OBESITY AND HEALTH


We're back!

And boy do we have some things in store for you!

Those whom know me will know by now that I am passionate about Health & Fitness. As someone whom has formerly battled against being overweight I am also just as personally driven & focused on getting clients sustainable results!

In my latest article I take a closer look at our nation's growing epidemic & a glimpse of some of the current research we have on the subject of Obesity.

Did you know according to the latest Report of the Chief Health Officer for Queensland:

"QUEENSLAND’S obesity crisis shows no signs of waning as new data reveals that close to 70 per cent of the population in some regional areas are either obese or overweight..."

"Two in three adults are now obese as well as one in three kids..."

In order to understand our growing problem, we must further explore and distinguish what Obesity is.

So without further ado, let's dive right in!

ON OBESITY.

Obesity simply put is a multi-factorial condition where body fat and gross weight has accumulated to the extent of impacting overall health.

It involves certain environmental and behavioral conditions to be perfectly met to produce an over-production of gross weight.

Gross Weight is the accumulation of weight mass you carry and can consist of:

⚠️ Muscle

⚠️ Fat

⚠️ Tissue

⚠️ Water

⚠️ Hair

⚠️ Skin

⚠️ Nails

⚠️ Food

⚠️ Hydration

⚠️ Clothing

Basically, anything that is within you, made of by you, consumed or added on can be defined as gross weight mass. The removal of any of the above mentioned weight variables will result in Weight loss.

Obesity is often attributed as a disorder of energy balance management. It most commonly arises from consuming an exponential amount of calories in excess over a prolonged period of time.

Part of the exponential energy balance is required to maintain life, organ functionality and perform physical work.

While the Thermodynamic 'Calorie Balance' model of energy balance is a useful framework for investigating obesity, it does not provide a causal explanation for why some people are predisposed to obesity or what to do about it.

To put things practically, changing one's body composition can be as simple as understanding the concept of Energy In = Energy Out. However managing obesity can be complex as it's largely dependent on one's individual situation.

Over time individuals will almost always encounter both psychological and physiological adaptations to weight loss resistance.

Given the current epidemic however, it has also become overwhelmingly difficult to ignore the long term success rate from dieting for most individuals.

WHAT IS THE LONG TERM SUCCESS RATE?

Individuals whom undergo weight loss are generally successful in the first instance. On average losing around 5-6kg per dieting attempt[76]. However on the context of long term dieting the statistics are quite poor.

To be frank, it is shockingly very low. So low in fact that only 5% of individuals whom diet are successful long term[34].

To put it simply:

6 out of 7 individuals will lose a significant amount of weight in their lifetime...

However, almost 80% of the same individuals will relapse to their beginning weight[29].

In 2 years this goes up to 85%[34].

In 3 years up to 95%[35].

Finally if that's not enough, almost 75% of the same individuals will gain MORE weight on top of their starting weight[36,77].

Obese individuals are generally a lot better off before dieting as research shows it is almost impossible to keep it off for good!

This leads us to the most obvious question: How do we get it off for good?

More on this later.

OBESITY AND BODY IMAGE.

Your body image is how you think and feel about your body. It involves your own perception, imagination and emotions. It doesn't necessarily always reflect what you see in the mirror but can also be influenced by what others see or what you think others see.

As a species we are generally a lot more motivated to do something about our weight on the context of sex appeal. A majority of weight management success stories centralize around individuals trying to look 'pleasing to the eye' more-so than complying with instructions of an allied health practitioner or physician.

Leading many individuals to start out and try many different diets that simply do not work for the long term.[18]

Coupled with the health risks when obesity becomes extreme i.e. visceral body fat overly-distributed in large areas, most individuals generally care more about their appearance than the health risks.

In turn, this can further result in an individual's weight range aka 'setpoint' fluctuating excessively for prolonged periods after constant dieting.[19]

Generally speaking most Diets are started due to poor body image, rather than an individual wanting to be within a healthy weight range. According to Dieting statistics Australia:

"Over 2.3 million Australians (13%) aged 15 years and over reported that they were on a diet to lose weight or for some other health reason. This included 15% of females and 11% of males."[23]

Poor body image and dieting can also be linked to eating disorders i.e. anorexia, nervosa, bulimia, binging and other mental health issues such as depression or anxiety. Constant dieting can also greatly enhance and further lead to physical illness and depression[20].

^one of the many reasons why it’s important to always maintain healthy eating behaviors where possible.

ON STRESS.

It is believed that much of the weight accumulation associated with obesity is environmental. Furthermore the behavioral response from environmental conditions is also an association and overall determinant.

If there is one thing we as a society experience too much of in this day and age, it is stress. Whether it's working a 9-5 job, going to school, raising a family or external relationships.

We will all deal with some form of stress on a daily basis.

Part of our natural biological stress response is the internal onset release of Cortisol and Epinephrine. To put it simply, these stress hormones help us become more resistant to stress in the short term.

Whilst encountering stress is a healthy component of becoming more resilient, there must always be a recovery period to become stronger.

Without a recovery period from chronic stress, we become susceptible of entering a state of constant exhaustion aka metabolic fatigue.

As the years roll by stress accumulates to the point of us numbing it's effects in our lives.

Here's the problem,

The psychological component of 'weight stigma' becomes a lot more complex to manage once an individual becomes significantly overweight and/or obese.[21]

In other words you are at a mental disadvantage before you even start managing your weight.

Chronically elevated cortisol (stress) levels is known to hinder our metabolic efficiency. In short, if we're grossly overweight and in a constant state of 'stress', you are more than likely already in metabolic fatigue.

In extreme circumstances, stress can contribute heavily to metabolic syndrome on a otherwise already healthy sedentary individual[70].

One's overall ability to lose body fat when dieting is greatly reduced with increased propensity to over consume high calorie foods[71].

Individuals whom spend a prolonged period of time in any one location are more likely to graze and/or snack more often.[27]

This may be of great concern for many stay-at-home/part-time working mums as according to research, kids with Healthy and Active Moms are up to 75% less likely to become Obese.[28]

OBESITY AND NUTRITION.

There are many popular diets that are advertised in today’s media that claim to be quick fixes for excess weight loss. Coupled with the never-ending emergence of FAD Diets, Weight Loss programs, supplements, ethics all adding to the mass confusion.

Most individuals are on the constant search for a ‘quick fix’ to manage their weight accumulation. This almost always stems from a lack of education and/or perceived lack lack of time to maintain a healthy lifestyle and diet.

The truth of the matter is that scientifically, nutrition's energy balance has not changed much at all.

According to the Government endorsed National Dietary guidelines by the National Health and Medical Research council (NHMRC), Australians should eat and enjoy a wide variety of Nutritious foods from the 5 groups per day every day including:

‐ 5 servings of Fruit & Vegetables

‐ Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties i.e. bread, cereals, rice,pasta, noodles, polenta, couscous, oats, quinoa and barley

‐ Lean meats and poultry i.e. Fish, Eggs, Tofu, nuts, seeds, legumes, beans

‐ Dairy i.e. Milk, Yoghurt, Cheese and/or their alternatives, mostly reduced fat

‐ Drink plenty of water

- Limit intake of processed food, soft drink and alcohol

The guidelines also recommend Australians keep physically active. Currently only 29% of the general population engage in weekly exercise activity to maintain muscle strength and stay within a healthy weight range.

Obesity is largely blamed on the combination of larger meal sizes, fast food consumption, sugar and a sedentary lifestyle of inactivity [10]. Whilst Nutritional Quality is important to improving one's Health, eating 'healthy' does not always equate to weight loss or successful weight management.

Why?

What the current evidence shows, when you look more closely at it, is that the different kinds of macronutrient proportions does not seem to confer to any long term advantage in weight control to individuals whom adhere strictly to them.

It is believed some of the prevalence to obesity lie's within one's macronutrient distribution. If we consider the thermic effect of nutrients where energy output is 2-3% for Lipids/Fats, 6-8% for Carbohydrates and 20-30% for Proteins[39]. The overall efficiency of nutrient utilization and distribution is more often than not mis-calculated or unaccounted for in most obese individuals.

In this case most obese individuals continue to maintain their weight within a narrow range aka 'set point' alongside their ^current macronutrient distribution. According to research a higher prevalence for overweight & obese individuals is to under report their overall energy (calorie) consumption and eating habits[82].

Further to the argument, a large body of studies have been put forward to further suggest that the problem isn't necessarily the food quality or macro distribution, rather the overall food quantity.

In accordance to the Department of Health and Human Services and the Calorie Thermodynamic model:

“...Does it matter what types of foods the calories come from? When it comes to calories and managing your weight, the answer is no. A calorie is a calorie."[11]

This is evident whether one follows low fat, low carb, carnivore, vegan, raw, keto etc.

But what about High/Low Carb Vs High/Low Fat?

Individuals whom consume a diet rich or low in either dietary fats or carbohydrates does NOT seem to impact or favor weight loss/health markers provided Protein, Calories and Fibre are accounted for! [2-9,38-68,72]

^The rise in evidence supporting an energy balanced model may be an ideal starting point for most individuals whom are looking to implement weight management and improve overall Health.

OBESITY AND HOLIDAYS.

Going by current research, individuals whom successfully lost weight from dieting are prone to significantly greater hunger levels than individuals whom don't lose weight[78,79].

It's believed the increase in hunger is at least 3 times higher alongside the corresponding weight loss acting as a strong determinant and predictor for weight regain[80].

The process of Losing Weight for an upcoming holiday followed by post festive weight gain has become part of the everyday Australian cycle.

However on the context on the rise of Obesity this is another further cause of a significantly larger problem as we are slowly putting on weight every holiday season[73,74].

WHY? To put things simply, holidays and festive seasons are times where we consume more than we are normally accustomed to: More festive foods = more Calories. Less activity = Less Energy Expenditure. More Calorie intake + Less Activity = Weight storage.

It's also uncommon for festivities to stretch out over multiple feeding days! For the everyday hard working Australian looking forward to some quality time off this is a perfectly natural part of one's cycle. On the context of Obesity however, gaining bodyfat every holiday season may not be for everyone. More-so for individuals whom attempt multiple yearly bouts of weight loss only to successfully increase their net weight by 0.5kg on average.

We know Obesity (Weight gain) is multi-factorial and stems from Psychological, Tradition, Culture, Physiological & Environmental factors.

The key in prevented weight gain over any holiday or Festive period stems from the behavioral word: prevention.

This includes everything from regular weighing, self-monitoring, food weighing to Weight management discussion alongside physical activity greatly assists expending excess calories from festive foods and drinks[75].

Behavioral interventions are great practical tools according to research and an important factor in successful weight management.