Dr Hector Perera         London

Obesity is a term used to describe somebody who is very overweight, with a lot of body fat. It’s a common problem, estimated to affect around one in every four adults and around one in every five children aged 10 to 11 in the UK. Unlike the Western world diets that are associated with high fat, salt and sugar but Sri Lankan diets are generally healthy. Now in Sri Lanka there are imported food in plenty of supermarkets and some adults and even children are tempted to eat those kinds of food that contain salt, fats and sugar in excess. The consumption of them are accepted in reasonable levels to avoid any long term health problems but sometimes there is no control of consuming those kinds of food then food related health problems such as cardiovascular diseases and obesity are possible.

Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnoea, certain types of cancer, and osteoarthritis. Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity. More details are found in Ceylon Medical Journal.

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and or increased health problems. People are considered obese when their body mass index (BMI), a measurement obtained by dividing a person’s weight in kilograms by the square of the person’s height in metres, exceeds 30 kg/m².

You can use the calculator to work out your score.

For most adults:

If BMI 25 to 29.9 means you are considered overweight, a BMI of 30 to 39.9 means you are considered obese, a BMI of 40 or above means you are considered severely obese.

BMI is not used to definitively diagnose obesity – as people who are very muscular sometimes have a high BMI, without excess fat but for most people, it can be a useful indication of whether they may be overweight.

A better measure of excess fat is waist circumference, and can be used as an additional measure in people who are overweight (with a BMI of 25 to 29.9) or moderately obese (with a BMI of 30 to 34.9).

Generally, men with a waist circumference of 94cm or more and women with a waist circumference of 80cm or more are more likely to develop obesity-related health problems.

BMI was developed by Belgium Statistician Adolphe Quetelet approximately 150 years ago.

How to calculate BMI for adults

There are two methods for working out your BMI – metric and imperial systems.
Metric system – Divide the person’s weight in kilograms by their height in meters squared.

For example:

If the weight is 90 kilograms of a person whose height is 1.9 meters? Then using the given formula, apply as shown.

 BMI = kilograms/meters squared that means BMI = 90/1.9×1.9

That means BMI = 90/3.61

The calculated BMI = 24.93

Using the Imperial system – the person’s weight in pounds, multiplied by 703, divided by the square of their height in inches.
For example:

BMI = (weight in pounds x 703)/height in inches squared

 Example:

Jane weighs 150lbs and is 5 feet 4 inches tall. She wants to know if she is overweight.

Jane’s height in inches is (5 x 12) + 4 = 66 inches

1. Using the first part of the formula we multiply her weight by 703.Then it comes to 150 x 703 = 105450
2. Using the second part of the formula we multiply Jane’s height by itself.66 x 66 = 4356
3. Finally we divide the first figure by the second.105450 / 4356 = 24.21

Jane’s BMI is 24.21

 How to determine your body weight status

Below are definitions recommended by the World Health Organization.
BMI less than 18.5 – Underweight; BMI between 18.5 and 25 – Healthy weight; BMI between 25 and 30 – Overweight; BMI between 30 and 40 – Obese; BMI over 40 – Very obese, morbidly obese

Now you can calculate your BMI in Metric or in Imperial system and check if you are obese, healthy or underweight.

Risks of obesity

Taking steps to tackle obesity is important because, in addition to causing obvious physical changes, it can lead to a number of serious and potentially life-threatening conditions, such as: type 2 diabetes , coronary heart disease , some types of cancer, such as breast cancer and bowel cancer, stroke.

Obesity can also affect your quality of life and lead to psychological problems, such as low self-esteem or depression.

Causes of obesity

Obesity is generally caused by consuming more calories particularly those in fatty and sugary foods than you burn off through physical activity. The excess energy is then stored by the body as fat.

Obesity is an increasingly common problem, because many modern lifestyles often promote eating excessive amounts of cheap, high-calorie food and spending a lot of time sitting at desks working in a computer or in an office, sitting comfortably on sofas and watching nonstop TV programmes or driving most of the times. Some people eat lots of chocolates, crisps and drink fizzy drinks in between main meals without realising they are excess energy food.

There are also some underlying health conditions that can occasionally contribute to weight gain, such as an underactive thyroid gland (hypothyroidism), although conditions such as this don’t usually cause weight problems if they are effectively controlled with medication.

Leading a sedentary lifestyle

With the arrival of televisions, computers, video games, remote controls, washing machines, dish washers and other modern convenience devices, the majority of people are leading a much more sedentary lifestyle compared to their parents and grandparents. Some decades ago shopping consisted of walking down the road to the high street where one could find the grocers, bakers, banks, etc. As large out-of-town supermarkets and shopping malls started to appear, people moved from using their feet to driving their cars to get their provisions. In some countries, such as the USA, dependence on the car has become so strong that many people will drive even if their destination is only half-a-mile away.

Less obesity among Sri Lankans

Fortunately Sri Lankans are not that lazy to do most of the day to day work even when modern technology is gradually within their budgets. In the past servants for any average house was a common thing but those so called servants are leaving the country for foreign employment so they have become gold dust. Try and observe the general public at a busy railway or bus stations and you wouldn’t see too many so called obese people unlike in Western world.

The diets of Sri Lankans are different to Western people that is another main reason for less obesity. Most people eat fish, dry fish, fresh fruits and vegetables and not too much fatty meat such as pork and beef. Their breakfasts have very little oil, salt and sugar whereas Western style meals always have SOS, sugar, oil and salt in excess that leads to some complicated diseases.

The less you move around the fewer calories you burn. However, this is not only a question of calories. Physical activity has an effect on how your hormones work, and hormones have an effect on how your body deals with food. Several studies have shown that physical activity has a beneficial effect on your insulin levels – keeping them stable. Unstable insulin levels are closely associated with weight gain. 

 Treating obesity

The best way to treat obesity is to eat a healthy, reduced-calorie diet and to exercise regularly. To do this you should:

Eat a balanced, calorie-controlled diet as recommended by your GP or weight loss management health professional (such as a dietician).

Join a local weight loss group, take up activities such as fast walking, jogging, swimming or tennis for 150-300 minutes a week, eat slowly and avoid situations where you know you could be tempted to overeat

You may also benefit from psychological support from a trained healthcare professional, to help change the way you think about food and eating.

Treatments for obesity

Dieting and physical exercise are the mainstays of treatment for obesity. Diet quality can be improved by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by increasing the intake of dietary fibre. Anti-obesity drugs may be taken to reduce appetite or inhibit fat absorption together with a suitable diet. If diet, exercise and medication are not effective, a gastric balloon may assist with weight loss, or surgery may be performed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.

Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public health problems of the 21st century. Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world.

This is not the first time anyone is reading and hearing about Obesity but some people have a don’t care attitude. Whenever people got a chance to eat such as in birthday parties, weddings or other occasions to eat, they eat as much as possible and drink as much as possible. Some people over eat and drink on regular basis then they are likely to get obese. The best thing is watch out for whatever you eat and drink that means eat and drink within limits or in moderation to avoid any long term ill health.

There is no “quick fix” for obesity. Weight loss programmes take time and commitment, but they work best when people are able to complete the programmes fully and are offered advice about maintaining the weight loss achieved.

Regularly monitoring your weight, setting realistic goals and involving your friends and family with your attempts to lose weight can also help.

Remember that even losing what seems like a small amount of weight (such as 3% or more of your original body weight), and maintaining this for life, can significantly reduce your risk of obesity-related complications like diabetes and heart disease. Your comments are welcomed perera6@hotmail.co.uk