About Obesity

Obesity is an excess of total body fat. Medically speaking, a person is morbidly obese when he or she is so heavy that their fat tissue load creates damage to their health. The excess fat creating the health problem results from an intake of calories that exceeds the number of calories the body needs for the amount of activity undertaken.

Obesity is emerging as a health epidemic around the world and is particularly a problem in western countries. Obesity effects people across all demographic groups and has significant health and social implications. As an obese individual you can expect to experience an increased risk of diabetes, cardiac disease, high blood pressure, stroke, depression, joint problems and joint disease, cancer, asthma and breathing difficulties, and reduced life expectancy. Surgery as a treatment for obesity is usually considered appropriate if the risk of the excess weight is greater than the risk of surgery.

New Zealand Obesity Facts

“Obesity is a time bomb for New Zealand and the Pacific,” Prime Minister Helen Clark said at the opening of the World Health Organisation’s annual regional meeting in Auckland. Clark, a former health minister, said chronic diseases, including those caused by obesity, are plaguing both rich and poor countries across the region.

The World Health Organization has estimated that the cost for obesity is much as 7 percent of the annual health budget, which equates to $303 million in New Zealand.

Research by the World Health Organization shows that in New Zealand 26 per cent of all boys and 27 per cent of all girls aged over 15 are classified as obese. Obesity in New Zealand adults over 15 years of age has developed a strong upward trend. The prevalence of obesity in 1989 was 11%, in 1997 it was 17% and in 2002 it had increased to 21%.

The 2002/03 New Zealand Health Survey found that in New Zealand certain ethnic groups were over represented in obesity statistics with 27% of Māori men and 27% of Māori women being obese and 36% of Pacific Island men and 47% of Pacific Island women being obese.

Obesity Causes

There are many factors that contribute to obesity including a person’s behaviour, environmental factors and genetics.

Behaviour

Regular physical activity, nutritious eating and eating portion sizes commensurate with energy needs are necessary for maintaining a healthy body weight. Choosing to eat high fat, high sugar or oversize portions will play a major part in putting on body fat. Similarly avoiding physical activity and adopting a sedentary lifestyle reduces the number of calories that you burn and increases the percent of calories that you store as fat.

Genes

Some individuals have a genetic tendency to gain weight and store fat. Although not everyone with this tendency will become obese, several genes have been identified as contributors to obesity. If you have a genetic predisposition to put on weight you need to control this using behavioural and environmental factors.

Environment

Work and home environments that make regular physical activity and regular healthy eating difficult will contribute to weight gain. It is important if you are in a sedentary job to plan regular exercise and organise to take nutritious lunches and snack foods. You also need to compensate by undertaking regular physical activity and exercise.

Obesity Consequences

Obesity brings with it very serious health issues that lower life expectancy. Morbidly obese men between the ages of 25-35, for example, have a 12-fold greater risk of dying prematurely compared to their normal weight counterparts.

Medical conditions that are commonly commensurate with obesity include:

• Pulmonary - obstructive sleep apnoea, obesity hypoventilation syndrome, asthma
• Cardiac - High blood pressure, Cor Pulmonale (a particular type of heart failure) caused by pulmonary hypertension, Coronary Artery Disease
• Gastrointestinal, abdominal - gallstones (associated with cyclic weight loss/gain)
• Gastro-oesophageal Reflux Disease, recurrent ventral hernias, urinary incontinence
• Endocrine - Diabetes, menstrual irregularity, infertility, hirsutism, hyperlipidemia, hypercholesterolemia
• Musculoskeletal - degeneration of knees and hips, disc herniation, chronic low back pain
• Skin - multiple disorders, most related to diabetes and difficulty with hygiene
• Cancer risk - breast, endometrium, colon, prostate

Obesity can also have negative psychological consequences stemming from social isolation and discrimination such as low self-esteem and depression. For patients with a Body Mass Index (BMI) score of over 40 (use the Quick bmi calculator above), it is usually fair to think of the excess weight as the actual underlying cause for most of the medical conditions outlined above. Surgical treatment of the obesity in such cases goes after the root of the problem.