An Abuja-based medical practitioner, Dr Zenith Chuks, speaks to GODFREY GEORGE about the management of obesity
Is there a difference between being overweight and obese?
Both are medical conditions, although obesity is a medical condition where one’s body accumulates fat to the point that it is enough to affect one’s health and life. Being overweight is also a situation where someone accumulates fat and it is like a spectrum from underweight to obesity. Being overweight is just a part of the spectrum where obesity is at the extreme end. We try to measure the body fat using what we call the Body Mass Index. For overweight, we have approximately between a BMI of 24.9-29.9. Once you exceed 29.9 or cross over to 30, then, it is said that you are obese. One can even get up to 40 or even exceed it. That is what we call morbid obesity. This is when it gets severe. That, most likely, is what can distinguish between one who is overweight and one who is obese.
What signs should someone see to show that one is overweight?
Practically, it is supposed to be a routine check to know the weight status in relation to one’s height. Obesity is not only a function of weight. Height is also involved. It is inversely proportional. It is also important that as humans we keep our health status in check and try to get our weight measurement. Also, I advise that everyone should learn how to calculate their weight as against their height, so they can tell if they are keeping themselves in shape or out of shape and to tell if they are accumulating fat or not. If you do those checks everyday and you are somewhere between 18 and 24 or 25, you are fine. Once you begin to tilt above these, it means you are entering into the not-so-comfortable zone of overweight. In between 25 and 29.9, which is a very thin line, that is when we say one is obese.
Is this calculation the same for both male and female?
Yes, it is the same thing. There are no grew areas. There is no specific area for sex. Once you get a value which is up to 29.9, that is obesity regardless of sex and age.
What sex is more predisposed to being obese?
It is more common in women.
What are the risk factors?
There are a lot of factors that can predispose one to easy accumulation of fat. The very first one is one’s lifestyle or behavioural pattern. Sometimes, some diseases can predispose one to accumulating fat. For some others, it is simply genetics. For behaviour, for example, living a sedentary lifestyle is a huge risk factor for obesity. Some people work hard mentally but don’t do so physically. You would see a teller at a bank who does too much mental activity but has been sitting down since morning he got to work. He has not done up to 100 metres of walk since he came to the office. That is a factor. This person will sit in a comfortable seat at the office, ride in a comfortable car; when home, sleep in a comfortable bed without doing any physical activity. He does this routine all round. This kind of life routine is sedentary. When there are no rigorous exercises and physical activities, it can predispose one to being obese. Secondly, food and diet are a problem. Many people love fat-rich, carbohydrate-rich and gluten-rich food. These foods help the body, but there should be a balance with what the body actually needs. When the intake of fat is actually higher than what the body needs, the body stores the remaining one as fat. The ease at which you can also get food can give rise to a behavioural disorder. The moment one is hungry and just gets into a fast-food restaurant to order food with all these fat contents, one is inviting disaster.
There are also some drugs that predispose one to having this medical condition. Examples are medications that contain prednisolone and hydrocortisone. Many of them can also make one to gain unnecessary weight. There is also the issue of anxiety which can reduce one’s activity level. So, if one has a lot of things disturbing one and make one not to be as active as one used to be, it can also predispose one to gaining some fat. Another factor is diseases. There are some ladies who have what is known as P-cos. It is one of the ailments that affect women. Here, there is a deregulation of hormones in the female which may make them to either add so much weight or lose so much weight. It can also cause acne. We have thyroid diseases too, which can cause that. There are also mental illnesses like eating disorders which can make one to overeat even when not hungry. They can predispose one to obesity. The last one is genetics. There may be a coded protein in the cells of our bodies known as leptin, which helps in the consumption of fats in our cells. There are people who are genetically leptin-deficient. Those kinds of people cannot control fat.
What are the dangers of being obese?
It is good to know the burden this has on our health. In one of the recent updates I read, there is a study to show the prevalence of overweight people in Nigeria. It showed that about 14.3 per cent of Nigeria’s population is obese. About 25 per cent is overweight. This is worse in women than in men. It is also worse in urban dwellers. Everyone should know how to calculate their BMI. Always know your weight and you height. Always find time to go to the hospital and let them explain to you how these things work. It is good one knows whether they are in shape or not, so nothing catches one unawares.
Obesity predisposes one to hypertension, pulmonary heart diseases, stroke, diabetes, arthritis, and even cancer. Some cancers, like colon and liver cancers, are some of the side pecks that come with it. It may lead one to sleep apnea (snoring). That can even cause hypoxia (insufficient oxygen supply) because of the snoring that one experiences during sleep. If you know that all these things can happen, then, it should be treated as an emergency.
What should be the one’s response if diagnosed to be obese?
First, don’t panic. Simply discuss with the doctor what the negative part of gaining weights is. The doctor would tell you all of the consequences and how it affects you. One should do everything within their human possibility to bring their weight down. Good enough, obesity is very preventable. It is one of the illnesses that one can work on by one’s self without having medication. Just get yourself into physical activities and get back your good health.
Speaking of prevention, you spoke of physical activities. How do you react to people who are not consistent with these weight loss routines?
If you go to the gym, you should know the reason you are there. The gym instructors also need to help get a plan that works for you so that when you start, you don’t easily go weary. The other part belongs to the patient trying to manage their weight. If you are disciplined enough, you may not need to visit any gym instructor. You can work on it all by yourself if you are disciplined enough to start doing some personal trainings by yourself. You can get some training kits, do some early morning jogging, do some brisk walk, go to game centres and do some games and work that fat out. We should know that our lifestyles are part of the issues that make fat accumulate in our bodies. So, discipline, not just with the physical activities but also with the kind of food we eat is required. We should avoid abusing or misusing drugs. It is a congregation of effort to help one to reduce weight when they are tilting towards the negative balance of weight.
Speaking of eating disorders, what exactly are they? Is there a time people should stop eating?
First of all, it is a mental disorder that makes you eat voraciously. I wouldn’t have the time to mention the cascade of illnesses. In the African setting, it is said that one should eat in the morning like peasant, eat in the afternoon like a prince and in the night as a king. But, actually, it is supposed to be the other way round. We are supposed to eat in the morning like a king, in the afternoon like a prince and in the evening like a pauper. When you leave your house with tea and bread breakfast, before afternoon, you are already so hungry. In the morning, our bodies can easily mop up anything we eat because there are a lot of activities. In the afternoon, it begins to drop. Then, at night when you are supposed to go and sleep, it is not expected you take anything heavy because your body is also ‘going to sleep’. If you decide to eat so heavily, the body takes the one it can use and stores the excess as fat. It is important that we reverse the eating pattern. Eat more in the morning and less at night. Or, just take water and some fruits at night. You won’t die. If you don’t have a mental disorder, one just try and discipline oneself. Don’t eat much more than your body can expend.
What is the place of junk food in being obese?
Part of dieting that causes obesity is taking fat-rich, carbohydrate-rich and gluten-rich foods. You have all of these wrapped up in the beautiful waterproof bags of fast foods. When you see all of those junks, they are ticking the boxes of these foods to avoid. For the people who eat junks, they already know where the problem is coming from. Avoid fatty foods and try to eat vegetables.
It is amazing to also know that, although these foods are fat-rich, they can also provide nutrients to the body occasionally. For the people who don’t eat it very frequently, the major point is to try not to gain weight which your body does not need. Don’t make eating junk a lifestyle.
Is surgery an option to manage obesity?
Of course, yes. The surgeries have their own complications too. Before you go under the knife, you should have tried other non-surgical options. There are many people who try to work out but it does not work out for them; it may be as a result of a genetic problem. But before surgery, make sure you have tried all other conservative measures.
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