Seven out of ten people, when asked, attribute obesity to ‘poor self-control’ and ‘lack of will power’. The general perception (or misconception to be precise) about being overweight or obese still persists. However, obesity is a serious chronic disease which needs to be managed like a disease.
The World Health Organization recognized ‘Obesity as a disease’ in 2004 when it reached epidemic proportions. The awareness about how to measure obesity, its prevention, management and the health concerns it brings along with it, is still very poor and questionable.
To be precise, obesity is much more than a physical problem; it is the root cause of serious illnesses like Diabetes, high blood pressure, heart disorders, sleeping disorders, joint pains, infertility and increased chances of cancer.
Urbanization and improved economic status have led to easily available means of transport that has cut down the physical activity to almost zero. Furthermore, easily accessible processed foods with calorie dense constituents and little/ no nutrient value inevitably add to the waistline circumference.
The mesh of interactions between genetics, nutrition, lifestyle, sleep pattern, and psychology contribute to weight gain. People often say, ‘Zip your mouth, have control, be motivated enough’, little do they know this may not work for everyone. Getting the numbers on the scale down is an uphill battle that many struggles with almost all their lives. The weight management is beyond calorie balance as there are several other factors that come into play which need to be understood and dealt with.
The rise in the obesity incidence in children is very alarming and importantly worrisome because 80% of these obese children grow into obese adults. Choice of food (low-nutrition/ high calorie), frequency of eating out and large portion sizes – all these aspects come together to become an unhealthy lifestyle choice not just among teenagers (10-14-year-old) and adolescents (15-17-year-old), but in children as well (5-9-year-old). These poor eating habits eventually manifest into a full-fledged eating disorder over a period of time. From a time when eating out used to be limited to festivals to present - there has been an extreme shift with online delivery applications that deliver anything and everything at your doorstep.
Obesity is as much a psychological problem as a physical one. Food is commonly used as a coping mechanism for those dealing with weight problems and emotional troubles. The answer to distress in these people is comfort eating which contributes to weight gain. The weight gain triggers guilt which reactivates this vicious cycle where they again turn to food to muddle through their disturbing emotions. This is more commonly seen in children and adolescents these days. Adolescence is a sensitive transition stage from childhood to adulthood where children are struggling between wanting independence and building their own identity while still needing parental guidance and support. This leads to a state of confusion which alters their behavior patterns, eating patterns and even sleep patterns.
When we talk about weight loss, we always give importance to a healthy diet and exercise. The third very important element which is always missed out is adequate sleep. Adequate sleep does not only mean 6 to 8 hours of sleep any time of the day but more importantly, WHEN DO YOU SLEEP. Following our biological clock is the key to good health and well being. Altered sleep patterns that are untimely sleep at odd hours contributes to eating at wrong times thus disturbing metabolism. 7- 9 hours of daily sleep at the right time is imperative. Odd timings of sleep encourage midnight binging which is mostly junk processed food that is high in calories. Moreover, no physical activity after that causes everything to be deposited as fat in the body during sleep. The next morning, the person obviously wakes up late and feels lethargic throughout the day. Poor energy and concentration levels persist throughout the day due to which there is no exercise in the day time as well. This slows down the metabolism even further and contributes to weight gain. And then comes the next day with exactly the same routine and this cycle adds a few hundred grams each day which we do not even notice. Someone doing nothing wrong in diet and still observing weight gain would be surprised to know that even sleep could play a role in that. In fact, less than 7 hours of sleep can reduce or even undo the benefits of diet and exercise. Sleep deprivation, in turn, makes one crave food and that too calorie dense food.
A present-day approach to obesity acknowledges the multifactorial determinants of weight gain and the health benefits to be derived from weight loss. Fundamental to any weight loss effort is a lifestyle change, diet, and increased physical activity. The last resort is surgical management i.e. Bariatric surgery which has proven to be the most effective treatment option for sustained weight loss and significant improvement of all obesity-related illnesses.