Prevention and management of overweight and obesity

Introduction

The scourge of overweight and obesity has eaten deep into the society and they have been linked to major health problems plaguing the populace. Both overweight and obesity are referred to as having excess body fat. Overweight can also be defined as a body mass index (BMI) ranging from 25 to 30 while obesity occurs at a BMI value higher than 30.

According to the Barry (2006), the world is the grips of an affliction that threaten to overwhelm entire nation’s health and shorten the life span of future generations. The cause is the increasing prevalence of overweight and obesity. This insidious creeping pandemic of overweight and obesity is now engulfing the entire world. “It’s as big a threat as global warming and bird flu” said Zimmer, an Australian expert on diabetes. Other experts said that the cost of treating health problems related to being overweight or obese was immeasurable on global scale, but was estimated as a billion of dollars a year in countries like Australia, Britain and the United States.

Philip (2006), a food service dietitian of the Australian Obesity Management Centre declared in describing how overweight or obesity affect human population that “we are not dealing with a scientific or medical problem, we are dealing with an enormous economic problems that is already accepted, is going to overwhelm every medical system in the world” He also said that government had been forced to confront rising overweight and obesity rates because of the expense of treating related health issues. Among the most worrying problems are skyrocketing rates of overweight and obesity among women, which make them prone to chronic disease as they grow older and could cut down years of their lives (Philip, 2006).

Craig (2003) said that young women in this generation could be the first in history to die before their parent because of health problems related to unchecked case of overweight or obesity. According to the National Institutes of Health (2010), obesity is an increase problem, where 60% of American adults, 35% American children are considered overweight or obese. They when further to highlight that the major contributory factor is an increasing sedentary life style, in which many people work at computer and sit down to watch television, for relaxation is at least partially responsible. However people who are genetically predisposed toward overweight or obesity can often make lifestyle choice that prevent or control the problem.

Cases of overweight and obesity is difficult to treat and has a high relapse rate. Even though medication and diets can helps, the treatment of overweight and obesity cannot be a short term “fix” but has to be a life-long commitment to proper diet habit, increased physical activity, and regular exercises (Bray, 2012).

Conceptual framework

Overweight and obesity are unhealthy health conditions which if not properly managed can lead to serious medical problems. The most effective way for evaluating overweight and obesity is by calculating the individual body mass index (BMI). Several definitions of overweight and obesity are available but in the real sense, they all contained the same concept. Overweight and obesity, in their simplest term, is the accumulation of too much fat in the body.

Overweight and obesity as defined by the World Health Organization (WHO, 2004) are conditions of abnormal or excessive fat accumulation that present a risk to an individual health. CDC (2012) defines overweight or obesity in a general term as medical conditions in which excess body fat has accumulated to extent that it may here an adverse effect on health leading to reduced life expectancy or increasing health problems.

Deurenberg (2000) stated that for the past 20 years, overweight and obesity has become the most prevalent nutritional problem in the world. It is a key risk factor for many chronic and non communicable diseases. According to Shield (2005) in Canadian Community Health Survey (2004) showed that 59% of the adult population is either overweight or obese. This highlights a pressing public health problem that shows no signs of improving on the near future. Overweight and obesity rate has drastically increased among boys and girls. This increase is cause for concern. Overweight and obesity should no longer be viewed as cosmetic or body image issue; the cause of overweight or obesity is complex and multi-factorial. The rapid increase in the prevalence of overweight and obesity is as a result of environmental and cultural influences rather than genetic factor (Abaluha, 2007).

International Council of Nurses (2012) encourages nurses to create public awareness of multiple and changing determinants of health that leads to overweight or obesity. And also to help the public understand that overweight or obesity is predominantly a social environmental disease. The World Economic Forum (2013) said that overweight and obesity has grown to epic proportions, tackling this issue has proven to be extensively more complicated as there is not one direct answer to solving it. They also estimate that 47 trillion of output might be lost in the next 20 years due to non communicable disease and mental health problems, with obesity to blame for 44 percent of the diabetes burden and 23 percent of heart disease.

Connor (2013) illustrated that an overweight or obese individual is indeed badly nourished, only with an excess of nutrients. He further added that the world is now facing a double burden of overweight and obesity stating that children are already overweight or obese and on the track to become obese adolescents and adults and develop chronic diseases. According to the World Health Organization (WHO, 2010) the solution to this health problem is better educated parents and adult who can over see a child’s nutritional intake and ensure that they are getting the right amount of vitamin, mineral, carbohydrate and protein, without excess.

Signs and symptoms of overweight and obesity

According to the National Health, Lung and Blood Institute (2006), the signs symptoms of obesity are as follows.

• Clothes feeling tight and needing a large size.
• Having extra fat around the waist.
• Heavy sweating and a feeling of always being hot.
• Lack of energy and constantly feeling tired.
• Difficulty sleeping.
• Type 2 diabetes

Causes of overweight and obesity

According to Gayle (2009), overweight or obesity occurs when you eat more calories than your body uses up. If the foods you eat provide more calories than your body needs excess is covered to fat initially, fat cells increase in size. When they can no longer expand, they increase in number. If you lose weight, the size of fat cells decrease, but the number of cells does not. But there are other factors that also play a role in overweight and obesity. These include.

• Medication: Certain drugs such as steroids and some antidepressants may cause excessive weight gain.
• Psychological factor: Psychological factors also influence eating habit and overweight or obesity. Many people eat in response to negative emotions such as sadness or anger.
• Illness: Although not as common as many believe, there are some illnesses that can cause overweight or obesity. These include hormone problems such as hypothyroidism (poorly acting thyroid slows metabolism, depression and some viral disease of the brain that can lead to overeating.
• Environmental factors: Although genes are an important factor in many cases of overweight and obesity, a person environmental factor include life style behaviours such as what a person eat and how active he or she is.
• Genetics: Overweight and obesity tends to run in families. In a study of adults who were adopted as children, researcher found that participating adult weights were closer to their biological parent’s weight then their adoptive parents.
• The environment provided by the adoptive family apparently had less influence on the development of obesity that the person’s genetic makeup.

Most recent studies Indicates that if one parent is either overweight or obese, the likelihood of having an overweight or obese child is three times higher. If both parents are either overweight or obese, the likelihood is 10 times higher (John & Merch, 2012). They added that the Harvard School of Public Health stated that genes influence every aspect of human physiology, development and adaptation, Overweight or obesity is not an exception.

Diagnoses of overweight and obesity

According to Ricker (2013), overweight or obesity is an abnormally high proportion of body fat. The doctor can often determine if you are either overweight or obese by looking at your body and assessing the percentage of body fat. Methods of assessing body fat are discussed below. Measuring your weight in proportion to your height is the traditional way of determining whether you are overweight, obese or at an appropriate weight, doctor can often determine if you are overweight or obese by calculating your body mass index (BMI), which is derived by dividing your weight in kilogram by your height on meters squared. Doctor may also estimate whether you have too much body fat by measuring your weight to help ratio. There are others tested that can estimate your percentage of body fat.

Accuracy of these tests varies and some are so expensive that you are not likely to have them at the doctor’s office. When combined with your visual appearance and weight circumference or weight to help ratio your BMI can usually provide a valid estimate of whether you are overweight or obese.

Test to diagnose obesity includes;

Body mass index (BMI) – A BMI of 25 to 29.9 is considered overweight and 30 or higher is considered obese.

According to World Health Organization (2004), body mass index (BMI) classifications of individuals are as shown below.

(Source: WHO, 2004)

• Waist circumference: Simple measurement that estimates the amount of fat deposited in the skin and inside the abdominal cavity. Waist to help ratio greater than 1 in men or 0.85 in women is considered obese. Waist circumferences that exceed 102 centimetres (40 inches) men or exceed 88 centimetres (35 inches) in women are associated with an increased risk of heart disease.
• Skinfold caliper: Most fat is deposited beneath the skin. This test measures fat just beneath the skin, but cannot measure fat accumulated inside the abdomen.
• Water displacement test: Fat floats; the rest of the body sink. Determining how well you float provides an estimate ratio of fat to body mass.
• Electrical measurements: A couple of test calculates your percentage of body fat by measuring the difference between the electrical characteristics of fat and often tissues in your body.
• Blood test: To rules out other medical conditions that may cause excess body weight, such as a thyroid disorder.

Types of obesity

There are several standardized types of obesity that have been classified by the World Health Organization (WHO, 2004), the types of obesity are:

• Class I
• Class II
• Class III

But have been subdivided by other organization into categories such as “mild obesity”   and “super obesity” the types of obesity set by the World Health Organization (WHO, 2004) were classified based on the true body mass index (BMI).

• Class I is the first and lowest types of obesity. Individuals with a BMI between 30 and 34.99 would fall into this category.
• Class II include body mass index of 35 to 39.99.
• Class III are those with body mass index over 40, include the sub-categories of several, morbid and super obesity in order of measuring severity.

Complication of overweight and obesity

According to Stanford Hospital and Clinics (2013), overweight and obesity has far ranging negative effects on health. The health effects associated with overweight and obesity include;

• High blood pressure: additional fat tissue in the body needs oxygen and nutrients in order to live, which requires the blood vessels to circulate more blood to the fat tissue. This increases the workload of the heart because it must pump more blood through additional blood vessels. More circulating blood also means more pressure on the artery walls. Higher pressures on the artery walls increase the blood pressure. In addition, extra weight can raise the heart rate and reduce the body’s ability to transport blood through the vessels.
• Diabetes: Overweight and obesity are the major causes of type 2 diabetes. This type of diabetes usually begins with adulthood but is now actually occurring in children. Overweight and obesity can cause resistance to insulin; the hormone that regulates blood sugar becomes elevated. Even moderate obesity dramatically increases the risk of diabetes.
• Heart disease: Atherosclerosis (hardening of the arteries) is present 10 times more often in overweight or obese people compared to those who are not overweight or obese. Coronary artery disease is also more prevalent because fatty deposits build up in arteries that supply the heart. Narrowed arteries and reduced blood flow to the heart can cause chest (angina) or a heart attack. Blood clots can also form in narrowed arteries and cause a stroke.
• Joint problems, including osteoarthritis: Overweight or obesity can affect the knees and hips because of the stress placed on the joints by extra weight. Joint replacement surgery, while commonly performed on damaged joints, may not be an advisable option for an overweight or an obese person because the artificial joint has a higher risk of loosening and causing further damage.
• Sleep apnea and respiratory problems: Sleep apnea, which causes people to stop breathing for brief periods, interrupts sleep throughout the night and causes sleepiness during the day. It also causes heavy snoring. Respiratory problems associated with obesity, occur when added weight of the chest wall squeezes the lungs and causes restricted breathing.
• Cancer: In women, being overweight or obese contributes to an increased risk for a variety of cancers including breast, colon, gall bladder and uterus. Men who are obese have a higher risk of colon and prostate cancers.
• Metabolic syndrome: The National Cholesterol Education Program (2011) has identified metabolic syndrome as a complex risk factor for cardiovascular disease, metabolic syndrome consist of six major components: abdominal overweight or obesity, elevated blood cholesterol, elevated blood pressure, insulin resistance with or without glucose intolerance, elevation of certain blood components that indicate inflammation, and elevation of certain clotting factors in the blood.
• Gynaecological problems (abnormal menses, infertility).

Prevention and management overweight or obesity

According to Mayo Clinic (2013) the following ways are used in preventing and to manage overweight or obesity.

• Monitor your weight regularly: people who weigh themselves at least once a week are more successful in keeping of excess pounds. Monitoring your weight can tell you whether your efforts are working and can help you detect small weight gain before they become big problems.
• Know and avoid the food traps that cause you to eat: Identify situations that trigger you out of control eating. Try to keep a journal and write down what you eat, how much you eat, when you ear, how you are feeling and how hungry you are. And develop strategies for handling these types of situation and stay in control of your eating behaviour.
• Exercise regularly: According to the American College of Sports Medicine (2000), you need to get 150 to 250 minutes of moderate intensity activity a week to prevent weight gain. Moderately intense physical activities include fast walking and swimming.
• Eat healthy meals and snacks: Focus on low calories, nutrient-dense foods such as fruits, vegetables and whole grain. Avoid saturated fat and limit sweet and alcohol. Ensure that you choose food that promotes healthy weight gain and good health more often than you choose food that don’t.
• Consistent: Stick to your healthy weight plan during the week.

Dietary guidelines for obesity

According to US Department of Health and Human Services (2012) the dietary guidelines are as follows:

• Reduce energy intake
• Reduce portion size
• Select food with lower fat content and low glycemic index
• Increase vegetables and fruit intake
• Reduce high sugar foods and drinks
• Use the water as the main beverage
• Eat more of whole grain product such as fish, poultry and nut
• Reduce intake of red meat
• Avoid junk foods.

References

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Bray, G. (2012). Healthy lives, healthy people: a call to action on obesity in England. London: Department of Health

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