National Obesity Week, 15 - 19 October 2012

As a nation that is serious about our sports and outdoor lifestyle, you would think that South Africans would be fairly healthy people. However, according to recent reports, this is not always the case.

Research conducted by a leading pharmaceutical company indicated that approximately 61% of the country's adults are overweight or obese. Even more worrying was the apparent lack of understanding about this issue amongst South Africans with 78% of obese people believing that they were of a healthy weight in the same study.

Not only is this a problem facing our adult population, but our youngsters as well. According to the South African Medical Journal, obesity in children and adolescents has reached epidemic proportions with an estimated obesity rate of one in every five children in industrialised and developing countries.

While these figures are most worrying, this health issue can be effectively addressed with increased awareness and education about what lifestyle and behavioural changes must be made to fight obesity in South Africa.

As part of the Government Employees Medical Scheme's (GEMS) ongoing effort to educate existing and future members on a range of healthcare topics, we would like to explore certain important healthcare issues. This article looks at the subject of obesity this National Obesity Week, 15 - 19 October 2012.

What is the difference between obesity and overweight?
Whether you are obese or overweight depends on a factor called your body mass index, or your BMI. This index is used as a global tool to calculate weight status and is calculated by dividing your weight in kilograms by your height in meters, as follows:

BMI  =  (weight in kilograms) ÷ (height in meters x height in meters)

So what does your BMI score mean?

• An individual with a BMI of below 18.5 is underweight
• An individual with a BMI of between 18.5 and 24.9 is normal
• An individual with a BMI of between 25.0 and 29.9 is overweight
• An individual with a BMI of between 30.0 and 39.9 is obese
• An individual with a BMI of 40.0 and higher is morbidly obese

What causes obesity?
When a person eats or drinks too much and exercises too little, he or she will usually start to gain weight. The longer this continues the more weight the person is likely to gain until eventually it reaches a point where he or she becomes obese.

While this is the main cause of obesity, there are other factors that can contribute to obesity, including:

• Older age - your body's metabolism is not as fast as it used to be so you do not need to consume as much food.
• Gender - women have a tendency to be more overweight than men, as they have a slower metabolism.
• Obesity in the family - parents who are obese are more likely to have obese children.
• Psychological factors - some people eat more than they need to when they feel negative emotions about themselves or their lives.
• Illness - Certain illnesses such as hypothyroidism can lead to obesity, however, these are not as common as people may think and it is important that you visit your doctor for a proper diagnosis if you believe that you may have a condition causing you to gain weight.
• Medication - drugs such as steroids and certain types of antidepressants have been linked to weight gain.

What are the health risks of being obese?
Obesity is associated with a number of dangerous conditions. According to the World Health Organization overweight and obesity are globally responsible for 44% of diabetes cases, 23% of ischaemic heart disease and 7 - 41% of certain cancers.

Obesity can lead to the following health conditions:

• High blood pressure
• High cholesterol levels
• Heart disease
• Stroke
• Type 2 diabetes
• Cancer of the uterus, cervix, ovaries, breast, prostate, colon and rectum
• Infertility in women
• Erectile dysfunction
• Non-alcoholic fatty liver disease
• Sleep apnoea, a disorder causing you to stop and start breathing repeatedly
• Gallbladder disease
• Osteoarthritis
• Depression

How should I address my obesity?
The first thing you need to do is to admit to yourself that you have a problem, and that you need to make changes in your life to address it. Your main goal will be to lose enough weight to get yourself down to a healthy BMI.

Before you decide to follow any particular weight loss programme you should consult your doctor. Depending on the severity of your obesity you will either need to make lifestyle changes or you may require a combination of a medical intervention, such as weight-loss surgery or prescription medications, and the development of healthier habits.

At the very least, you will need to commit to the following in order to lose weight:

• Changes in your diet
• Changes in your activity levels
• Changes in your behaviour

How can I prevent my loved ones and myself from becoming obese?
There are five key lifestyle rules that must be followed in combination with one another, in order to maintain a healthy weight:

Stay active - try to do at least 30 minutes of moderate exercise each day, such as going for a walk or riding a bicycle.
Eat healthily - make the foundation of your diet consist of fresh fruit and vegetables, whole grains, lean protein and unsaturated fats such as nuts or vegetable oil. Try to cut out high-fat and sugary foods and drinks as much as possible. You can still eat what you enjoy, but in moderation. It is also important to drink enough water - eight glasses a day is a good amount.
Weigh yourself often - keep track of your weight on a regular basis so that you know when you are not doing enough to keep your weight down.
Be aware of the situations that cause you to eat unhealthily - many people eat ‘junk food' or more food than they need to when they are feeling tired, stressed or bored. Try to avoid these situations and when they do arise, find another way to deal with them. 
Remain consistent - how you manage your weight should be a way of life that you apply at all times, regardless of whether it is a weekday or a holiday. Naturally you will sometimes end up eating certain things on special occasions that you ordinarily would not, but do not make a habit of this. It is also important that you do not allow your weekends to become a ‘time-off' from your healthy lifestyle.

For any GEMS member queries please phone the GEMS call centre on 0860 00 4367 or visit our website at www.gems.gov.za. GEMS will assist you in every way possible to ensure your family's health and wellbeing.

Sources:
1. The World Health Organization, www.who.int
2. The Mayo Clinic, www.mayoclinic.com 
3. The Star, ‘More than half SA adults overweight or obese', www.iol.co.za
4. South African Medical Journal, Volume 102, No 5 (2012), ‘Obesity in childhood and adolescence', www.samj.org.za