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Can I Supersize That Order?


Obesity is an unhealthy amount of excess body fat. In the United States, like many other developed countries, the prevalence of obesity is increasing. Over the past decade, children and adolescence are becoming more obese. Multiple health risks are affiliated with being obese. This excess amount of body fat is further categorized using a tool known as the Body Mass Index (BMI). BMI is the one way to categorize and monitor obesity. However many people with increased muscle mass may also appear to be obese based on BMI. A BMI greater than 30 is considered obese.

You may be wondering why in this age of medical advancements is the population getting so fat? Look no further than your workplace and daily routine. Many jobs are sedentary in nature with minimal movement required where we spend the vast majority of our time in front of a computer punching in data. Also the average work hours has increased to the point where many individuals bring their work home. Unfortunately, this leads to less time spent exercising. Poor diet, lack of physical exercise and increased caloric intake are key components of weight gain. A good portion of the public take in more calories than they are able to burn off on a daily bases. This excess of caloric intake is what leads to weight gain. Our choice of foods can also lead to weight gain which includes a diet high in carbohydrates, carbonated beverages, saturated fats and high sodium (salt). Certain medications can also lead to excessive weight gain. Please consult with your doctor before starting any medication and or supplements. Certain diseases such as thyroid disease (hypothyroidism) may also lead to weight gain. Inadequate sleep can also predispose individuals to become obese.

Being obese opens the gateway to multiple other health concerns. It has been shown that obese individuals die younger compared to their healthier counterparts. Many of those who are overweight also suffer from other diseases such as diabetes, hypertension, high cholesterol, heart disease, obstructive sleep apnea. Unfortunately, individuals who are obese have a high risk of coronary artery disease and stroke. Many of these disorders can be managed through weight loss and medical treatment.

Obesity can lead to chronic pain. Overtime obese patients can develop osteoarthritis which can lead to increased pressure on weight bearing joints such as knees and hips. We also tend to see gout in more obese patients. Obesity has also been associated with a higher risk of certain cancers. Obstructive sleep apnea, more common in obese individuals, is usually due to an excess amount of fat over the neck that constricts your upper airways causing one to gasp for air. Depression and anxiety are common among this growing population.

There are various strategies to overcome obesity. These strategies include dietary changes, regular exercise, medications and bariatric surgery. Lifestyle medication is essential not only to help in weight loss but to maintain it. Necessary diet changes include increasing the amount of fresh vegetables, fruits, proteins and fiber. Limiting poor food choices such as carbonated beverages, take-out/ junk foods, and foods containing high amount of saturated fats and salt is a good start. There are many dietary fads that have been recently publicized in the media such as the Mediterranean, Atkins, and south beach and so on. None of these diets have been proven to be more superior then the others. Portion control and eating a variety of foods is the key. There are also many weight loss programs such as Weight Watchers, Nutrisystem which have been getting public appeal. Before you start any of these diets or programs, please contact your primary care physician.

Incorporating an active lifestyle is also a crucial part to maintain good health. Activities such as running, jogging, brisk walking, swimming, bicycling have been shown to be beneficial forms of exercise that aid in weight loss. Getting a fit bit which can monitor your daily activity (10, 000 steps daily) level may also be motivating. About thirty to forty five minutes of exercise at least four to five days in a week is a good starting point. As a colleague once told me, exercise is the use of a machine without a motor.

Multiple medications (such as belviq, contrave) exist that have been used to aid in weight loss in obese patients. This is beneficial in those in which lifestyle modifications by itself has not been helpful. Do not start any of these medications without the permission of your physician. Talk to your physician about your options. Many of these medications do have different risks and adverse effects.

When all else has failed bariatric surgery is an option. Patients with morbid obesity and other who are obese with multiple comorbidities (hypertension, diabetes, high cholesterol, sleep apnea, diabetes) may qualify for these procedures. Different techniques exist in bariatric surgery each with its own risks and benefits. An initial consultation with a Bariatric Surgeon will help to explain these differences and to chose the best option on an individual bases. As this is a very big change, therapy sessions which include counselling before and after the procedure is recommended. It is necessary to continue an active healthy lifestyle in order to maintain the weight loss.

Do not hesitate to make an appointment with your primary care physician to discuss different ways to combat obesity. Please come in to talk to us if you have any questions, or contact us today at 770-395-1130

-- Dr. Mithun Daniel


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