Obesity, now recognized as a disease, is a complex issue

Obesity is a complex disorder involving an excessive amount of body fat. A recent study found that more than two-thirds of Americans are either overweight or obese.

The American Medical Association now recognizes obesity as a disease. It is an endocrine-related disease with multiple interactions among hormonal and neural pathways that regulate food intake and body fat mass. Obesity isn’t just a cosmetic concern, as it increases your risk of diseases and health problems, including:

▪ Type 2 diabetes

▪  High triglycerides and low high-density lipoprotein (HDL) cholesterol

▪  High blood pressure

▪  Heart disease

▪  Stroke

▪  Cancer

▪  Breathing disorders, including sleep apnea

▪  Gallbladder disease

▪  Gynecological problems, such as infertility and irregular periods

▪  Erectile dysfunction and sexual health issues

▪  Nonalcoholic fatty liver disease

▪  Osteoarthritis

The good news is that even modest weight loss (between 5 and 10 percent of your current weight) can improve or prevent the health problems associated with obesity. Greater weight loss is associated with greater benefits.

Adult overweight and obesity ranges are determined by using weight and height to calculate a number called the “body mass index,” or BMI. BMI is used because, for most people, it correlates with their amount of body fat. An adult who has a BMI between 25 and 29.9 is considered overweight, and an adult who has a BMI of 30 or greater is considered obese.

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

▪  Genetics

▪  Family lifestyle

▪  Inactivity

▪  Unhealthy diet

▪  Medical problems, such as Prader-Willi syndrome, Cushing’s syndrome and other conditions

▪  Certain medications

▪  Social and economic issues

▪  Age

▪  Pregnancy

▪ Lack of sleep

Why is gaining weight so easy?

The hypothesis is that you start eating high fat/high carb food that causes hypothalamic injury in the brain, so the brain can’t tell how much fat is stored and how much food is eaten. This will lead to reduced sense of satiety and to craving that causes increased food intake and weight gain.

Why is losing and maintaining weight loss so difficult?

It is not that people lose their willpower or interest; it is simply more difficult. Weight loss produces changes in hormones that encourage weight regain.

What you can do?

If you think you may be obese, and especially if you’re concerned about weight-related health problems, see your health care provider. You and your provider can evaluate your health risks and discuss your weight-loss options. Setting realistic weight-loss goals is an important first step to losing weight.

Try to lose 5 to 10 percent of your current weight over six months. The best way to lose weight is slowly, aiming to lose one to two pounds a week. If you’ve lost 10 percent of your body weight and are still overweight or obese, you may want to consider further weight loss.

Dietary changes, increased physical activity and behavior changes can help you lose weight. Prescription medications and weight-loss surgery are additional options for treating obesity.

Maintaining weight loss

Maintaining your weight loss over time can be a challenge. The key to losing more weight or maintaining your weight loss is to continue with lifestyle changes. Adopt these changes as a new way of life.

We must also adopt an approach of looking at obesity as an endocrine disease. If we think about obesity as an energy problem – just eat less and exercise more – this will not solve the problem. The future holds the use of multiple approaches in combination with medication and surgery.

Sahar Hachem is an endocrinologist with Kansas Physician Group.

This story was originally published June 26, 2015 at 3:23 PM with the headline "Obesity, now recognized as a disease, is a complex issue."