3 Things You Didn’t Know About Obesity

 

Meditations 920 Images / Apple Measures / CC BY CCO
Waist circumference may be more valuable in determining health than body weight. Meditations 920 Images / Apple Measures / CC BY CCO

Anyone who has watched the news or seen Supersize Me knows by now that obesity is on the rise. The problem is apparent as evidenced by myriad magazine covers announcing the arrival of the next miracle weight loss solution. We know that being overweight and obese comes from overeating and under-exercising. It’s not surprising that obesity increases the risk of heart disease and diabetes. We even know that we can measure a person’s level of obesity by looking at their BMI. But is it really all that simple? Maybe not.

  1. There are “skinny fat people” who might be at just as much risk for obesity-related complications as people with higher weights.

Having enough high-quality muscle is as important as having a low amount of body fat. Therefore, it is important to maintain muscle mass and strength through consistent exercise and daily activity. Additionally, an unhealthy diet high high in sugar and cholesterol may lead to an imbalance of fat and muscle, resulting in a condition called sarcopenic obesity. 1

While being overweight is certainly not good for you, the story is a little more complicated than “skinny is healthy, fat is not”. 2 Body Mass Index, or BMI, uses weight and height to calculate a person’s health based on weight. Even though it is the most widely used method of determining whether a person is underweight, normal, overweight, or obese, it is not the most accurate way to measure body composition. BMI measures excess weight, but not body fat percentage or location of fat, which may be more important for health than weight itself. 3  Moving away from using BMI and using waist circumference instead may be a better baseline for health status. 4

  1. Gaining weight is not just about diet and exercise.

There is increasing evidence that something in the environment may be contributing to the obesity epidemic. 5 Endocrine disrupting chemicals are substances that mimic the body’s hormones and are one of the many possible explanations for the rise of obesity. 6  These chemicals can be found in in pesticides, plastics and foods. Pesticides are widely used on farms and other location, and small amounts can be found on food and in drinking water. 7 8

Many studies have tried to find the relationship between obesity and pesticide exposure.  Several studies have found that when pregnant women are more highly exposed to a particular class of pesticides known as organochlorines, their children are more likely to be overweight. 9 10 Fortunately, one particularly toxic organochlorine pesticide known as DDT is now banned in the United States and other nations. Additionally there is a greater public awareness of the health effects of pesticides.

  1. Excess weight even affects your sleep.

With the high rate of obesity comes a high number of accompanying diseases. One of these conditions is obstructive sleep apnea (OSA). A person with OSA has occasional blockages of air flow, causing breathing to repeatedly start and stop during sleep. Excess visceral fat (fat in the belly and around internal organs) may create these blockages, making it a risk for OSA. Recent estimates suggest that a staggering 45% of overweight  and 30% of obese people have some form of the disorder. 11

OSA can lead to poor sleep quality, high blood pressure, and diabetes. 12  Men of all ages, African Americans, and postmenopausal women are at particularly high risk. 13

So what can you do?

While knowing your height and weight is a good start, measuring your waist is another way to find out if you should modify your eating and exercise habits. 14  Central obesity is defined as a waist circumference of more than 85 cm (35 inches) for women and 102 cm (40 inches) for men, according to the American Heart Association. 15

The EPA is making great strides in banning the use of pesticides that are known to be problematic for human health. However, there are still many pesticides being used that we don’t know as much about, and that we consume in low levels through much of our food. To reduce your exposure, wash your produce with running water, peel away skin and outer layers when possible, and eat a variety of foods to avoid increased intake of any one pesticide. 16

If you think you may have sleep apnea, ask your doctor about a home sleep test. If you are diagnosed with the disorder, there are two effective treatments. First, losing weight helps reduce symptoms of OSA, so work with your doctor to come up with a healthy eating plan and exercise program that is right for you.  Additionally, your doctor may send you home with a Continuous Positive Airway Pressure (CPAP) machine, which gently pumps air into your mouth and nose to keep the airway open. 17

Notes:

  1. Roubenoff, R. (2004). Sarcopenic obesity: the confluence of two epidemics. Obesity, 12(6), 887-888.
  2. Lee, Mi Jung, et al. “Normal Body Mass Index with Central Obesity Has Increased Risk of Coronary Artery Calcification in Korean Patients with Chronic Kidney Disease.” Kidney International, vol. 90, no. 6, 2016, pp. 1368–1376., doi:10.1016/j.kint.2016.09.011.
  3. Nuttall, Frank Q. “Body Mass Index: Obesity, BMI, and Health: A Critical Review.” Nutrition Today 50.3 (2015): 117–128. PMC. Web. 19 Apr. 2018.
  4. Lee, Mi Jung, et al. “Normal Body Mass Index with Central Obesity Has Increased Risk of Coronary Artery Calcification in Korean Patients with Chronic Kidney Disease.” Kidney International, vol. 90, no. 6, 2016, pp. 1368–1376., doi:10.1016/j.kint.2016.09.011.
  5. Baillie-Hamilton P. Chemical toxins: a hypothesis to explain the global obesity epidemic. J Altern Complement Med 2002; 8: 185–192.
  6. Colborn, T, F S vom Saal, and A M Soto. “Developmental Effects of Endocrine-Disrupting Chemicals in Wildlife and Humans.” Environmental Health Perspectives 101.5 (1993): 378–384. Print.
  7. Díaz, G., Ortiz, R., Schettino, B. et al. Bull Environ Contam Toxicol (2009) 82: 701. https://doi.org/10.1007/s00128-009-9687-7
  8. Bempah, Crentsil Kofi, et al. “Residues of Organochlorine Pesticides in Vegetables Marketed in Greater Accra Region of Ghana.” Food Control, vol. 25, no. 2, 2012, pp. 537–542., doi:10.1016/j.foodcont.2011.11.035
  9. Karmaus W, Osuch JR, Eneli I, Mudd LM, Zhang J, Mikucki D, HaanP & Davis S. (2009) Maternal levels of dichlorodiphenyl-dichlor-oethylene (DDE) may increase weight and body mass index in adultfemale offspring. Occup Environ Med 66, 143–149.
  10. Smink, A. , Ribas‐Fito, N. , Garcia, R. , Torrent, M. , Mendez, M. A., Grimalt, J. O. and Sunyer, J. (2008), Exposure to hexachlorobenzene during pregnancy increases the risk of overweight in children aged 6 years. Acta Pædiatrica, 97: 1465-1469. doi:10.1111/j.1651-2227.2008.00937.x
  11. Schwartz, A. R., Patil, S. P., Laffan, A. M., Polotsky, V., Schneider, H., & Smith, P. L. (2008, February 15). Obesity and Obstructive Sleep Apnea Pathogenic Mechanisms and Therapeutic Approaches. Retrieved April 10, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645252/
  12. Romero-Corral, A., Caples, S. M., Lopez-Jimenez, F., & Somers, V. K. (2010, March). Interactions Between Obesity and Obstructive Sleep Apnea Implications for Treatment. Retrieved April 10, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021364/
  13. Schwartz, A. R., Patil, S. P., Laffan, A. M., Polotsky, V., Schneider, H., & Smith, P. L. (2008, February 15). Obesity and Obstructive Sleep Apnea Pathogenic Mechanisms and Therapeutic Approaches. Retrieved April 10, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645252/
  14. Lee, Mi Jung, et al. “Normal Body Mass Index with Central Obesity Has Increased Risk of Coronary Artery Calcification in Korean Patients with Chronic Kidney Disease.” Kidney International, vol. 90, no. 6, 2016, pp. 1368–1376., doi:10.1016/j.kint.2016.09.011.
  15. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112:2735-52.
  16. “Food and Pesticides.” EPA, Environmental Protection Agency, 14 Mar. 2017, www.epa.gov/safepestcontrol/food-and-pesticides.
  17. Sleep apnea. (2018, March 09). Retrieved April 10, 2018, from https://www.mayoclinic.org/diseases-conditions/sleep-apnea/diagnosis-treatment/drc-20377636

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