In 2013 the American Medical Association classified obesity as a disease. This was an important step in recognising that obesity is not a cosmetic problem. Obesity is increasing to epidemic levels in both developed and developing countries. In the 2010 National Health Survey, 10.8% of Singaporeans were obese with a body mass index greater than 30kg/m2.
How serious is obesity?
There are many medical, physical and psycho-social consequences of obesity. In fact, obesity can shorten an individual’s lifespan by more than 10 years.
Obesity increases the risk for diabetes, high blood pressure, cholesterol disorders, fatty liver, kidney disease and joint pain, especially osteo-arthritis of the knee.
In women, obesity is an important risk factor for irregular menses and sub-fertility.
Obesity triples the risk for gallstone problems and increases the risk for obstructive sleep apnoea (OSA) ten-fold. OSA is associated with excessive snoring and sudden death during sleep. Obesity increases the incidence of depression by 50% and affects intimacy and sexual function in both men and women.
Can losing weight help?
Yes, weight loss has a very powerful effect on these conditions. Many of these obesity-related disorders can improve or disappear after weight loss. On average people can eliminate 70% of their chronic disease medications after losing weight.
How can one lose weight?
The scientific evidence is quite clear that once an individual has gained weight to obese proportions, it can be exceedingly difficult to lose that weight. The first step is to change one’s eating behaviour. It is important to reduce or eliminate refined and processed foods from one’s diet. Eat more natural foods including whole grains, fresh vegetables and fruit, and a variety of lean animal and plant proteins.
Despite cutting down on food intake, many obese individuals find that their weight does not change. Compare this with smoking. If a smoker develops heart disease, stopping smoking will not automatically make the heart healthy. Similarly for obese individuals, cutting out the calories alone may not be enough. For such individuals, a structured lifestyle intervention program, sometimes with the help of protein shakes and medication, may increase the metabolic rate and burn calories.
For some individuals the best long term solution is weight loss (bariatric) surgery to control food intake and alter the digestive process. Bariatric surgery is performed using keyhole technique by specially trained surgeons. Of the several procedures performed worldwide, the gastric sleeve (also called vertical sleeve or laparoscopic sleeve gastrectomy) is the most popular. In the gastric sleeve procedure the stomach is stapled and reduced to one-quarter of the original size.
Combined with effective dietary and lifestyle intervention, bariatric surgery can be extremely effective in helping individuals lose weight and also treat co-existing medical problems such as diabetes. A 5-year study from the Cleveland Clinic, USA recently reported that “bariatric surgery is a highly effective treatment for Type 2 diabetes”.
• Obesity can shorten your life by more than 10 years
• Obesity increases your risk of diabetes, blood pressure, fatty liver, depression, obstructive sleep apnoea, gallstones and knee arthritis by 2 – 10X
• Weight loss leads to significant improvement of those conditions in 60 – 90% of individuals
• Obese individuals undergoing weight-loss surgery reduce their risk of death from heart attacks, cancer and diabetes complications by 50 – 90%
1. Pi-Sunyer, Xavier. “The Medical Risks of Obesity.” Postgraduate medicine 121.6 (2009): 21–33.