[Muffie's Mom]

OBESITY. IS IT AN EATING DISORDER?

Health risks associated with obesity

Hypertension. (High blood pressure, a contributor to stroke and heart disease).

Overweight young people (20-45) have a six times higher incidence of hypertension than do peers who are normal weight. Older obese folks seem to be at even greater risk.

Diabetes.

Even moderate obesity, especially when the extra fat is carried in the stomach and abdomen (instead of hips and thighs), increases the risk of non-insulin dependent diabetes mellitus (NIDDM) ten-fold.

Cardiovascular disease.

Both the degree of obesity and the location of fat deposits contribute to the potential for heart and blood vessel disease.

The fatter the person, the higher the risk.

People who carry extra weight in the trunk area (stomach and abdomen) are at higher risk than folks who store fat in hips and thighs.

Cancer.

Obese men are at elevated risk of developing cancer of the colon, rectum, and prostate.

Obese women are at elevated risk of developing cancer of the breast, cervix, uterus, and ovaries.

Endocrine problems.

Irregular menstrual cycles; other menstrual problems; and pregnancy complications, especially toxemia and hypertension.

Hormone imbalances of various kinds may contribute to, or be the result of, obesity.

Gall bladder disease.

Obese women 20-30 years old are at six times greater risk of gall bladder disease than their normal-weight peers.

By age 60 almost one-third of obese women will have developed gall bladder disease.

Lung and breathing problems.

Obesity can impede the muscles that inflate and ventilate the lungs.

Obese individuals may have to work hard to get enough air and over time may not be able to take in the oxygen needed by all body cells.

Arthritis.

Obese individuals are at increased risk of developing gouty arthritis, a distressingly painful disorder.

In addition, excess weight stresses vulnerable joints, in particular the back and knee, which may develop osteoarthritis, a mechanical rather than metabolic problem.

A recent (2005) survey published by the American Orthopaedic Foot and Ankle Society found that even if people escape arthritis, increased rates of foot and ankle pain are found in individuals who are overweight and obese.

Premature death.

Research indicates that obese people die sooner than their normal weight peers.


Other problems associated with obesity

Sleep disturbances.

Especially sleep apnea (breathing stops for several seconds; then the person rouses, gasps, and struggles to catch breath.

Episodes may continue through the night.)

Sleep apnea can lead to high blood pressure, other cardiovascular disease, memory loss, weight gain, impotency, and headaches.

It can also contribute to impaired job performance and automobile accidents.

Fewer opportunities to play.

Inability to fully participate in recreational activities

Fewer opportunities to play sports. Inability to compete effectively in sports and athletics; being picked last, or not at all, for team sports

Career limitations. Inability to perform some jobs; reduced job opportunities

Bias. Prejudice and discrimination in school and the workplace

Social limitations. Restricted social opportunities

Relationship problems. Restricted opportunities for romantic relationships.

Low self-esteem and body-image problems.

Some related to prejudice and discrimination encountered in school, at work, and in social settings.

Others stemming from one's perception of how far one is from the culturally accepted ideal body type.


One important piece of good news

Obese people do not seem to have any more psychological problems, or more serious psychological problems, than folks of normal weight.

Many of the problems they do have are a consequence of anti-fat prejudice and discrimination.

Some studies have suggested that many obese individuals are less anxious and depressed than normal-weight peers.


What can be done about obesity?

The simplistic answer: eat less and exercise more.

A more helpful answer:

Work with a physician to identify and correct any underlying medical, biological, or metabolic problems contributing to excess weight.

Check with a counselor to see if you are using food for a purpose that food cannot fulfill: love, comfort, escape, an antidote to boredom, and so forth.

If you are self-medicating with food, work with the therapist to come up with better ways of managing stress, painful emotions, and problems.

Don't ever diet or restrict calories when you are legitimately hungry.

If you do, you will set yourself up to binge later.

Eat normal, reasonable, moderate amounts of a wide range of healthy foods.

Portion control and exercise are probably the two most important factors in a successful weight management program.

Emphasize fruits, vegetables, and whole grains.

Don't cut out sweets and fats completely.

If you do, you will crave and sneak them.

Besides, your body needs the nutrients found in fats and carbohydrates.

Just don't overdo it.

Eat a nutritious breakfast every morning.

Ninety-six percent of everyone who loses weight and keeps it off eats breakfast every day, according to Ann Yelmokas McDermot, a nutrition scientist at Tufts University (USDA Nutrition Research Center).

If you skip breakfast, later in the day when your blood sugar drops and fatigue and cravings build, you will be vulnerable to binge eating or overeating.

Get enough sleep every night.

Scientists have found that sleep deprivation increases levels of a hunger hormone and decreases levels of another hormone that makes you feel full.

The combined effect may lead to overeating and weight gain. (Two studies are summarized in USA Today, December 7, 2004, page 1-D)

Very important:

Exercise consistently.

Get regular amounts of moderate, self-loving exercise.

Start with a few minutes of walking and slowly extend the time until you can do 30-60 minutes a day, 3-5 days a week.

If you haven't exercised in a while, be sure to check with your doctor first.

Find a support system.

Friends are great; so are support groups.

Be gentle and realistic with yourself.

If everyone in your family is round and sturdy, chances are you will never be a super model -- but you can be happy and healthy.

Also remember that healthy, realistic weight loss takes time.

Losing one-half to one pound a week isn't very glamorous, but if you go any faster, you will make yourself hungry, and hunger will inevitably make you overeat.

What about diet pills, other weight-loss products, and weight loss programs?

Surgery?

Over-the-counter products.

There are many items in drugstores and health food stores that claim to help people lose weight.

None seem to be both safe and effective.

The ones that are effective are only minimally so, and they have significant side effects and health risks.

The ones that are safe don't seem to be very effective in helping folks lose weight and keep it off.

Think about it: if there really were a safe and effective weight loss product available over the counter, everyone in the Western world would be slim.

Our best advice: save your money.

Prescription medications.

Surgery.

For some obese people, gastric bypass (and stomach stapling and related techniques) may be a lifesaving measure.

The procedure is major surgery and is associated with risk of significant side effects and complications.

For this reason it should be considered a treatment of last resort.

Also, to be successful, the patient must cooperate with an entirely new way of eating and managing food.

If nothing else has worked for you, and if your medical situation warrants such a drastic approach, talk to your physician to see if you might be a candidate for this procedure.

Above all else, nothing will beat switching to a healthy way of eating and exercising. If you haven't started doing this, get with the program and do it now!*!