13 May Fighting back against Obesity
So somehow NASA can launch a human mission to Mars by 2037, but a preventable disease that’s predicted to affect 35% of Australians by the year 2025, has been ignored. Obesity has become today’s most visible, yet most neglected, public health problem. This is despite the staggering increase in the number of individuals who are at risk of, or are obese.
What is obesity?
Obesity is when our bodies accumulate excessive or abnormal fat amounts to the degree that our health may be compromised. The World Health Organisation (WHO) classifies individuals as obese when our body mass index (BMI) is greater or equal to 30.0 kg/m2.
BMI is a calculation of dividing your weight (in kilograms) by your height (in meters squared). The use of BMI is controversial as it’s a crude measure of the amount of fat we actually have. This is because it doesn’t take into consideration the difference between fat (and the different distributions of fat) and muscle mass. That said, it’s a simple and inexpensive tool that has been utilised since 1835.
How prevalent is obesity in Australia?
In Australia, currently 27.9% of our adult population are obese. As a result, obesity now contributes substantially to the overall burden of non-communicable disease in Australia. Recently obesity has been placed as the second leading contributor to preventable illness and death. With over a quarter of our population being obese, it’s important to understand what factors have led to this epidemic.
Why is obesity increasing in Australia?
Obesity is on the rise due to the number of individual, social, environmental and cultural influences that have changed the way we live. Our beliefs about food and exercise, as well as individual physiological and genetic factors, are all critical influences contributing to the increase in obesity.
We have adopted to endless diets that contain excess energy, saturated fats and simple carbohydrates. In addition, we’ve reduced both our professional and leisure-based physical activity. The unfavourable combination of the two is seriously impacting our risk of developing obesity.
From a scientific perspective, at the simplest level, obesity results from an energy imbalance. If energy in significantly exceeds energy out, it leads to excess fat accumulation. Let’s look at energy in… These days, inappropriate, energy-dense food is readily available, easily accessible, cheap and aggressively marketed. This leads to over-consumption. On the energy expenditure side, the daily total energy expenditure has decreased over several decades. This is mostly a result of more sedentary work, but also because travel, leisure and everyday living environments have become less favourable to physical activity.
The risks of being obese:
It is essential to highlight that obesity is a complex chronic disease. It’s a fundamental cause of major chronic diseases including diabetes, heart disease, and some cancers. If you have a BMI of greater than or equal to 40 kg/m2, you have a 43% increased risk of developing diabetes in comparison to those with a healthy BMI (8%). Additionally, obesity in its own right is a debilitating condition, with a life expectancy decrease of 8.3 years in men and 6.1 years in women.
What can we do to reduce rates of obesity?
Despite being a global epidemic, obesity is preventable. It can be managed and treated with a range of lifestyle changes. Lifestyle interventions for the management of obesity initially begin with improved nutrition and increased physical activity. The combination of the two has been shown to produce the most considerable and most sustained weight loss results.
Supplement therapies include education, support, pharmacological agents and bariatric surgery. The combination of these strategies will also often require considerable input and focus on continued action to achieve significant weight loss (usually considered as >5% of body weight).
How much exercise do you need to lose weight?
Exercise is by far the cheapest and most accessible treatment for obesity, but how much do we need to do for weight prevention and weight loss?
We have been heavily focused on the current guidelines of 150 minutes of moderate intensity physical activity each week for being the magic number. However, recent studies have suggested that this amount does not result in weight loss. We need to be actually preforming a minimum of 300-420 minutes per week (60 minutes per day), of at least moderate intensity aerobic physical activity for meaningful weight loss.
Sound like a lot? Need help getting started? Read on…
How can exercise physiology help?
As an Accredited Exercise Physiologist, I regularly see clients overwhelmed by the amount of exercise recommended. It can be alarming to some, especially for those who currently do not exercise.
Exercise physiologists can help you to achieve these guidelines for weight loss as we:
• Prescribe and deliver tailored exercise programs
• Set attainable and realistic short- and long-term goals
• Provide ongoing exercise advice
• Structure appropriate aerobic exercise regardless of any limitations or health conditions
• Focus on behavioural and lifestyle change
• Work with family members and hold group meetings for additional support
Contact your local Exercise Physiologist to help manage your risk and/or treatment for obesity.
Rachelle is an Accredited Exercise Physiologist at North West Exercise Physiology. She is currently completing her PhD at the University of Sydney where she has a research focus on novel exercise therapies for the modulation of body composition in obesity and diabetes.