OBESITY: ARE YOU TRYING TO LOSE WEIGHT?

Need to lose weight? How?

Need to lose weight? How?

Look around! Have you noticed how most people are overweight? You have heard about the obesity epidemic, but why should you care? For you, is it about your appearance? Do your clothes no longer fit? Is it about how you feel when you try to exercise? Are you thinking about your health? Or perhaps your children’s health? Even so, once you decide to lose some pounds, do you know how?

Why Should You Care?

In fact, there is a worldwide epidemic of obesity in just the last six or so decades. It started in the developed world and has spread throughout emerging countries as their middle classes rise. All races are affected.

In 2015 in the United States, over 20% of the population in ALL states are obese. In 45 states, the obesity rate is over 25%. In 22 states, over 30% of the population are obese. Finally, the obesity rate in three states (Arkansas, West Virginia, and Mississippi) is over 35% percent! Moreover, kids between 2 and 19 years of age have a 17% obesity rate.  And these numbers are measure of obesity. The milder version, called “overweight”, shows numbers approximately twice these!

These are astounding figures with profound consequences!

There is good news in one area ….. In the US, a massive campaign against childhood obesity, importantly led by Michelle Obama, has produced some results. The obesity rates of children between 2 and 5 has decreased from 13.9% in 2003-2004 to 8.4% in 2011-2012!

A strong case can be made that modern technology and urbanization are leading to lifestyle changes leading to obesity. From caveman days, everyone was very active simply to survive. Even the advent of agriculture still required lots of activity. And people continued to sleep soon after sundown while getting up around dawn.

As people moved to cities and invented lights, sleep reduced accordingly and exercise declined in parallel. Then automobiles were developed, reducing exercise even more. Nowadays, more and more people are sedentary, sleeping less while spending more time on various types of screens, and eating foods out of stores with higher levels of refined and processed foods.

An interesting study shows what to do about these factors in childhood obesity. Following 8,550 4-year-olds, childhood obesity reduces 40% by following three simple things: sharing family dinner 5 days a week, having children get 10.5 hrs of sleep a night, and limiting TV to 2 hours a day during weekdays.

[Anderson, Whitaker, Journal of Pediatrics, Mar 2009]

So What? What Are the Health Dangers of Obesity?

It is very well-known that heart disease and many cancers are related to obesity. The rate of colon cancer is double that of non-obese people.

One large study followed 17,643 adults for over 3 decades. Obese people in this study had a 43% higher rate of heart disease even in those whose blood pressures and cholesterol values were perfectly normal!

[Journal of the American Medical Association, Jan 2006]

Young girls experience early puberty if they are obese.

[Joyce Lee, Journal of Pediatrics, Mar 2006]

A huge study of 186,000 adults followed over time shows that overweight people suffer premature death at 20-40% higher rates. This premature death rate is 300% higher in obese people. This confirms a similar study of 1.2 million people followed in a Korean study.

[New England Journal of Medicine, Aug 2006]

Of course, you are not merely concerned about premature death rates. You want to know what chronic diseases arise from overweight or obesity:

Heart Disease and Stroke

High Blood Pressure

Diabetes

some Cancers — especially breast and colon.

Gallbladder Disease and Gallstones

Gout

Sleep Apnea

Asthma

[https://www.webmd.com/diet/obesity/obesity-health-risks]

What Can You Do to Lose Weight?

As readers of these blogs know, 50% of weight loss occurs by sleeping between 7 and 9 hours in a 24-hour cycle. About 30% is adequate exercise, which needs to be at least one hour a day in women. Diet represents about 10% of weight loss, contrary to many commercial marketing programs prevalent on the internet.

A very important principle to understand is that rapid weight loss fails. Approximately 90% of people losing more than 2 pounds a week end up regaining their weight, plus 10% or more, within a few months!

The optimal rate of loss is 1 or 2 pounds a week. It is a good strategy to keep a record of your weight once or twice a week. If you lose too fast, cut back on your program. And of course, if you are losing too slowly, increase your program.

Far and away the most important focus is to maintain your weight loss once you achieve your target rate. Most people neglect this step! They actively lose weight and then relax disciplines once their target is achieved. Your body thrives on routines, so maintaining the disciplines that got you to your target — for the rest of your life — is crucial!

The first task is sleep! There is plenty of research showing that weight loss is very  difficult if you sleep less than 7 hours or more than 9 hours in a 24 hr cycle.

The most thorough sleep and obesity study followed 18,000 adults. Those who sleep less than 4 hours have a 73% higher rate of obesity. Those getting 5 hours have a 50% higher obesity rate. And those getting 6 hrs of sleep have 23% higher obesity rates. The trend in these numbers suggests that this is truly causative rather than merely a coincidence or random correlation.

[Heimsfield, Gangwisch, National Health and Nutrition Examination Survey (NHANES), presented at North American Association for Study of Obesity, 2004]

Another interesting study showed that increasing sleep by merely 20 min decreases BMI a statistically significant amount.

[Archives of Internal Medicine, Jan 2005]

The next discipline is exercise! Although there are studies that suggest diet is effective even in the absence of exercise, this is a difficult approach to maintain over time, plus exercise is crucial for many other reasons including heart disease prevention, arthritis relief, immune support, prevention of dementia, and cancer prevention.

For adult women, the need for weight-loss exercise is 60 minutes daily. Casual walking is not good enough, nor is walking the dog or ordinary gardening. The idea is to exert at a level to be slightly out of breath and sweating. The best study involved 34,079 women and was quite convincing.

[Journal of American Medical Association, Mar 2010. This study bolsters similar results found by the Institute of Medicine in 2002.]

Finally, diet needs to be approached! There is a huge industry making vast amounts of money addressing this topic. Research validates Weight Watchers and similar approaches as being effective. Then there are other studies for Atkins, Paleo, Vegan, low-fat and high-fat.

An obvious bottom line, validated by many studies, is avoidance of refined and processed sugar and grains. Fresh foods are optimal. Common sense reigns. Simply remember that the closer we get to our Caveman-evolved genes, the better.

The one common denominator in all these approaches is portion control. People weigh their food, and count calories, keeping records all along. The problem with these tasks is that they are not appropriate for long-term management for the rest of your life! It is fine to lose weight to the target goal, but maintenance over a long time is even more important.

I have a simple approach. Instead of measuring food, simply count fistfuls. Start by thinking about your daily food portions prior to starting your program. Imagine how many fistuls of food you eat in a whole day, no matter whether it is vegetables or meat or cake! Lets say you are eating 15 fistfuls of all kinds of food in a day.

Then set a goal that is, say, 30% less. If you were eating 15 fistfuls a day, apply enough discipline to eat 10 fistfuls in a day.

This, along with 7 to 9 hrs of sleep and one hour of exercise a day, should be enough to lose 1 or 2 pounds a week (not more!). If you lose too fast or too slowly, you can adjust the number of fistfuls a day.

The advantage of this approach is that larger people have larger calorie needs and usually have larger hands! Smaller people have correspondingly smaller hands! Moreover, this is an easy  way of managing portion sizes for the rest of your life! It becomes second nature!

 

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