Tuesday, May 15, 2012

The Skinny on Obesity: Part 2

Part 2 of "Weight of the Nation" is entitled "Choices" and talks about the different courses one might take to lose weight.  They highlight three: diet, exercise, and surgery.

"The diet industry has no reason to solve the problem.  Solving the problem puts them out of business."
- Susan Yager

A number of overweight participants in this documentary list the different diets they have tried.  Not surprisingly, none of them succeeded.  They call it yo-yo dieting.  You lose a few pounds and gain it all back (and then some).  The rigidity of downsizing a diet coupled with plateauing weight losses discourages dieters and contributes to this "yo-yo" effect.  The problem with this is that weight loss requires these plateaus.

Why do we gain weight?
Weight gain is the product of evolution.  Without the ability to store energy in the form of fat, one famine would knock out every human.  But evolution wasn't kind to women.  Men, typically, gain visceral, or belly, fat.  Belly fat provides an easily accessible store of energy that burns quickly.  Aided by estrogen, women gain weight in their chest and thighs to provide energy for breastfeeding and pregnancy, but this fat does not burn as fast.  A woman's body will actually fight weight loss.

With this knowledge of evolution in mind, it's easy to see why weight loss is such a long process.   Unfortunately people become discouraged when they don't see results as fast as they'd like and then simply give up.  It could take a year for your body's metabolism to catch up and acclimate to your new lifestyle.  Don't give up after a month.  You will lose weight.

Stress and Weight Gain
Stress changes the biochemistry of our blood.  When something is getting us worked up, say a deadline for a big report, our brain perceives the stress as a threat.  This triggers the secretion of adrenaline and cortisol.  Cortisol is a steroid hormone, which is responsible for the metabolism of fat, protein, and carbohydrates.  An increase in cortisol tells the brain to look out for more calorie dense foods.  This is why stress eaters reach for ice cream over carrot sticks.  Ice cream has more calories than a carrot (whose caloric content is negligible at best).  It doesn't help that foods high in sugar and fat produce an opioid-like , or pleasurable, sensation.  

The same reaction that causes pleasure from fatty foods can be mimicked by the effects of exercise on the body though.

Physical Activity Guidelines (for adults) are:
  • 150 minutes of moderate aerobic activity every week.  (That's about 22 minutes a day.)
  • Muscle strengthening exercises performed twice a week.
Climbing stairs, walking to the store, playing with your kids-- even sex is exercise.  Find something that you enjoy doing and get out there!

For those who have exhausted their options and continue to be obese and sick, there is bariatric surgery, but it comes at a price.  1 in 300 patients die from the surgery.  There is also the possibility of multiple infections, fistulas, kidney stones, etc.  There is a slew of consequences associated with this surgery.  One must weigh the risks against the reward.  It is by no means the easy way out.

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