Obesity Weekly

A weekly update about some aspect of Obesity. Published Monday mornings

Welcome to Obesity Weekly

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Why a weekly blog about obesity?  Well this blog will discuss the various aspects of obesity, including social implications, novel research about the causes and potential treatments for obesity, helpful insights into lifestyle modification techniques and successful strategies used by others in their battle for a healthy lifestyle. The topic of obesity touches every individual in some way, whether it is a personal struggle, an empathetic reaction to a friend or loved one’s own battle with weight, or (God forbid) an annoyance with someone who is too big for the neighboring seat on the airplane.  It is clear that the first world is gaining weight compared with 20 or 40 or 100 years ago.  This phenomenon fuels a multibillion dollar industry from gadgets and pills to reality TV shows.  We will discuss the obesity-associated industry later, but perhaps the current media responsible for bringing the discussion of obesity to our livingrooms and water coolers is NBC’s The Biggest Loser.  In my opinion, it is one of the most inspiring reality television shows on the air since it demonstrates that lifestyle modifications result in dramatic decreases in weight and, more importantly, in increased fitness.  Although not much medical detail is shared about the biophysical changes that the contestants undergo, the show’s physician, Dr. Rob Huizenga, does collect quite a bit of data on each of the contestants.  In previous seasons contestants successfully controlled their blood pressure, asthma, and diabetes by decreasing weight and increasing fitness; some to the point of being able to eliminate certain medications altogether.

One of the oddities of the show is just how high the expectations become for weight loss week after week.  Hydration loss can give a dramatic weight loss for a short time, but is not sustainable week after week. And obviously, a 0 or 1 pound loss would be disappointing, considering all of the time spent exercising. But when contestants continue to lose 4-8 pounds per week, a half to one pound a day, there should be no reason for disappointment.  A weight loss at that rate is phenomenal.   This phenomenon clearly demonstrates our obsession with weight as an endpoint.  Perhaps more emphasis should be placed on the drastic medical improvements made by the contestants which are not just related to weight loss but also to increased fitness.

In the US, and in particular southern California, appearance is nothing short of an obsession.  Fat is considered unfit and ugly while skinny is seen as fit and pretty.  Unfortunately, skinny does not equal fit.  There is a a phenomenon called skinny-obese in which a person can be a normal weight but actually be obese on the inside.  All fat is not the same.  Fat under the skin, subcutaneous fat, is different than fat contained in the abdominal cavity.  While subcutaneous fat can be readily observed, visceral fat, which is the fat packed around the internal organs, the heart, liver, lungs and intestines, is impossible to observe from the outside. It is not completely understood why some people are more susceptible to visceral obesity although there are clearly genetic factors involved.

Visceral obesity is predictive of long-term adverse medical consequences.  The reason we should be concerned about weight should not be from a vanity perspective but from a health and wellness perspective.  Obese individuals have a greater risks of:

Medical Name Parameters affected Increased risk of: What you should know
Dyslipidemia Decreased HDL cholesterol

increased LDL cholesterol and triglycerides

Cardiovascular diseases including heart attack and angina Fasting lipid profile
Insulin Resistance/Diabetes Increased fasting blood glucose/insulin/glucagon impact on quality of life, dizziness, weakness, lethargy and eventually diabetes complications including blindness and amputation Fasting blood glucose and insulin
Acanthosis nigricans Dermatology disorder Increased awareness of appearance
Systolic blood pressure First number of the blood pressure reading Heart disease, heart failure, stroke, kidney failure Resting blood pressure
Focal segmental glomerulosclerosis (FSGS) Increased urinary protein, decreased plasma protein and decreased glomerular filtration rate Acute or chronic renal failure Urinalysis results and any signs of swelling around the hands or feet or around the face
Gallstones No available blood tests for gallstones per se but blood tests can assess infections or obstructions

Gallstones are diagnosed by imaging

Liver or kidney damage, pancreatitis and potentially much PAIN when passing a stone
Sleep Apnea Sleeping patterns Quality of life decreases – lethargy, heart disease, high blood pressure headaches and memory problems Your sleeping patterns.  Normally told to you by someone else.
Weight associated skeletal issues:

slipped capital femoral epiphysis

genu valga, tibia vara (Blount disease)

flat kneecap pressure/pain, flat foot

spondylolesthesis (low back pain)

scoliosis

osteoarthritis

Joint pain and musculoskeletal issues Quality of life and mobility decreases

Many of these associated conditions can be decreased or eliminated with proper weight loss and increased fitness.  As this weekly blog continues we will explore a variety of subjects based on obesity, everything from hard-core science to popular culture and strategies to improve fitness in yourself, your family and your friends.

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Written by ecable

March 9, 2009 at 12:45 pm

Posted in Health

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One Response

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  1. Hi Ed,

    nice work! I will remember to check it often.

    good luck.

    Max

    Max Dang

    March 15, 2009 at 3:42 pm


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