What is obesity?
Traditionally, obesity is determined based on your body mass index (BMI). Here’s how to calculate BMI: Divide your weight in kilograms by the square of your height in meters. You can also get your BMI by dividing your weight in pounds by the square of your height in inches and multiplying the result by 703. The traditional BMI based classification is as follows:
|30.0 and higher;||Obesity|
The fact is there are many “skinny but fat” as well as “chunky but healthy” people to whom this standard does not apply. What really matters is the ratio of fat mass to lean mass in the body. A metabolically healthy body has less fat mass than lean mass. So, even if your BMI is in the normal range, you are susceptible to the metabolic consequences of obesity like diabetes, metabolic syndrome, hypertension, high cholesterol, atherosclerosis, etc if your fat mass is more than your lean mass… Conversely, if your lean mass exceeds the mass of fat in your body, then metabolically your health is sound even though you may look chunky. That is why it is critical to discover the percent of fat mass in the body before embarking on a treatment program for obesity.
Distribution of fat is as important as the amount of fat
Why do we have fat to begin with?
Fat is more than passive depot of extra energy
Determining the root cause of obesity is a must.
- Genetics: Yes, it’s true that there are some congenital syndromes e.g. Prader Villi, where genetics play a role, but often the explanation of obesity running in families lies in family members sharing similar eating and activity habits.
- Lifestyle: Undoubtedly, indulgence in unhealthy, processed, and junk foods and a sedentary lifestyle tend to exacerbate obesity. Consuming empty calories in alcohol is another known cause of weight gain.
Causes of Resistant Fat: Why Can't I lose weight?
- Dysbiosis: Trillions of microorganisms inhabit the human body, some good and some bad. These microorganisms colonize the gastrointestinal tract and outnumber our own cells. Disruption of the ecological equilibrium in the gut (i.e., dysbiosis) has been associated with obesity and its related comorbidities. Prebiotics and Probiotics can reshape the gut microbiota and restore the balance between good and bad bacteria. Supermarket shelves are overflowing with products to help but a thorough evaluation is needed to determine what strains will help you the most.
- Fatty Liver or NAFLD: Obesity is associated with an increased risk of nonalcoholic fatty liver disease (NAFLD). An excessive amount of triglyceride represents metabolic imbalance. This complex metabolic condition leads to a constellation of adverse alterations in glucose, fatty acid, and cholesterol resulting in systemic inflammation, insulin resistance making it difficult to lose weight. In simpler words, the liver has to repackage the nutrients it receives from the gut. Sometimes the metabolic pathways involved in doing so are preoccupied with metabolizing toxic substances like alcohol, pesticides/herbicides, industrial and household products, plastics, detergents, flame retardants or ingredients in personal care products. Other times the liver is receiving more than what it can repackage efficiently. Both these scenarios lead to fatty liver or NAFLD. The liver plays a crucial role in keeping blood glucose stable. When the liver is not functioning optimally blood sugar starts fluctuating leading to intense cravings for sugary foods.
- Hormonal Imbalance: There are multiple hormonal axes in the body. They work together for optimum physiology. Sex hormones are well recognized but they work together with hormones made in the adrenal, thyroid, and pancreas. For optimal health, they all need to work together like multiple musicians in an orchestra to play together to create a symphony. Hormone disruptors or mimickers like xenoestrogens such as BPA take the place of normal estrogen in the body. Artificial sweeteners contribute to metabolic syndrome and obesity by changing the host microbiome, decreased satiety, and alter glucose homeostasis, leading to increased caloric consumption and weight gain. Your body’s natural daily cycles are called circadian rhythms. They respond primarily to light and darkness. A “master clock” in the brain helps coordinate your body’s natural rhythms. Overexposure to blue light may affect melatonin, leading to changes in circadian rhythms and weight gain from altered eating patterns. Wheat gluten promotes weight gain in part by reducing the thermogenic capacity of adipose tissues. Lactose restriction leads to decreased levels of TSH. Gluten and dairy overload is a commonly believed trigger to the immune system which can lead to thyroiditis. Stress may play a major role in the development and maintenance of obesity in individuals who have an increased glucocorticoid exposure or sensitivity by affecting cortisol levels.
- Medication: Emotional disturbances resulting from hormonal imbalance are frequently treated with anti-depressants and anti-anxiety medicines. Many of these meds can cause weight gain and intensify food cravings.
Why Obesity is now labeled as a disease?
American Medical Association (AMA) in 2013 recognized obesity as a disease state. Obesity can lead to a plethora of diseases and ailments like metabolic syndrome, PCOS,
Type 2 diabetes, atherosclerosis, hypertension, high cholesterol, sleep apnea, heart disease, many kinds of cancer, and even infertility! Obesity is known to cause erectile dysfunction and irregular periods. Since all of these conditions are the result of high VAT ( visceral adipose tissue), it makes sense to resolve the root cause instead of putting a bandaid on each of these chronic conditions.