Most people know that obesity can result in serious health problems, yet many of us continue to focus on its cosmetic consequences rather than its risks to health.
This distorted view may change now that the American Medical Association (AMA) has finally labelled obesity a disease, not just a risk factor for other disorders. Last month, the organisation recognised that obesity is a verifiable illness that warrants far more attention than physicians, patients and insurers currently give it.
The designation may change how aggressively doctors treat obesity, foster the development of new therapies, and lead to better coverage by insurers. The AMA has said in effect that it is medicine’s responsibility to provide the knowledge and tools needed to curb this runaway epidemic.
On June 19, James Gandolfini, the hefty award-winning actor who portrayed Tony Soprano in “The Sopranos,” died at 51, apparently of a heart attack, while on a vacation. Even if genetics played a role, Gandolfini’s weight contributed significantly to his risk of sudden cardiac death.
Fran Saunders, a 62-year-old Brooklynite, is determined to avoid a similar fate. At 4’ 11’’ and 71 kg, she was clinically obese. She was sent for blood tests when she complained of a vision problem. All her lab readings — total cholesterol, triglycerides, blood sugar — were seriously abnormal.
Her doctor said she was a heart attack waiting to happen. But “the bad news was a blessing in disguise,” she told me.
She now monitors what she eats and how much she exercises with a free cellphone app, My Fitness Pal. Gradual weight loss started almost overnight at a pound or two a week.
Although her goal weight is 50-52 kg, her blood test results improved significantly after she lost just over 3 kg. “My doctor told me that every pound I lose lowers my risk,” said Saunders. “I know it’s possible for some people to be fit and fat, but that wasn’t the case for me, and it was time to stop kidding myself.”
The list of obesity’s hazards goes on: infertility in women, pregnancy issues, gallstones and gout, emotional disorders, social ostracism and employment discrimination.
The first step toward avoiding all of these is a simple calculation to determine whether you are at risk. The most frequently used measure is body mass index, calculated by dividing weight in kilograms by height in meters squared. In general, a BMI of 25 or more indicates overweight, but BMI can be misleading if heavy bones and big muscles account for a large portion of someone’s weight.
The easiest assessment of all? Stand naked in front of a mirror and honestly assess the contribution that fat is making to your body’s composition. It’s not hard to see.
The New York Times