The Concept of Overweight and Obesity - Essay Example

Benefits of Exercise for Overweight Women Abstract Being overweight or obese clearly poses a problem for women across America. Overweight women have an increased risk of cardiovascular disease, diabetes, joint-related diseases and certain forms of cancer. They have elevated risks for mortality from these diseases and the risk increases as weight is gained. In reviewing the risk factors associated with obesity and being overweight, weight reduction treatments such as dieting and exercise were compared to determine which poses more benefits for the woman dedicated to regaining a healthier body and a healthier lifestyle. Introduction Overweight and Obesity kill roughly 300,000 Americans annually (Allison, et al., 1999). United States Surgeon General David Satcher in his December 2001 report states that obesity and being overweight is fast overtaking smoking as the country’s leading cause of preventable death. To date there are about 100 million Americans who are overweight or obese, prompting the description of obesity as an epidemic not just in the United States but in most industrialized countries as well (Poston and Foreyt, 2000). The American Obesity Association (AOA) fact sheet 2002, state an average of 62 of women age in the United States between age 20 to 74 years are overweight with a Body Mass Index (BMI) greater than or equal to 25 but less than 30. About half of the women in this category are obese (National Health and Nutrition Examination Survey, 2003). The problem of overweight and obesity poses also poses serious economic impact as obesity related expenditure increase annually. In the US, nearly $75 billion cases attributable to overweight and obesity related health problems are financed by Medicare while and $21 billion is financed by Medicaid (Finkelstein, Fibelkorn and Wang, 2004). In essence this means that more money is being spent by the government on the highly preventable diseases associated with excess weight. Inversely, concomitant weight reduction would ameliorate this problem. Measuring Health: When is Weight “Overweight”? The Journal for Obesity Research (1998) established key measures to determine if a body is overweight. Body Mass Index or BMI measures the distribution of weight for height (CDC, 2005) and is computed the formula: BMI = [weight (lbs)/height2 (inches)] x 703. A BMI greater than 25 to 29.9 is considered overweight, while a BMI 30 or greater is considered obese. However, though percentage of body fat is indeed one of they key measures of determining risk, it is only one of the measurements used. Another is the waist circumference measure or waist–to–hip ratio, which measures the distribution of adipose tissue by dividing the minimal waist circumference with the maximal hip circumference. A waist-to-hip (WTH) ratio of more than 1.0 for mean and 0.8 for women is already a measure of obesity (Mladenovic and Bessesen, 1995). An increased BMI, with a WTH ratio on greater than 0.8 in women, coupled with the presence of co-morbidities such as Diabetes, Hypertension, Heart Disease and related diseases increase the mortality rate for this population. Whenever caloric intake exceeds energy expenditure, the result is a gain in weight. In addition, consuming more fat than one burns, results in a positive “fat balance” which also contributes significantly to weight gain. Other factors include genetics (which explains 25-30% of weight variation in the population); dietary influence (“Western” or “Modern” diet which promotes a positive fat balance); decreased energy expenditure (due to decreased physical activity or lack of exercise); appetite (obese and overweight individuals have a preference for high fat food); and metabolism (number and size of fat cells in the body). Reviewing Risk Factors Associated With Being Overweight The percentage of women who are overweight or suffering from obesity is alarming, more so when the risks associated with excess weight is taken into consideration. Women with a BMI greater than 25 and an elevated waist-to-hip ratio have an increased susceptibility to diabetes, hypertension, cardiovascular disease (due to increased levels of cholesterol and triglycerides in the body), gout (joint pain caused by excess uric acid), osteoarthritis (wearing away of the joints), gallbladder disease (formation of gallstones that clog the gallbladder), breast cancer, endometrial cancer and polycystic ovary syndrome. (Hu, 2003). Suicide Risk Increases for Overweight, Depressed Women Another major risk factor for overweight women is depression. Women with a disturbed body image often suffer from self-esteem issues. In a study by Friedman, Reichmann, Costanzo and Musante on the relationship between obesity and psychological distress (2002), they found that: “(1) body-image evaluation was related to both depression and self-esteem, (2) degree of obesity was correlated with body-image evaluation, (3) degree of obesity was associated with depression and self-esteem, and (4) the relationship between weight and depression/self-esteem was partially mediated by body image.” The study is disturbing in that it adds another risk factor to the issue of being overweight or obese: suicide. About 15% of those who are clinically depressed die by suicide (Suicide and Depression, 2004). According to Charles Palmer in his 2003 article “Body Mass Index, Self-Esteem, and Suicide Risk in Clinically Depressed African American and White American Females”, it was found that depressed, obese White American females had significantly lower self-esteem and increased suicide risk than depressed healthy-weight and overweight White American females. Lifestyle Modification: The Benefits of Exercise Exercise plays an important role in a successful weight loss program. Since weight gain happens because of a positive caloric balance, in order to lose weight, an overweight individual must either decrease caloric intake or increase energy expenditure in order to produce a negative caloric balance (Hu, 2003). In essence, one must either eat less than one burns or burn more than one eats. Why Diet Alone Is Not Enough In a recent article on Clinical Obesity by Dr. Edward Abramson (2005), he underlined the futility of using dieting as the sole means of losing weight. Americans have taken advantage of many dieting trends and fads like the use of Very Low Caloric Diets (VLCD) whereby the dietary intake of calories is decreased to 800 kcal/day (Mladenovic and Bessessen, 1995) to extremely low fat or low carbohydrate and even an all protein diet, in order to lose extra pounds. Although, these diets can produce moderate to significant weight loss, there is still, according to Abramson, “no compelling evidence that dieting alone produces permanent weight loss.” In a report by Dr. Richard Lewanczuk on the effects of “Long-term Dietary Interventions: Effects on Weight Loss and Health” (2004), he stated that dieting alone is insufficient for long term benefits because most people who use dieting as the sole means of losing weight gain back the weight they lost after one year. Dieting ignores the underlying reasons why an individual eats. In most cases of persons who are overweight or obese, there is an underlying psychological need to eat, that goes beyond the need to physically replenish one’s energy stores. For many women, eating is a way to cope with stress, anxiety, anger or depression. Since dieting focuses only on the physical aspects of weight loss, it does not address these issues, which are often times the root cause of weight problems (Abramson, 2005). Burning Calories: Key To Good Health The benefits of exercise are multifold. According to the AHA Guideline on Cardiovascular Disease Prevention in Women (2005), women who exercise reduce the risk of suffering from sudden cardiac death (SCD) and the development of cardiovascular diseases. This is especially true for women who are near the age of menopause, because they are particularly prone to weight gain during these times (Thomson, Rakow and Perdue, 2004). Exercise is also credited with lowering the risk for the development of type 2 diabetes. The center for Disease Control and Prevention as well as the American Heart Association advocate use of aerobic exercises with the end goal of burning 400 calories per day. This may be done through a combination of activities that include a formal workout or brisk walking. Exercise lowers the blood pressure and reduce cholesterol levels in the body with weight reduction increases the production of HDL-C (the good cholesterol) by as much as 1 mg/dL for every 3kg or 7 lbs of weight loss.(Mosca, Hsia and McBride, 2005). Low levels of HDL-C have been associated with increased risk of coronary heart disease (CHD). Exercise keeps the heart muscles healthy by improving the pumping efficiency of the heart and by lowering the heart rate and improving the dilatation of blood vessels that supply the heart muscles (Exercise Not Drugs, 2000). Calorie burning and weight reduction activities are also associated with the reduction of risk for the development of colon cancer (Allen, 2001). Women who exercise regularly tend to maintain their weight loss more often than those who exercise for only brief periods, such as women who wish to lower weight quickly or those who engage in fad weight loss diets. Studies have shown that regular exercise among teenaged women, especially those engaged in sports activities have decreased risk for depression, drug abuse or unwanted pregnancies. They generally have higher self-esteem than their non-exercising, overweight counterparts. For the older, menopausal woman prone to weight gain, exercise helps improve muscle tone and promote the development of lean muscle, which leads to increase muscle strength and continued skeletal development. This in turn, leads to a stronger muscle-skeletal base, key to the prevention of falls and fall-related mortality in elderly women. Regular physical activity carries benefits beyond the need for weight loss. It significantly decreases the risks of developing diseases associated with obesity. How Much Exercise Is Enough? In order to attain and maintain one’s desired weight and reverse obesity or overweight related risk factors, it is advised that an individual exercise at least 30 minutes as day and do resistance training for 20-30 minutes per week (CDC, 2005). However, if one wishes to lose weight John Jakicic, PhD of the University of Pittsburgh’s health and physical activity department, recommends that 300 minutes of exercise, coupled with dietary changes should be done every week (Hitti, 2005). Moderate exercise, as opposed to vigorous exercise is also advised. There is no significant difference in weight reduction in women who undergo a rigorous exercise regimen than women who do moderate intensity exercises (JAMA, 2003). Conclusion The long-term benefits of an exercise program for women who are overweight are multitude. Physical activity whether it involves brisk walking or moderate aerobic exercise significantly decrease the risks associated with a BMI greater than 25. Successful weight loss clearly reduces blood pressure, improves insulin action and blood glucose control, puts less stress on joints, and improves the lipid profile. However exercise alone, despite its clear benefits, cannot be taken as the sole means of reducing weight and regaining health. Eating healthy, reducing saturated fat in the diet, behavior modification therapy (exploring the psychological reasons for craving food), even surgical and pharmaco-therapeutic means of weight reduction should also be taken into consideration if weight loss is to be maintained. Women, who are especially prone to the problem of weight gain as they grow older will benefit from a holistic approach to weight loss that addresses both their physical as well as psychological needs. This will, in the long run, help them maintain their ideal body weights and minimize their risk of developing complications associated with being overweight or obese. Literature Cited Abramson, E. (2005). Clinical Nutrition & Obesity: On the Futility of Dieting. Medscape General Medicine 7(4),p31. Allison DB, Fontaine KR, Manson JE, Stevens J, Vanitallie TB. (1999) Annual deaths attributable to obesity in the United States. JAMA 1999;282:1530-1538. Allen, S.R. (2001). Exercise: Her Options. South Medical Journal 94(12):1143-1144 AOA Fact Sheets. (2002). American Obesity Association. Retrieved on November 28, 2005 from http://www.obesity.org. Barclay, L.(2004). AHA Updates Guidelines for Cardiovascular Disease Prevention in Women. Medscape Medical News. Retrieved on November 26, 2005 from http://www.medscape.com/viewarticle/468708 Blackwell, G.L., Lewancauk, R. (2004). Long-term Dietary Interventions: Effects on Weight Loss and Health. Medscape. Retrieved November 26, 2005 from http://www.medscape.com/viewprogram/3455_index Exercise, Not Drugs, an Effective First Option to Reduce High Blood Pressure. (2000).Medscape Medical Journal. Retrieved on November 27, 2005 from http://www.medscape.com/viewarticle/412069 Finkelstein, E.A., Fiebelkorn, I.C., Wang, G. (2004). State-Level Estimates of Annual Medical Expenditures Attributable to Obesity. Obesity Research 12. p18-24. Friedman, K. E., Reichmann, S. K., Costanzo,P.R., Musante G.J. (2002). Body Image Partially Mediates the Relationship between Obesity and Psychological Distress. Obesity Research 10:33-41. Hitti, M. (2005). How Much Exercise Sparks Weight Loss? WebMD Health News. Retrieved on November 26, 2005 from http://www.medscape.com/viewarticle/514802 Hu, F.B. (2003). Overweight and Obesity in Women: Health Risks and Consequences. Journal for Women’s Health 12(2), 163-172 Little, L. (2005). Consistent, Moderate Exercise Reduces Women's Risk of Sudden Cardiac Death. Medscape Medical News. Retrieved on November 28, 2005 from http://www.medscape.com/viewarticle/504456 Mladenovic, J., Bessesen, P. (1995). The Obese Patient. Primary Care Secrets.(pp. 397 - 404). Singapore: Hanley and Belfus, Inc. Mosca, L., Hsia, J. A., McBride, P. E. (2005). 11Women's Agenda Targeting Cholesterol in Heart Disease (W.A.T.C.H.) Case Studies Series: Interaction for Improved Intervention. Medscape CMEs. Retrieved on November 26, 2005 from http://www.medscape.com/viewprogram/4081_index. Palmer, C.J. (2003). Body Mass Index, Self-Esteem, and Suicide Risk in Clinically Depressed African American and White American Females. Journal of Black Psychology, Vol. 29, No. 4, 408-428 Poston, W.S.C., Foreyt, J.P. (2000). Successful Management of the Obese Patient. American Family Physician, Vol. 61/No. 12. Thompson, D.L., Rakow. J., Perdue, S.M. (2004). Relationship Between Accumulated Walking and Body Composition in Middle-Aged Women. American College of Sports Medicine. Retrieved on November 27, 2005 from http://www.medscape.com/viewarticle/478984 United States Department of Health and Human Services. (2001). The Surgeon General's call to action to prevent and decrease overweight and obesity. Rockville, Md: Public Health Service, Office of the Surgeon General Read More