Obesity is truly an epidemic in the United States, and growing at an alarming rate. In the early 1960s, it was estimated that roughly one in eight Americans were obese. Yet at the turn of the century, that figure grew to nearly one in every three Americans. Even more frightening, at last count, nearly two out of three Americans are overweight, and childhood obesity has tripled since 1980. With this rise in obesity, so too has obesity-related death risen. Obesity is blamed for close to 300,000 deaths in America each year, or one death every two-and-a-half minutes.
When we talk about overweight and obese, what do we mean? Both are terms to describe the amount of excess fat an individual carries. To better define the amount of excess fat a person has, one calculation is commonly employed, a BMI (Body Mass Index). BMI is equal to your weight in kilograms divided by your height in meters squared. Accordingly, a normal BMI is less than 25, overweight is a BMI of 25 to 30, while obese is defined at a BMI greater than 30. To avoid this complicated math, I sometimes recommend a simple calculation to determine whether they are at their ideal body weight. Take your height in inches and divide by 2, which should be your waist size or less. If your waist size is greater than this, you are probably overweight.
Interestingly, fat can classically be carried in one of two major distributions. Although everyone is different, men and women tend to carry excess fat in characteristic areas. Men tend to carry excess weight around their waist, the so called ”apple shape.” Women tend to carry their excess weight in the hips and thighs, the so called ”pear shape.” It is now thought that the people who have the ”apple shape” tend to have higher rates of heart disease than their ”pear-shaped” colleagues.
Simply stated, obesity is a killer. Being overweight places you at elevated risks of heart disease, stroke, diabetes, high blood pressure and arthritis. Obesity is associated with an abnormal and unhealthy cholesterol profile, which leads to accelerated rates of atherosclerosis, heart disease and strokes. Excess weight is commonly related to sedentary lifestyle and immobility, both of which raise blood pressure, which again raises the rates of heart disease and stroke. Additionally, carrying around 30 or more extra pounds can ravage the bones and joints, causing accelerated arthritis, joint pain and immobility.
So what can be done? The simple answer is eat less and exercise. Like anything worthwhile, there are no short cuts, only commitment to a long-term goal. I tell my patients not to diet, because a diet implies that there is an end point after which it is back to the same old you. Instead, adopt a healthier lifestyle. Start simple, don't change anything you eat, but eat less. Next, start to make healthier choices. Incorporate fish and lean meats into your diet, and avoid salt and sugar at all cost. A good rule of thumb is ”if it is white, leave it alone.” White rice, white pasta, and white bread are turned into sugar in the body almost as soon as they hit the tongue. Replace these with brown rice, whole wheat pasta and multigrain bread, and throw out the salt shaker and sugar bowl. Hit the fresh fruits and vegetables, snack of salt free nuts and make sweet desserts a rare treat and not a daily staple.
Changing your food intake is merely half the battle. Exercise is essential to get the weight off, and keep it off. If you change your diet alone, you are likely to fail. You simply need to start moving more. Walking is the best and easiest. It is low impact, easy to do and relatively cheap. In the winter, walk outside when possible or indoors at the mall at least five times a week, for at least 30 minutes a session. Start simple with a realistic exercise plan, and make it a part of your life, forever. For others, a more rigorous cardiovascular exercise is appropriate. This can also be done at home, while others prefer gyms, as they help some people achieve their exercise goals. A good rule of thumb for exercise is that at the end of the workout, your face should be warm and red, and you should have broken a sweat. You will maintain a healthy weight, sleep better and feel better about yourself. If you have a medical condition or you have not exercised recently, you must consult with your physician before engaging in any exercise routine.
Obesity is an epidemic in America. But with the right food decisions and exercise, this trend can be reversed. See your physician and talk about these issues. Your heart and health depend on it.
David M. Donaldson, MD, is an Auburn native and currently a cardiologist at Massachusetts General Hospital in Boston.
Interestingly, fat can classically be carried in one of two major distributions. Although everyone is different, men and women tend to carry excess fat in characteristic areas. Men tend to carry excess weight around their waist, the so called ”apple shape.” Women tend to carry their excess weight in the hips and thighs, the so called ”pear shape.” It is now thought that the people who have the ”apple shape” tend to have higher rates of heart disease than their ”pear-shaped” colleagues.
Simply stated, obesity is a killer. Being overweight places you at elevated risks of heart disease, stroke, diabetes, high blood pressure and arthritis. Obesity is associated with an abnormal and unhealthy cholesterol profile, which leads to accelerated rates of atherosclerosis, heart disease and strokes. Excess weight is commonly related to sedentary lifestyle and immobility, both of which raise blood pressure, which again raises the rates of heart disease and stroke. Additionally, carrying around 30 or more extra pounds can ravage the bones and joints, causing accelerated arthritis, joint pain and immobility.
So what can be done? The simple answer is eat less and exercise. Like anything worthwhile, there are no short cuts, only commitment to a long-term goal. I tell my patients not to diet, because a diet implies that there is an end point after which it is back to the same old you. Instead, adopt a healthier lifestyle. Start simple, don't change anything you eat, but eat less. Next, start to make healthier choices. Incorporate fish and lean meats into your diet, and avoid salt and sugar at all cost. A good rule of thumb is ”if it is white, leave it alone.” White rice, white pasta, and white bread are turned into sugar in the body almost as soon as they hit the tongue. Replace these with brown rice, whole wheat pasta and multigrain bread, and throw out the salt shaker and sugar bowl. Hit the fresh fruits and vegetables, snack of salt free nuts and make sweet desserts a rare treat and not a daily staple.
Changing your food intake is merely half the battle. Exercise is essential to get the weight off, and keep it off. If you change your diet alone, you are likely to fail. You simply need to start moving more. Walking is the best and easiest. It is low impact, easy to do and relatively cheap. In the winter, walk outside when possible or indoors at the mall at least five times a week, for at least 30 minutes a session. Start simple with a realistic exercise plan, and make it a part of your life, forever. For others, a more rigorous cardiovascular exercise is appropriate. This can also be done at home, while others prefer gyms, as they help some people achieve their exercise goals. A good rule of thumb for exercise is that at the end of the workout, your face should be warm and red, and you should have broken a sweat. You will maintain a healthy weight, sleep better and feel better about yourself. If you have a medical condition or you have not exercised recently, you must consult with your physician before engaging in any exercise routine.
Obesity is an epidemic in America. But with the right food decisions and exercise, this trend can be reversed. See your physician and talk about these issues. Your heart and health depend on it.
David M. Donaldson, MD, is an Auburn native and currently a cardiologist at Massachusetts General Hospital in Boston.
