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Healthy You Archives |
Protecting Your Health
Obesity-Is It Your Fault?Not entirely, researchers say. Inborn factors also are involvedRecord numbers of Americans are overweight, and there’s no doubt that poor diet and lack of exercise are largely responsible. “But we’re beginning to recognize that obesity has genetic and metabolic components as well,” says family physician Jack Lenhart, M.D., of Lehigh Valley Hospital and Health Network.In other words, it’s not just about the lifestyle choices you make, but also the genes you inherit and the metabolism you’re stuck with. As far as health insurers are concerned, Lenhart says, overweight is still strictly the result of poor lifestyle. But the day may come when obesity is classified as a disease, and insurers pay for treatment knowing that it could prevent serious health problems later. Overweight is fast overtaking smoking as the leading cause of preventable death in the United States. Nearly one-third of us are obese and two-thirds of us overweight, percentages that have doubled in the past two decades. The long-term consequences include diabetes, high blood pressure and high cholesterol—all major risk factors for heart disease and stroke, Lenhart says. Being overweight also raises your risk for various cancers, gall bladder disease, sleep apnea and arthritis. So what does cause overweight?The simple answer is that if you eat more calories than you burn through activity, you gain weight, says endocrinologist Sumon Agarwala, M.D., of Lehigh Valley Hospital and Health Network. With today’s “supersized” portions and heavy reliance on fatty prepared foods, it’s not difficult to let eating get out of control. Likewise, our national pattern of sitting in front of the television or computer and going everywhere by car encourages a sedentary lifestyle.But that’s not the whole story. Overweight also can stem from:Genetic predisposition—“We know that a family his-tory of obesity makes it more likely that children will have weight struggles,” says pediatrician Michael Schwartz, M.D., of Lehigh Valley Hospital and Health Network. Studies of twins reared apart show that genes matter, he says. “But the genetic composition of a population takes a long time to change, so we can’t really blame the sudden ballooning in obesity rates on that.”Metabolic differences—“Some people have a metabolism that lets them store fat more efficiently than other people,” Lenhart says. “It’s probably a protection against starvation that evolved over millions of years. (See “Your Personal Metabolism,” right.) Low birth weight—Surprisingly, babies who weigh less than 5 pounds, 5 ounces at birth are more likely to become overweight adults. “When the unborn baby doesn’t get sufficient nourishment—for example, because his mother smokes—brain signals may cause his body to keep trying to catch up,” Schwartz says. Certain medical conditions—Polycystic ovary syndrome and underactive thyroid are two of the more common obesity-causing conditions, Agarwala says, and other endocrine or hormone-related diseases can lead to obesity since they affect appetite suppression. Finally, people on steroid treatment also may gain weight. What can you do about it?First, figure out the extent of your weight problem by calculating your body-mass index, or BMI (see chart below). But it’s not just the amount of fat that matters, it’s the location. Fat that accumulates in the belly (the so-called “apple shape”) also surrounds the internal organs and carries a higher health risk, Agarwala says, than fat on the hips and buttocks (“pear shape”). The good news is that belly fat is more responsive than hip fat to diet and exercise.Liposuction can trim away fat near the surface but can’t remove the more dangerous internal variety or reduce your heart disease risk. Some new drug and gene therapies for weight loss are on the horizon, and in extreme cases your doctor may suggest gastric bypass surgery. But the answer for most of us is the old familiar prescription: take in fewer calories; cut out fat and sugar in favor of whole grains, fresh produce and lean protein; and get more exercise.  This chart is for adults age 20 or older. To find out how to calculate your child’s BMI, call 610-402-CARE.
Want to Know More about the metabolism test or about nutrition programs at Lehigh Valley Hospital and Health Network? Call 610-402-CARE. This page last updated 2/12/08 04:08 PM
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 January February 2005 Eating Healthy
Staying Fit
Caring for Mind and Body
Just for Women
Just for Men
Raising a Family
Heart of Healthy You
Protecting Your Health
Coping with Illness
Aging Well
Keeping Up to Date
Weight Control
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