Why Obesity Is A Medical Problem And Not A Cosmetic Concern Alone?

by Dr Sameer Mohammad

A significant component of weight control is to avoid sleep deprivation because lack of sleep disturbs our body and upsets the balance between appetite and satiety.

Obesity is one of the most important healthcare concerns of the twenty-first century.  It is one of today’s most blatantly visible yet neglected public health problems. Obesity is not merely a cosmetic concern but a medical problem of gigantic proportions. Being overweight costs you, both literally and figuratively. Often, the damage to health and well-being can be irreversible.

People with obesity have an increased prevalence of diseases like cardiovascular diseases, Type 2 diabetes mellitus, certain types of cancers, and a significant degree of endothelial dysfunction. Obesity considerably reduces the quality of life and is one of the leading causes of death, worldwide. Obese subjects have a relatively weak immune system and therefore, are vulnerable to infectious diseases as well.

Indeed, Obesity has emerged as a strong risk factor for worse outcomes in the current pandemic disease, Covid19. Several independent studies have observed that people with obesity are at a greater risk of severe disease and death due to Covid19. During the 2009 HIN1 pandemic, patients with severe obesity were more likely to require hospitalization, ICU admission, and death due to the disease. Data over the years have indicated that obesity negatively affects host immune defence making it vulnerable to infectious diseases. Excess fat is associated with significant changes in the resident immune cell composition of adipose tissue, which leads to a state of chronic low-grade inflammation. Thus, obese subjects provide a unique microenvironment for disease pathogenesis, resulting in severe infection, increased rates of hospitalization and relatively poor survival.

What turns the balance towards weight gain?

To comprehend how the obesity epidemic got out of hand, we first need to understand the regulation of body weight and energy balance. Energy balance is determined by the number of calories ingested and the amount of energy consumed in metabolic and physical activity. Weight gain is largely a result of positive energy balance, a consequence of increased calorie intake and reduced energy expenditure.

Before the advent of the modern era, humans had to work hard for food by hunting and farming. This labouring process consumed a substantial amount of energy and so did the making and maintaining of short-term shelters. Food was inconsistently available and calorie-rich diets, refined carbohydrates, and processed foods were non-existent.  The main diet is comprised of natural nourishments both vegetarian and non-vegetarian. There was always a scarcity of food and over a long period of time, the human body adapted and evolved to survive on very little food. The biggest challenges of humankind were those of malnutrition and undernutrition, and obesity was essentially non-existent.

To overcome this shortage and scarcity of energy, human bodies transformed into extremely proficient and adept machines that could utilize energy very efficiently allowing us to live on a lesser number of calories. Accordingly, our present-day sedentary way of life represents an alien and unnatural practice from the standpoint of our inherited physiologic requirements. Therefore, in this modern world, every single human being is at an increased risk of gaining weight and becoming obese. However, the genetic makeup of every human being is unique and therefore, the degree of predisposition varies considerably from person to person.

 Possible way out

Two critical components define whether we gain weight or not: genetic makeup and our lifestyle. To put it in simple words external factors combine with a biological predisposition to determine our body weight. Genetic makeup plays a massive role and puts people at an increased risk but external factors like diet and physical activity finally decide if we get obese or not.

Since we have no control over our genetic makeup; lifestyle remains the lone factor that can be modified in order to bring about a positive change. Several independent scientific studies have demonstrated that a healthy lifestyle that includes diet control and exercise can reverse weight gain and ameliorate metabolic abnormalities that are associated with excess adiposity.

So, how does one define a “healthy lifestyle”? There is no single definition of a “healthy lifestyle”, if you ask 10 people, you will most likely get 10 different answers. In simple terms, a healthy lifestyle means eating a balanced diet, getting regular exercise, and indulging in activities that can reduce stress like getting enough rest and sleep. Adopting a healthy lifestyle can be tough, particularly if you plan to do it alone. People who are used to longstanding unhealthy practices, find it extremely challenging to start a healthy lifestyle.

One of the best ways to adopt a healthy lifestyle is, to begin with, easy and achievable goals and gradually add new ones. It is easier to sustain your healthy lifestyle if you make it entertaining and enjoyable. In addition, sharing your lifestyle goals with a friend, a parent, or a sibling can make all the difference in keeping up healthy habits. Another significant component of weight control is to avoid sleep deprivation because lack of sleep disturbs our body and upsets the balance between appetite and satiety. Multiple lines of evidence have indicated that “night shift works” are at an increased risk of developing abdominal obesity and metabolic syndrome independent of age and gender. In short, five basic pillars of a healthy lifestyle include 1) Eating a balanced diet 2) Being physically active and doing regular exercise 3) Reducing sitting and screen time 4) Sleeping well and on time and, 5) doing away with smoking and alcohol.

Dr Sameer is a Research Scientist in the King Abdullah International Medical Research Centre, Riyadh. He graduated from the School of Life Sciences, JNU and received postdoctoral training at Cornell University, New York.  Currently, he is working to evaluate molecular mechanism(s) underlying obesity-induced metabolic dysregulation and cardiac dysfunction.