The silence of dramatically epidemic of obesity (overweight) in Gambia

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What is obesity (overweight)?

Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It’s a medical problem that increases the risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.

There are many reasons why some people have difficulty losing weight. Usually, obesity results from inherited, physiological and environmental factors, combined with diet, physical activity and exercise choices.

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The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. A healthier diet, increased physical activity and behavior changes can help you lose weight. Prescription medications and weight-loss procedures are additional options for treating obesity.

If you consume a high amount of energy, particularly fat and sugars, but do not burn off the energy through exercise and physical activity, much of the surplus energy will be stored by the body as fat.

Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It’s a medical problem that increases the risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.

There are many reasons why some people have difficulty losing weight. Usually, obesity results from inherited, physiological and environmental factors, combined with diet, physical activity and exercise choices. The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. A healthier diet, increased physical activity and behavior changes can help you lose weight. Prescription medications and weight-loss procedures are additional options for treating obesity.

Causes

Although there are genetic, behavioral, metabolic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through normal daily activities and exercise. Your body stores these excess calories as fat.

In the United States, most people’s diets are too high in calories — often from fast food and high-calorie beverages. People with obesity might eat more calories before feeling full, feel hungry sooner, or eat more due to stress or anxiety.

Many people who live in Western countries now have jobs that are much less physically demanding, so they don’t tend to burn as many calories at work. Even daily activities use fewer calories, courtesy of conveniences such as remote controls, escalators, online shopping and drive-through banks.

Risk factors

Obesity usually results from a combination of causes and contributing factors:

Family inheritance and influences

The genes you inherit from your parents may affect the amount of body fat you store, and where that fat is distributed. Genetics may also play a role in how efficiently your body converts food into energy, how your body regulates your appetite and how your body burns calories during exercise. Obesity tends to run in families. That’s not just because of the genes they share. Family members also tend to share similar eating and activity habits.

Lifestyle choices

Unhealthy diet. A diet that’s high in calories, lacking in fruits and vegetables, full of fast food, and laden with high-calorie beverages and oversized portions contributes to weight gain.

Liquid calories. People can drink many calories without feeling full, especially calories from alcohol. Other high-calorie beverages, such as sugared soft drinks, can contribute to significant weight gain.

Inactivity. If you have a sedentary lifestyle, you can easily take in more calories every day than you burn through exercise and routine daily activities. Looking at computer, tablet and phone screens is a sedentary activity. The number of hours spent in front of a screen is highly associated with weight gain.

Certain diseases and medications

In some people, obesity can be traced to a medical cause. Medical problems, such as arthritis, also can lead to decreased activity, which may result in weight gain.

Some medications can lead to weight gain if you don’t compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.

Social and economic issues

Social and economic factors are linked to obesity. Avoiding obesity is difficult if you don’t have safe areas to walk or exercise. Similarly, you may not have been taught healthy ways of cooking, or you may not have access to healthier foods. In addition, the people you spend time with may influence your weight — you’re more likely to develop obesity if you have friends or relatives with obesity.

Age

Obesity can occur at any age, even in young children. But as you age, hormonal changes and a less active lifestyle increase your risk of obesity. In addition, the amount of muscle in your body tends to decrease with age. Generally, lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs and can make it harder to keep off excess weight. If you don’t consciously control what you eat and become more physically active as you age, you’ll likely gain weight.

Other factors

Pregnancy. Weight gain is common during pregnancy. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women.

Quitting smoking. Quitting smoking is often associated with weight gain. And for some, it can lead to enough weight gain to qualify as obesity. Often, this happens as people use food to cope with smoking withdrawal. In the long run, however, quitting smoking is still a greater benefit to your health than continuing to smoke. Your doctor can help you prevent weight gain after quitting smoking.

Lack of sleep. Not getting enough sleep or getting too much sleep can cause changes in hormones that increase appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.

Stress. Many external factors that affect mood and well-being may contribute to obesity. People often seek more high-calorie food when experiencing stressful situations.

Microbiome. Your gut bacteria are affected by what you eat and may contribute to weight gain or difficulty losing weight.

Even if you have one or more of these risk factors, it doesn’t mean that you’re destined to develop obesity. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes.

Complications

People with obesity are more likely to develop a number of potentially serious health problems, including:

Heart disease and strokes. Obesity makes you more likely to have high blood pressure and abnormal cholesterol levels, which are risk factors for heart disease and strokes.

Type 2 diabetes. Obesity can affect the way the body uses insulin to control blood sugar levels. This raises the risk of insulin resistance and diabetes.

Certain cancers. Obesity may increase the risk of cancer of the uterus, cervix, endometrium, ovary, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate.

Digestive problems. Obesity increases the likelihood of developing heartburn, gallbladder disease and liver problems. Sleep apnea. People with obesity are more likely to have sleep apnea, a potentially serious disorder in which breathing repeatedly stops and starts during sleep.

Bonne diseases. Obesity increases the stress placed on weight-bearing joints, in addition to promoting inflammation within the body. These factors may lead to complications such as osteoarthritis.

Severe COVID-19 symptoms. Obesity increases the risk of developing severe symptoms if you become infected with the virus that causes coronavirus disease 2019 (COVID-19). People who have severe cases of COVID-19 may require treatment in intensive care units or even mechanical assistance to breath.

What is female obesity prevalence?

Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in meters). A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight. Overweight and obesity are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer.

Treatment

The goal of obesity treatment is to reach and stay at a healthy weight. This improves overall health and lowers the risk of developing complications related to obesity.

The initial treatment goal is usually a modest weight loss — 5% to 10% of your total weight. That means that if you weigh 200 pounds (91 kilograms), you’d need to lose only about 10 to 20 pounds (4.5 to 9 kilograms) for your health to begin to improve. However, the more weight you lose, the greater the benefits.

All weight-loss programs require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your obesity severity, your overall health and your willingness to participate in your weight-loss plan.

Outlook

There’s no quick fix for obesity. Weight loss programmers take time and commitment, and work best when fully completed.

The healthcare professionals involved with your care should provide encouragement and advice about how to maintain 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 developing obesity-related complications like diabetes and heart disease.

For further information, WHO and UN websites, BMJ on female obesity in The Gambia, send email to [email protected], send only text messages to Dr Azadeh WhatsApp on 002207774469 working days from 3 to 6PM.

Dr Hassan Azadeh MD, senior lecturer at the University of The Gambia, clinical director at Medicare Health Services.