National Obesity Week 15 - 19 October 2013

Many South Africans believe that carrying some extra body weight is a sign of health and vitality and indeed in some cases it can be. However, what many people do not realise is that being overweight or obese can increase our risk of developing a number of different medical conditions and be dangerous to our health.

According to the World Health Organization (WHO), at least 2.8 million adults around the globe die each year as a result of being overweight or obese. And obesity is on the rise, having nearly doubled since 1980. The problem is no less acute in South Africa with some 66% of women and 33% of men being overweight, and between 10% of men and 28% of women classified as morbidly obese.

While obesity is on the increase, most South Africans believe they eat and drink healthily. In a recent survey, some 62 percent of men and 66 percent of women said that they thought they ate and drank healthily and did not need to adopt a healthier lifestyle. Close on 70 percent of men and 63 percent of women also said they were happy with their weight. It would seem that many South Africans are not as healthy as they think they are.

Health conditions associated with obesity
A number of health conditions or complications are associated with obesity including high blood pressure, coronary heart disease, insulin resistance, type 2 diabetes, stroke, gall bladder disease, several types of cancers, depression and lower back pain. These conditions can all pose a serious risk to one's health and, as more people become obese, so to do their risk factors for developing such complications.

At the Government Employees Medical Scheme (GEMS) we work to assist our members to deal with potential health problems before they become a major health issue. For this reason, we encourage those who are struggling with weight problems to visit their healthcare practitioner who can assist them to draw up a strategy to keep the problem under control.

What causes weight gain?
A person may be considered to be obese when their body weight and fat are more than is healthy for them. You tend to put on weight when you take in more calories than you burn off through physical activity. Your body stores these unused calories as fat. You may become overweight and then obese when you:

• Eat more food than your body can use
• Do not get much exercise
• Live a sedentary (inactive) lifestyle
• Suffer from an under-active thyroid

Certain medications, such as certain antidepressants and antipsychotic medications, may also cause an individual to gain weight.

According to WHO global increases in overweight and obesity are attributable to a number of factors including a shift in diet towards increased intake of energy-dense foods that are high in fat and sugars but low in vitamins, minerals and other micronutrients; and a trend towards decreased physical activity due to the increasingly sedentary nature of many forms of work. And it is showing on our waistlines. Once thought to be a problem of South Africa's upper and middle classes only, obesity is now increasingly being seen among less wealthy people too.

What is overweight?
One way you can ascertain whether you are at a healthy weight or not is to calculate your Body Mass Index (BMI). This is your weight in kilograms divided by the square of your height in metres (kg/m2). WHO defines "overweight" as a BMI equal to or more than 25, and "obesity" as a BMI equal to or more than 30. However, BMI should be considered as a rough guide only because it may not correspond to the same degree of fatness in different individuals.

Another way to determine whether you are at risk from being overweight is to measure your waist. This is because the most dangerous type of fat is generally that stored around the waist. Those individuals who carry a lot of fat around the waist are considered by doctors to be at much higher risk for heart disease or diabetes.

Getting healthy
If you tend to be susceptible to weight gain it does not mean that you should work to make yourself too thin as this can bring with it its own health problems. Those who are overweight should rather focus on trying to get healthy and fit than on getting skinny. This will help you to stay strong and avoid getting to a point where your weight can trigger any of the serious medical conditions listed above. 

You don't need to visit the gym every day or do excessive exercise in order to get healthy. You also do not have to ‘diet' in the traditional sense of the word. Making sensible choices when it comes to food and small lifestyle changes can go a long way in assisting you to slim down. These include:

• Have at least three meals per day. Opt for healthy snacks between meals like fruit if you are constantly hungry.
• Eat breakfast. People who skip breakfast are more prone to obesity.
• Reduce your fat intake, especially saturated fats. Saturated fats are animal fats and can be found in cookies, pastries, processed and fast foods.
• Try to eat fish at least three times a week - but not fried fish. Fish is rich in protein and naturally low in fat.
• Try to prepare food by using healthy cooking methods such as steaming, boiling, grilling or baking. This will automatically reduce the fat while you will maintain the essential nutrients in the food.
• Use extras such as cream, butter, mayonnaise, margarine, oil and dressings sparingly.
• Increase your fibre intake by using wholewheat bread and pasta, brown rice and oats. Fibre makes you feel fuller for longer.
• Remember your five portions of fruit and vegetables per day.
• Limit your alcohol intake and try to drink "light" wine and beers, as this is lower in energy.

Exercise and your weight
The combination of exercise and diet is the most effective long-term approach to losing weight. There is, however, no need to go to extremes when it comes to exercising. Simply try walking if you do not like jogging. Opt for the stairs instead of the lift. Or even just park your car further away from the entrance of the shopping mall. Exercise is not just about losing weight - it is about looking after your health. It will also motivate you to keep a watchful eye on what you eat.

Remember to add some light weights to your exercise programme in order to ensure that you do not lose muscle. Muscle helps to burn fat even when you are not exercising.

Even a moderate weight loss can have a lot of health benefits and reduce one's chances of developing complications such as diabetes. Visit your healthcare provider or a dietician so that you can come up with a way to lose weight that will be best and healthiest for you.
 

References
1. IOL News:  http://www.iol.co.za/news/south-africa/a-nation-of-the-hungry-and-obese-1.1558765#.Ujggxrz38b0..
2. Health Systems Trust:   http://www.hst.org.za/news/more-south-african-adults-now-die-obesity-poverty.
3. South African Society for Obesity and Metabolism:   http://www.sasomonline.co.za/G_QA.asp
4. World Health Organization:  http://www.who.int/topics/obesity/en/