Obesity is much misunderstood; the causes of obesity are many and varied, and the solutions to obesity can be anything but straightforward, but a third of UK adults suffer from it (with a further third being overweight)
Obesity is the most common metabolic disorder in clinical practice. Alongside a range of other risk factors, including hypertension, high blood glucose, abnormal blood fat (high triglyceride) and low HDL (good) cholesterol, obesity constitutes the metabolic syndrome.
Obesity shortens life span by an average of 14 years and reduces the quality of life.
“To my amazement, he was full of lead”
This obese 50-year-old painter and decorator presented with painful hands and was diagnosed with rheumatoid arthritis. I did a battery of tests, and, to my great amazement, he had a very high level of lead (used in many old paints.)
I supported him with some nutritional changes, and we started to rid his body of the heavy metal. His arthritic symptoms resolved, and he was delighted to lose nearly 20kg of weight in the bargain.
There are many causes behind every case of obesity. These include genetic defects, chronic stress, food sensitivity, toxins, hormone imbalance, alcohol excess, sedentary life and highly processed, refined food.
“I suspected her hormones were not helping”
This 55-year-old lady presented with a history of increasing lethargy and weight gain. She was also noted to be irritable and forgetful, with mood swings. She complained bitterly about nocturnal symptoms of hot flushes and excessive sweating, disturbing her sleep, and visiting the toilet several times a night. I suspected that hormones were playing their part in her metabolic syndrome.
She gained nearly two stones in weight; her blood pressure was high at 145/90, and her blood sugar was in the prediabetic range (6.2). Her lipid profile reported high cholesterol, high triglycerides, and low protective HDL (the good guy.)
This is an example of postmenopausal weight gain, affecting 60% of ladies in this age group.
A slimmed-down history of obesity
Obesity has become more prevalent over the last 20 years, bringing high blood pressure, type 2 diabetes, vision loss, nerve damage, cardiovascular disease, leg and foot problems and potential amputation.
66% of UK adults are obese or overweight – and the drugs, the plans, the powders, and potions just don’t work. A 2018 Health Survey for England (HSE) revealed that 31% of adults in the UK were clinically obese with a Body Mass Index (BMI) greater than 30, with a further 35.6% being overweight. More worryingly, 15% of children aged between 2 and 15 were obese, and 13% were overweight.
There are many reasons for this comparatively recent problem. Richard Nixon wanted to get re-elected as US President in 1971, and one of his central campaign issues was how expensive food was in the States. He put measures in place to produce high fructose corn syrup (HFCS) and cheap corn oil, which made food much cheaper but powered brands like Coca-Cola, Pepsi Cola and McDonald’s to the forefront of people’s diets.
The trouble was not only were these foods high in sugar, but their production removed fibre and nutrients from the food, leaving just empty calories.
In this blog, we will discuss the reasons behind weight gain, what makes (or should make) people want to lose weight, why conventional weight management programmes are not helping, and what simple steps can help you lose weight, look good and feel great.
Many people visit my clinic with the primary goal of losing weight. Almost all of them have seen a steady weight increase over many years. And they are fed up with the yo-yo effect of dieting.
Obese and overweight people are much more likely to contract long-term conditions. Some of these diseases are difficult to diagnose at the stage when they can still be resolved.
How do you know you have a problem?
BMI is a simple formula devised by Adolphe Quetelet, a Belgian mathematician in the 1830s, to assess weight. It is calculated by dividing weight in kilograms by height in metres squared.
A BMI of 18.5 to 24.9 is healthy, 25 to 29.9 is overweight, while 30 and above indicates obesity.
Obesity is divided into 3 classes: Class 1 (low-risk) obesity is a BMI of 30.0 to 34.9; class 2 (moderate-risk) is 35.0 to 39.9, and class 3 (high-risk) is equal to or greater than 40.0.
A better guide to your risk
BMI tells you if you have a weight problem, but it does not assess your risk of chronic disease; the Waist Hip Ratio (WHR – simply, the ratio of your waist to your hip measurement) is a more useful tool, which indicates the amount of fat stored in abdominal organs such as the liver and pancreas.
According to the World Health Organization (WHO), a healthy WHR is 0.9 or less in men and 0.85 or less in women. According to research, this tool accurately predicts life expectancy in middle-aged and older adults.
Another way of looking at this is that a waist size of over 40 inches in men and 35 inches in women is strongly associated with a risk of chronic diseases such as diabetes and heart disease.
Neck circumference showed similar or better associations with risk of metabolic disease and is more practicable than waist circumference. Hence, neck circumference may be a better alternative to waist circumference.
Neck circumference is measured at a point below Adam’s apple with the person looking forward with relaxed shoulders. Normal value <12.5 inches (32cm) in females and <15 inches (38cm) in males.
What the Dickens is this OPA?
In The Pickwick Papers, Charles Dickens wrote about Joe the fat boy, who was always asleep, and his snoring was given the term, Pickwickian syndrome. The more helpful term “sleep apnoea” was introduced in the 1960s to indicate partial or complete closure of the airways of obese people during sleep.
Neck circumference is a better predictor of obstructive sleep apnoea (OSA) than general obesity. Patients with OSA have approximately 67% total neck fat than the normal person. This causes them to have a smaller upper airway and a greater chance of narrowing during sleep, meaning frequent waking, unrefreshing sleep, and loud snoring due to recurrent episodes of partial or complete airway obstruction, resulting in intermittent hypoxia (low oxygen levels.)
This represents a growing epidemic, affecting 60% of the general population due to our progressive increase in body mass index (BMI) over the last few decades.
What are the causes of obesity?
Your weight gain and any associated health problems are not your fault!
Genetic obesity can run in families – people can inherit multiple obesity genes but also inherit poor lifestyles.
A high concentration of maternal cortisol retards intrauterine growth in humans, producing small babies. However, low birth weight is associated with an increased risk of developing obesity and cardio-metabolic disease during adulthood.
A study on adverse childhood circumstances showed that individuals who reported several adverse childhood experiences exhibited a 1.4 to 1.6 increase in the incidence of severe obesity as adults.
Hormonal changes in middle age alter your body composition. You lose muscle mass (5% every decade) and gain fat. People at this stage of life slow down and become less active.
Obesity is more prevalent in low socioeconomic groups due to the consumption of unhealthy, cheap, fast, and processed foods and limited access to recreational facilities.
Also, the marketing and advertising of calorie-dense foods and increased portion sizes can contribute to the development of obesity.
Fat is where your body stores toxins, and exposure to environmental toxins, such as BPA in plastic, interferes with your hormones and forces your body to make more fat.
Chronic stress can lead to dietary over-consumption (especially of palatable foods), increased visceral adiposity and weight gain. The chronic release of cortisol explains the obesogenic effect of chronic stress.
Eating simple sugars and processed carbohydrates pushes your insulin sky-high so that your calories are stored as fat rather than used to fuel activity. Conversely, increased physical activity contributes to weight management by building muscle. Muscles are metabolically active and require a lot of energy to stay in good shape.
Our ‘modern diet’ gave them pre-diabetes in two days!
Our western diet, rich in simple sugar and processed carbs, is addictive. When you go on it, you won’t be able to stop, and you will have to continue having it in increasing quantities, which, over time, would result in being overweight and then obese.
I am sure most of us have observed the magical effect of popping a sweet into the mouth of a crying child. This instantaneously brings calm and a lovely smile to their face. This is because sweets prompt your brain to release dopamine, the feel-good hormone.
One study demonstrated the damaging effect of the modern diet. The participants were asked to consume 6,000 calories per day, consisting only of refined and processed foods. They were not allowed to do any exercise for the duration of the study. Instead, they were advised to watch TV!
The diet resulted in 3.5kg (7.7lb) weight gain in one week, insulin resistance (pre-diabetes), an increase in adipose (fat) tissue, and inflammatory markers. The terrifying result was that participants developed insulin resistance (pre-diabetes) in only two days.
Let’s have a moan about hormones
I am sure many of us are familiar with the fact that an underactive thyroid gland is almost always associated with weight gain and obesity. Your metabolism slows down due to a lack of the thyroid hormone (thyroxine) and its active form (T3) involved in the energy production to keep us warm and comfortable, resulting in lethargy and cold intolerance.
Leptin is a hormone produced by fat tissues in response to having an abundance of energy. It acts upon receptors in the hypothalamus (appetite centre) to reduce appetite and prompt you to stop eating.
High leptin levels reduce your appetite, so you do not eat much. When your leptin is low, the food tastes good, and you want to eat more of it. However, leptin resistance is when leptin is high, but your brain cannot respond to it. In this case, you lose control and continue to eat beyond your needs. This results in consuming more energy to store as fat, resulting in weight gain and obesity.
Recent studies confirm that what is generally known as a “gluten-free diet” is the cause of obesity and vascular disease epidemic.
A key study published in 2015 observed coeliac patients at the time of diagnosis and again one year later. At diagnosis, only two out of the 98 people fulfilled the criteria for metabolic syndrome. However, after 12 months on a gluten-free diet, 29 were confirmed to have the condition.
There were also similar changes in individual metabolic risk factors. Having an abnormal waist size moved in the wrong direction – from 48 people at the point of diagnosis to 72 people one year later
The lack of beneficial bacteria
The diversity of your microbiome is key to your overall health and ideal body weight. Research shows lack of beneficial gut bacteria such as Lactobacillus strains and Akkermansia contribute to weight gain. Eating fermented food is one way to increase the diversity of the live bacteria in your gut to facilitate your weight loss programme.
Common problems in obesity
Besides diabetes, obese people are 3.5 times more likely to have high blood pressure. Other complications include heart disease, stroke, chronic kidney disease, certain types of cancers, sleep apnoea, arthritis, gout, and depression.
Excess body weight puts pressure on the pelvis, back and knees, the pelvis being pulled forward and the lower back becoming strained, resulting in chronic back pain.
Acid reflux is a common symptom among obese and overweight people, accumulation of fat that increases the intra-abdominal pressure and pushes stomach acids to cause a burning sensation in the gullet. For the same reason, obese and overweight people are likely to have a hiatus hernia when part of the stomach migrates into the thorax.
Obese people also have receding gums and dental fillings (because of their sweet-based diet, which alters the mouth microbiome.) The dysbiosis results in low-grade inflammation and oxidative stress, which contributes to the development of gum disease.
Arthritis is common among obese and overweight people. Besides weight overload, the low-grade metabolic inflammation spreads from belly fat to joints giving osteoarthritis.
Gout is a type of arthritis triggered by a high level of uric acid, initially affecting the joint at the base of the big toe. The liver processes sugar (fructose) into uric acid.
Being overweight or obese increases the amount of cholesterol in your bile, which increases the risk of gallstones. 30% of morbidly obese people have gallstones. Rapid weight loss also increases your risk of having gallstones.
Obese people are also more likely to fall and so be at risk of fractures compared with lean people. The NHS has gone out of its way to support obese people, especially in transporting them during an emergency. An obese person will usually need non-standard equipment to accommodate their weight (usually more than 150kg) and altered body shape.
Solution: eat more and exercise less!
The simple concept of “eat less and exercise more” to lose weight is a myth, as your body needs more nutrients to shape up. In fact, in many cases, you need to eat more and exercise less to stay calm, alert and fully motivated.
Everybody is different and needs a personalised method to win the battle against your weight and potential disease risk, but here are the 7 underlying principles to RESOLVE obesity…………
Return to mother nature, to a whole, organic, locally grown fruit and vegetables, with less commercial meat and poultry, and more small fish, beans, seeds, and nuts.
Enhance your detoxification by consuming organic food, taking nutrients such as the Brassica family of vegetables (broccoli), exercising and having infrared saunas to sweat the toxins out of your body.
Shape up with a physical activity that includes cardio and muscle-building exercises, together with yoga for relaxation, muscle strength and core training.
Open-air, sunshine and the natural world are vital for you to gain vitamin D and reset your circadian rhythm.
Lower your stress by changing your perception or response. You can also use stress-relieving techniques such as deep breathing, meditation, prayer and listening to humour.
Value your loving relationships and supportive communities, and practise unconditional love, forgiveness, and gratitude.
Every day should end with 7 to 8 hours of restful sleep.
Please, my friends, don’t be one of the millions who are heading for obesity – and all of its dangers – and neglect to do something about it until it’s too late. You can do some initial assessment yourself, and if you are in any doubt, please ask for my advice or book an appointment.
Please share your thoughts and ask any questions on this subject – in the Comment section below is always best so that I can respond most quickly – and please do subscribe to the newsletter so that you don’t miss further vital information. Thank you!
Gluten sensitivity and Metabolic syndrome
Hormones and Metabolic syndrome
Class 3 obesity formerly known as morbid obesity
Obstructive sleep apnoea and metabolic syndrome
Neck circumference as an anthropometric Indicator of a central obesity in patients with