Many South Africans are living a deathstyle, not a lifestyle. So says Dr. Gary Hudson, a Specialist Physician with a particular interest in weight management. He was responding to the fact that South African women now have the second highest obesity rate in the world after the United Arab Emirates. This puts the percentage of obese women in South Africa as higher than in the United States of America, a country which was long touted as the fattest nation on earth.1 South African men are not off the hook either, coming in at third place globally.1
Obesity is defined as a chronic, relapsing, multifactorial disease. So much more than being overweight, obesity is a significant risk factor for several other non-communicable diseases (NCDs) such as diabetes, heart disease and certain cancers, amongst others.2
In fact, while Dr. Hudson says that it is the most common non-communicable disease globally, it is also fully treatable and fully preventable1. "If left unchecked, it will ultimately be fatal," he says. The most widely used method of measuring and identifying obesity globally is body mass index (BMI), which is calculated as weight in kilograms divided by height in metres squared. In adults, a BMI of ≥30kg/m2 is defined as obesity, and is the standard measure used by the World Health Organisation (WHO).2
Although commonly used, BMI can be a restrictive measurement, with the waist-to-height ratio being a more accurate measurement that can be applied to anyone, including children.1 Also referred to as the 'string test', this measures a person's abdominal girth (measured just under the ribs), with this measurement needing to be equal to or less than half of a person's height1. For men, abdominal girth should be 94cm or below and in women, this should be 84cm or less1. Waist-to- height ratio is also a strong predictor of hypertension.3
While the number on the scale is what many of us might focus on, Dr. Hudson says that weight isn't the problem, the problem is how much fat we have and where the fat is sitting, with visceral fat being the most important measurement.1
Visceral fat is the fat located deep within the cavity in the belly surrounding some of our vital organs. This fat is worse for your health than fat anywhere else in the body and is just as harmful for your heart as high blood pressure and smoking. Fat around the belly also makes you more likely to have a heart attack and more likely to have a stroke.4
Another revelation that might surprise many is that brisk walking has been shown to be the most effective exercise when it comes to weight loss. The World Health Organisation recommends brisk walking for 30 minutes 5 times a week, at a pace where you can talk but you can't sing1. The good news is that by losing only 5% of your bodyweight, your risk factors start to improve, and these will improve even more with a 10% loss. According to Dr. Hudson, for some patients who lose 15% of their bodyweight, some of their comorbidities disappear.1
Dr Hudson also stresses the importance of sleep, and that 30% of weight problems are rooted in sleep, or lack thereof. While lifestyle changes, improved nutrition, increased movement, and better sleep are imperative, for many people, medication or surgery are also viable and sometimes vital options.1
In fact, the use of approved prescription medication along with lifestyle changes can assist with rapid weight loss within three months. A 5-10% loss of body weight that can assist with establishing a new set point for your weight.1
With two-thirds of patients visiting a general practitioner in South Africa likely to be obese, your healthcare practitioner is someone who can assist you with the tools and knowledge when it comes to losing weight and making these potentially life-saving lifestyle changes.1
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Content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.
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