may discuss medication and surgical options with you.
Whatever you do, don’t despair. There is help available to enhance your decision to embark on a healthier lifestyle and we are here to support you along the way.
Reviewed by Dr Rhianna McClymont, Lead GP, Livi