Fighting Obesity

February 4, 2004

By Greg Sanders, MD


Last month, Dr. Fred Davis discussed obesity in this column. I would like to continue this discussion, because of the significance of this issue on your health. Today, obesity is probably the most important issue confronting family physicians and their patients.

We are an overweight society and we are getting fatter. Obesity is defined as weighing 120% or more than your ideal body weight. The majority of adults are overweight, and 30% are obese. Your weight, in general, is a result of your genes, and your behavior. Your genes could be programmed so you gain weight easier than someone else. Your behavior, in relation to your weight, determines how much you eat, and how much you burn off via your activity level.

Most overweight adults were not overweight children. What happened? It may have been a result of their metabolism slowing down, so even if they ate the same amount and exercised the same amount, they would gain weight. However, many adults eat more and are less active, so that is the usual cause of weight gain.

Why should we care about obesity? The answer is that obese people get more diseases and they don’t live as long as non-obese people. The common diseases among obese people are adult-onset diabetes, high blood pressure, and high cholesterol. Scientists are discovering that there is a connection between these three diseases, in that if you have one or two of these diseases, there is a significant chance that you will get the others. These are killers, causing heart attacks, strokes, and lots of other problems, most can be prevented by not getting fat.

There is no successful medication for treating obesity. Some medications help individuals loose weight, but unless they are permanently prescribed, along with healthy eating and good physical activity, they don’t work in the long run. Most health care providers do not believe it is good medical practice to permanently prescribe medication for weight loss.

How should obesity be treated? Since it is typically a preventable situation, start with prevention. Basically, eat healthy foods without overeating, and become more active. It really is that simple for most of us. Remember physics? You want what goes in to equal what goes out. What you eat must be what you burn off. This way you don’t gain weight.

Now that you know the answer, what is there left to talk about? You are probably still reading this because you already knew the answer, and that isn’t enough. The problem is that you struggle to change your behavior, and you need help with this. Well, I can give you some tips, but you still have to "just do it", to borrow a popular saying. You must do it regularly, for the rest of your life, like brushing your teeth.

Lets talk about physical activity. Find physical activities that you like to do, so you will have some motivation and reinforcement. Make it fun -- don’t get bored. Some people like to walk, which is fine. In the winter, you may want to use an electric treadmill, while rewarding yourself by watching a movie or television. Try not to have a lot of barriers to the activity. It can be a hassle to get in the car to go to the club, which costs money. Consider varying your activity, so you don’t get bored. Go bicycling with the kids, roller-skating, swimming, etc. You just need to be physically active for 30 minutes at least 4 days of the week, for the rest of your life.

Please be careful about “diets”. Unfortunately statistics show that over 90% of diets don’t work. This is because you may initially loose weight, then you let up on the diet, often because you were too strict and got tired of the diet. Then typically you regain the lost weight plus some. Shift to sustainable healthy eating. It took years to gain all that weight, so take some time to loose it in a sustainable fashion.

Lets talk about healthy eating, which sounds better than dieting. You want to have healthy eating habits for the rest of your life. Most of us have some bad eating habits. Usually, you just need to cut back on the food volume, and make healthier food choices. Healthy eating habits include eating breakfast, eating your biggest meal at lunch, eating more vegetables and grains, drinking fewer sugary beverages, drinking more water, eating slower so your body has time to know when it is full. Also, eat out less; eat fewer sweets and fewer fatty and fried foods. Try a regular burger without cheese, and hold the fries. You should develop the discipline to eat healthy, which will give you the freedom to occasionally splurge.

Remember, the keys to preventing and to treating obesity are eating healthy foods without overeating, and becoming more physically active. With a lifetime commitment, this approach almost always works. Good luck!