Obesity and Overweight

Overweight and Obesity

According to the Australian Institute of Health and Welfare three in five Australian adults are obese or overweight, with more than 25% of these falling into the "obese" category. People who are obese have an abnormally high and unhealthy proportion of body fat.

An adult who is overweight has a body mass index (BMI) of 25.0 to 29.9. An adult who is obese has a BMI of 30.0 or more. (To calculate your BMI, divide your weight in kg by your height in metres squared. The resulting number is your BMI. This measurement is not suitable for children.) The BMI can, however, be misleading as a measure of health risk. For example a heavy, muscular, very fit sportsperson, such as a shot-put thrower or rugby player may have a high BMI without being “fat”. Abdominal obesity is linked to significant health risks. This is because fat deposits in the organs of the abdomen such as the liver. This kind of fat seems to have a metabolic life of its own and is linked to diabetes, liver disease, high blood pressure, some cancers, heart disease and stroke. For this reason, it is just as important to measure a person’s waist circumference as their BMI.

The waist circumference is measured with a simple tape measure at the belly button level after breathing out. At greater than 102cm (40 inches) for men and 88 cm (35 inches) for women, it is strongly associated with high disease risk. If you type “BMI and waist circumference calculator” into your search engine, and plug in your own weight, height and waist measurements, you will get a very good idea about where you are at with respect to health risks. Heavy people who don’t have abdominal obesity (as well as those who do) will also be at risk for arthritis (joint wear and tear) just from carrying their weight around.

Obesity can raise some cancer risk

There is strong evidence that certain cancers of the breast (occurring after menopause), the lining of the uterus (endometrium), colon and rectum, kidney, oesophagus, pancreas, thyroid, gall bladder, are associated with obesity and physical inactivity.

Obesity is linked to heart attacks in younger adults

Obesity has been linked to a rise in fatal heart attacks in young people. Teenagers and young adults who are obese or have type 2 diabetes, show signs of artery damage that may increase the risk of heart attack and stroke later in life. Children who are overweight are much more likely to become overweight adults, resulting in a lifetime of very serious health problems. 

Obesity makes life more difficult

For those who are obese, daily life itself is harder. Simple tasks such as carrying groceries, walking up stairs, kneeling, and stooping are more difficult for obese people. Sleep apnoea, a condition in which you intermittently stop breathing when asleep, is more prevalent among obese people, and is often a cause of drowsiness during the day. The chronic diseases associated with (especially abdominal) obesity….high blood pressure, diabetes, heart disease, oesophageal reflux and asthma…usually require long-term medication which brings with it other health risks. Because of these factors, our major hospitals are having trouble coping with the obesity epidemic. What should be minor surgical procedures, forFor those who are obese, daily life itself is harder. Simple tasks such as carrying groceries, walking up stairs, kneeling, and stooping are more difficult for obese people. Sleep apnoea, a condition in which you intermittently stop breathing when asleep, is more prevalent among obese people, and is often a cause of drowsiness during the day. The chronic diseases associated with (especially abdominal) obesity….high blood pressure, diabetes, heart disease, oesophageal reflux and asthma…usually require long-term medication which brings with it other health risks. Because of these factors, our major hospitals are having trouble coping with the obesity epidemic. What should be minor surgical procedures, for example, often become complicated in obese patients. example, often become complicated in obese patients.

Obesity speeds up girls puberty, but reduced fertility

A study published in the Journal of Paediatrics found that young girls who are overweight tend to develop breasts and pubic hair earlier than their peers, as young as 8 or 9. Early puberty may put girls at risk for behavioural and emotional problems. Nonetheless, there is a well-established link between being overweight and having more problems falling pregnant. 

Obesity is a cause of diabetes in kids

Increases in childhood obesity have led to the sharp, unprecedented increase in type 2 diabetes among kids. In type 2 diabetes, the body is unable to make enough insulin or use insulin effectively. Experts believe that in the next 10 years, more children will have type 2 diabetes than type 1 diabetes. In the past, type 2 diabetes was only seen amongst middle-aged or older adults, and was almost unheard of in children.Diabetes Australia says most children with type 2 diabetes are overweight or obese. Children who get little exercise, eat too much, and have a family history of diabetes are at highest risk.

Why the epidemic?

At no time in the planet’s history has such a wide choice of food been so readily available to our species. The easy access to ready made and processed food is very recent in human historical terms (about the last 60 years) and has coincided with a decline in the need for physical activity. The type of food (energy dense-nutrition poor), with high glycaemic index (dumps sugar quickly into the blood stream), is also new to human physiology. Our bodies are finely tuned to keep our sugar levels steady so that food that cause spikes and dips in the blood sugar levels (and insulin release) result in increased hunger even though the calories aren’t needed. In Europe, prior to the 18th century, sugar (from sugar cane) was an addictive luxury, to be kept under lock and key. Scientists are now discovering that more complex factors are at play other than self-restraint and the energy-in/energy-out dogma. Other hormones (leptin and ghrelin) control our feelings of hunger and fullness. These can differ between people due to genetics as well as epi-genetics (events that switch genes on or off).

How We Care

Our doctors understand that fatness has important implications for a person’s physical and mental health. They know that poor decisions about food and physical activity are made for a variety of reasons.

International students may need extra guidance avoiding the pitfalls of fast food choices due to being time-poor or unskilled at self-catering. Knowing that excess weight gain during life results in serious health consequences, your doctor will be a willing partner in your commitment to reverse the process. As well as identifying where you are “going wrong” and offering helpful tips about shopping, cooking and exercise, this may involve referral to a dietitian.

Achieving and maintaining a healthy weight is a journey best undertaken with a companion. Our doctors are prepared to be that companion.

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