Obesity is the most important public health problem in resource-rich countries. With the increased prevalence of obesity has come the increase prevalence of its comorbidities, such as the metabolic syndrome and cardiovascular disease (CDV). Obesity isn’t just being above ideal body weight. Obesity means an excess of fat. Although not perfect for clinical application, the standard estimate that is used to assess the degree of obesity is the relation between weight and height–the body mass index (BMI).
Adults with a BMI between 25-30 kg/m2 are considered overweight. Beyond that, designations such as obese and morbidly obese are applied to a progressive BMI score template.
While it is felt by some that overeating is an addiction, this analogy falls short in that one must eat to survive. The gift of taste as a sense is a double-edged sword, in that the pleasure invoked from eating something that is delicious is associated with the release of the “reward” neurotransmitter, dopamine. When men were hunter-gatherers and women worked hard with children and household chores, they ate to survive. The pleasures of today’s culinary arts, combined with the epidemic of physical inactivity, portends poorly for society, now trending toward obesity at an epidemic scale.
While the analogy to addiction falls short, it isn’t completely untrue. Cravings for the pleasures of eating or due to the necessity for psychological crutches (“comfort food”) that afflict persons with depression and anxiety can make management very difficult.
The problem is obesity and the solution is weight management. Weight management, however, is fraught with pitfalls that conspire to defeat the best intentions:
Today’s social climate: we are social animals. We meet together, we entertain together, we savor special occasions, all of which involve eating. Birthday parties, the Superbowl, romantic dinners–every day offers sabotage to any diet.
Today’s social media: we are constantly barraged by succulent items on fast-food commercials. We are also seduced by advertisements that promise magical weight loss by use of pills or special exercise devices.
Psychological issues: the food-hoarding of abused children is revealing into how psychological disturbances can affect our eating habits. Many obese individuals who fail to lose weight consider themselves victims–and many rightfully are–which make them feel hopeless. With hopelessness comes a lack of all motivation.
Unreasonable expectations: weight was gained slowly, so the best way to lose it is slowly. Rapid weight loss always fails, simply because a person suffers until a goal was met, only to re-emerge into the same old habits, instead of changing his or her entire life to attain and live that goal comfortably.
Barriers to weight loss: family obesity dooms any individual’s diet by the close proximity of poor food choices. Insurance companies often will not cover consultations by dietitians or nutritionists, and certainly will not cover the expense of gym memberships.