More than a billion people are overweight and that number is expected to increase substantially over the next decade. How can we live past 90 while being obese? How can we remain healthy until our last breath? During the last decade, doctors have been successfully applying medical principles to the search for an obesity cure. But there is no magic medication, no vaccine that can head off the obesity epidemic as sweeps across the planet. Dr. Ali discusses the realities of obesity and its repercussions, which include poor health, high medical costs, restrictions on lifestyle and activities, and more. He shows how we can address obesity, starting in childhood, to prevent it from getting worse, both on a personal and on a societal level, and how we can reverse its effects through proper diet, exercise, and lifestyle choices as well as medical procedures and medications.
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THE OBESITY REALITYA Comprehensive Approach to a Growing Problem
By Naheed Ali
ROWMAN & LITTLEFIELD PUBLISHERS, INC.Copyright © 2012 Rowman & Littlefield Publishers, Inc.
All right reserved.
Chapter OneUNDERSTANDING OBESITY
One of the world's leading causes of death from preventable diseases is obesity, widely considered one of the most dangerous and threatening public health dilemmas of the century. The disease has reached global epidemic proportions and affected over 300 million adults who suffer from its clinical form. It is currently viewed as the major culprit of the worldwide burden of chronic disease and disability. It spares no age group, race, gender, religious, or socioeconomic group, and is even found in developing nations with malnutrition and undernutrition in high numbers.
The current obesity epidemic shows the major changes that society has gone through in the past few decades. Although genetics is known to play an important role in defining someone's propensity for obesity, in the end, it could be just an energy imbalance determined by caloric intake and lack of exercise. It is still important to note that changes in nutrition and social transition are driving forces of this epidemic, as are globalization and economic growth. In a world where nations boast a higher number of cars than people, fast food chains rapidly expand to reach even the poorest regions. Jobs go from being highly physical and manual to sedentary. That said, obesity is a dangerous reality at your doorstep.
Obesity levels differ from region to region, with a level of under 5 percent in Japan and some parts of Africa, to a little over 75 percent in Samoa. Even in countries with low nationwide prevalence, such as in China, a few cities like Beijing report that over 20 percent of their population is obese.
Childhood obesity is also reaching epidemic levels in some parts of the world and is on the rise. Estimates show that there are approximately 22 million children around the world below the age of five are overweight. This is observed in Thailand, a country that felt a recent increase in obesity in children between five and twelve years old. The rates spiked from around 12 percent to 16 percent in a two-year period. The circumstances appear to show that not a single region of the world escapes the shadow of obesity.
With the discovery of appetite controlling hormones such as leptin and adiponectin and neurotransmitters such as neuropeptide Y, interest in this disease has grown and, as a result, scientists and pharmaceutical companies developed drugs such as orlistat and sibutramine. Although obesity could have previously been accepted as a sign of good health and wealth, it's now looked upon as a warning sign for many other potentially fatal medical conditions. Global cognizance of the obesity problem is also rising, in hopes of controlling this disease and its catastrophic consequences.
PLANTING THE SEEDS OF OBESITY
The way in which people have looked at obese populations varies by culture over time. In the past, obesity was considered a sign of prosperity, health, fertility, and happiness. However, texts from as far back as the days of Hippocrates describe sudden deaths and horrible ailments in obese people. The thought of obesity being equivalent to wealth and high social class is an older assessment that is antiquated in most cultures today.
For around 95 percent of their existence on Earth, humans have survived as hunter-gatherers and have had to deal with frequent periods of food deprivation. The hunter-gatherer system led to a natural selection process where individuals with a genetic makeup that allowed for energy storage in the form of fat were the ones to survive. Overweightness and obesity were desirable in prehistoric times, since those who survived periods of famine were undoubtedly the ones with greater amounts of body fat. This allowed for the continuance of both tribe and species.
Shaping Obesity into Existence
Signs of obesity have been identified in artifacts from the Stone Age. In the Neolithic Age, artisans made a point of sculpting robust female figurines to symbolize fertility and good health. The earliest evidence of the existence of obesity is the prehistoric statue known as the Venus of Willendorf. Thought to be around 25,000 years old, this statue is exhibited at the Museum of Natural History in Vienna, Austria. It is basically a female figurine with a massive belly and large, pendulous breasts. This was probably meant to represent motherhood and fertility.
Two other known maternal obese figures include the ivory statuette of Lespugue and the limestone statue of Laussel. These figures represent morbid obesity not as a symbol, but a reminder of obesity's theoretical significance in preserving the species.
The Pharaoh's Creed Ancient Egyptian paintings show obesity as a disease, and some archaeologists have discovered Egyptian mummies of persons who were obese when living. The mummified bodies were of people who had died from complications related to obesity, such as diabetes and heart disease. The four-thousand-year-old mummies of wealthy Egyptians also showed striking signs of atherosclerosis and myocardial infarctions (heart attacks). However, statues and depictions of the pharaohs and Egyptian courtesans are almost always "athletic" and designed to inspire admiration. These portrayals differ drastically from the reality of the time, since many famous pharaohs were renowned for their obesity. Amenhotep III and Ramses III were among those topping the list.
China's Output The ancient Chinese were attentive to the early onset of obesity and were aware of its varied consequences. They were among the first to encourage the prevention of fatness as a way to prolong their life expectancy. However, the first Europeans to visit China and the Far East depict the rulers and high officials of the court as being obese.
Indian Roots In Hindu mythology, overweightness was regarded as a symbol of inner happiness. Many ancient Hindu and Buddhist sculptures depict obese, abdominally large, smiling gods.
The Greco Effect The Greco-Roman medical writers Celsus, Pedanius, and Ephesus are widely accepted pioneers in the description of obesity as an illness and seconded the Hippocratic line of thought that the same could in fact be treated. Oribasius, the Roman emperor Julian the Apostate's personal physician, clarifies the basic treatment options such as exercise, dieting, baths, and massages, while all the writers of that era described the importance of emotions and temperament in the onset of obesity. The ancient Greeks and Romans are considered the original experts of diet therapy, and Hippocrates ranks among the first of the great physicians interested in the topic of nutrition. He initially described some of the factors leading up to obesity as well as ways to combat the illness, including adequate amounts of exercise and sleep and diet plans.
Also noteworthy are the Spartans, who lined up their young men at the beginning of each week and enrolled anyone who looked like they had gained weight in a rigorous exercise program. If the results weren't up to par by the beginning of the following week, any young man who didn't fit the bill was banished from Sparta as he was deemed worthless for battle. The health-conscious Spartans considered obesity an unforgiveable sin and shame to their nation.
Britain During the Middle Ages and the peak of the European monarchies, obesity stood for power and influence in high circles of society. Due to favorable views on obesity, great wealth and prosperity accompanied those who survived the famines and plagues, and monarchs were frowned upon if they lacked huge appetites and were thin.
The Church The Catholic Church's position on obesity was that it was a punishment for gorgers. Being obese was a deadly sin. Whereas the church frowned upon obesity, most artists of the time ignored conventional standards and painted obese individuals as the primary subjects of many portraits. This attitude was also adopted by monks, among whom obesity was common at the time. During the thirteenth century, however, Pope Innocent III centered his attention on gluttony and condemned all clergymen who were obese and overweight. Researchers discovered that Benedictine monks living in a monastery in Edinburgh, Scotland, during the twelfth century developed a natural potion to reduce appetite so they would be able to fast without feeling hungry. According to historians and anthropologists, the monks of the Sutra Aisle monastery and hospital made this concoction using a bitter plant centuries ago.
The Tribal Sense Since ancient times, in some parts of Mauritania, women who are not obese are unlikely to marry. Larger brides-to-be are revered, celebrated, and sought out for marriage due to the belief that their weight ensures good health and betters the odds for childbearing. Mothers dedicate much time, effort, and wealth to feeding (and sometimes force-feeding) their young daughters to ensure they will be attractive to future suitors. In exchange, men offer their riches and proposals of marriage only to the most overweight girls.
Many African tribes look at obesity as a requirement for having children, and great care is taken to "plump up" girls until they reach an acceptable weight before the marriage is allowed to take place. Family conflict ensues since mothers take great care in giving the future bride the best food (and in most cases the only food) the family has, potentially leaving others to starve.
Is Obesity Part of a Lost Custom?
In the sixteenth and seventeenth centuries, overweightness and obesity were considered symbols of sexual attractiveness and well-being. Scholarly theses on the subject of obesity date back to as early as the end of the sixteenth century, and medical monographs describing the illness first appeared in the eighteenth. Most of these texts blamed the obese person for being morally weak—for allowing themselves to reach such a state of apparently unacceptable health. Although these texts were still influenced by the thinking of Hippocrates and Galen, they introduced some new ideas about chemical and physical aspects that made a theoretical basis for understanding the functions of the body.
One of the greatest proponents of these ideas was the Italian named Giovanni Alfonso Borelli. His ideas about the origins of obesity took some of the fault away from the person and put more blame on the functioning of the body. Obesity may be part of a lost custom after all, partially proven by this time period, which also depicted obesity in the form of art, for example, in paintings by Peter Paul Rubens, who required that his models be overweight. The term rubenesque is named after him and refers primarily to overweight women.
WATERING OUR KNOWLEDGE THROUGH RESEARCH
During the eighteenth and nineteenth centuries, medical research brought forth many important findings that were related to obesity and its causes, beginning with the identification of the human cell. Many human cell types were described, including the "fat cells" known today as adipocytes. The possibility that obesity was due to an excess of this cell began to be widely accepted by doctors and researchers.
Lavoisier's calorimeter, the first device to successfully measure calories, unearthed the idea that calories are involved with obesity. Known as the creator of the caloric theory and as the "father of modern chemistry," Lavoisier is credited with conceptualizing both direct and indirect calorimetry. His theories have been tested and proven.
The body mass index (BMI) as a standard for measuring body weight was developed in the nineteenth century, and remains an important but nonexclusive part of obesity diagnosis today. The role of hereditary factors in the onset of obesity was also described in detail in the past when it comes to obesity research.
With the Declaration of Milan, countries outside the European Union acknowledged obesity as a multifactorial problem associated with numerous comorbidities, including cardiac, rheumatologic, digestive, and endocrine problems. In 2002, the World Health Organization, through its resolution WHA 55.23, developed the Global Strategy on Diet, Physical Activity, and Health. This manifest was adopted by member states in May 2004.
Initiatives to fend off worldwide obesity should apply not only to research professionals, but also to sectors of the population encompassing all levels of government, public health services, the food industry, and the general public. Sectors such as catering, education, and technology should focus on plans to provide information and encourage athletics and physical activity. The World Health Organization has classified obesity as a worldwide epidemic and several countries now have nationwide research programs dedicated to obesity prevention and awareness. This is especially true in industrialized nations.
New hopes in the twenty-first century should lead to more scientific discoveries, especially in genetic research. Another hopeful insight, perhaps more realistic, is the better understanding of how regulating body weight may contribute to the future advancement of more effective medications for obesity treatment.
THE DEFINING MOMENT
Unfortunately, present day culture scoffs at obesity victims and promotes thinness, sometimes to the extreme. This is defined by European fashion runways, as young models strive to be "beautiful," which tortuously means "thinnest." Research also shows a massive increase in incidence rates of anorexia and bulimia in both young females and males. However, these statistics are small in comparison to the obesity numbers and its many severe complications. Research suggests that more than 30 percent of all adults living in the United States are obese, and difficulties from obesity are the number one cause of death in the country. This may unhappily turn characteristic of many other countries in the years to come.
Regrettably, people occasionally associate the term "morbid obesity" with massive, deformed, bed-ridden bodies, unable to move and weighing hundreds of pounds. The medical disease known as "obesity" generally refers to an excess of total body fat that may lead to adverse effects on your health. The word has its origins in Latin, where the obesus is a contraction of two Latin words: ob, which means "toward," and edere, which means "to eat."
The body is comprised of different substances including a high percentage of water, protein, and fat, among other things. The normal functioning of the human body depends on a careful balance of these percentages. Adequate percentages of fat are required for the storage of body energy, shock absorption, and heat insulation, as well as other essential body functions. When these percentages are distributed inaccurately, along with the excess of fat, obesity develops.
Being obese and being "overweight" isn't the same. BMI compares your weight and height and is used to determine when you are overweight or obese. BMI is calculated by dividing your weight, measured in kilograms, by your height, measured in meters squared (m2). When in generally good health, you reach a BMI between 18.5 and 24.9. A BMI above 25 may indicate too much fat unless excessive muscle weight is responsible. A BMI greater than 30 delineates you as obese. So, fatness is not limited to what is called morbid obesity, but to anyone with a BMI greater than 30. This is very common, with some capital cities having a 25 percent prevalence of overweightness in their adult population.
WHEN ONE LEADS TO THE OTHER
There are quite a few physical, social, and psychological consequences associated with obesity. Being obese is a serious risk factor for many life-threatening medical conditions and symptoms including: cardiovascular diseases such as coronary heart disease (CHD) and hypertension; Type 2 diabetes; elevated cholesterol; gallstones; gout; osteoarthritis; lower back pain; and pulmonary diseases such as sleep apnea. Some studies point out that at least 80 percent of people diagnosed with Type 2 diabetes mellitus are either obese or overweight. This correlation is very important because being overweight puts extra stress on your body, bringing down your ability to maintain adequate blood sugar levels.
Diabetes-Related Obesity Obesity can turn into diabetes, and with it, the series of health risks that the latter brings. In several cases, obesity will make the body resistant to insulin, thereby affecting the way you use insulin and transform energy. For people with diabetes, it will mean that a higher dose of insulin will be required for treatment. For people without diabetes, getting obese substantially bumps up the risk of having the former.
Excerpted from THE OBESITY REALITY by Naheed Ali Copyright © 2012 by Rowman & Littlefield Publishers, Inc.. Excerpted by permission of ROWMAN & LITTLEFIELD PUBLISHERS, INC.. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Part I:The Big Picture
1: Understanding Obesity
2: The Diagnosis
3: Causes and Symptoms
5: Obesity in America
6: Worldwide Obesity
Part II: The Front Lines
7: Childhood Obesity
8: Obesity and Mental Health
9: Blame and Guilt
10: The Economics of Obesity
Part III: Keep it Up!
11: The Art of Exercise
12: Finding Motivation
Appendix A: Obesity-Related Websites
Appendix B: Research and Training
Appendix C: Obesity-Related Organizations
Appendix D: Selected Studies
About the Author
What People are Saying About This
...A well-written, easy to read fat-fighting book... (John Basedow, Fitness Expert and TV Personality)
This book is very concise and factual, yet easy to read for everyone. It is inclusive of all the current data on obesity. I was especially impressed with the vivid descriptions of the surgical treatments. It’s definitely much to my liking and highly recommended.
Ali has presented us with a book that serves as an essential tool in the worldwide fight against the epidemic of obesity. He opens our eyes to the multitude of physical, emotional and inter-relational effects of a disease that affects a growing proportion of our nation. The health, economic and societal burdens of obesity cry out for more national and personal attention. Dr. Ali's book thoughtfully and logically takes our collective hands and says, ‘Here is the problem. These are the consequences, and this is what we need to do about it.’
The Obesity Reality is a fascinating look at the greatest health challenge the world faces today. The author increases our knowledge and understanding of obesity using both a scientific and medical approach. He covers all aspects of obesity, including history, pathophysiology, social, legal, economic aspects and provides some practical advice. This is a concise but comprehensive guide for anyone who is wrestling with excess weight and wants to conquer their problem through greater understanding and knowledge.
Naheed Ali’s The Obesity Reality has something to offer to a wide audience. Overweight adults, parents of obese children, doctors, corporate CE's and government policy makers will all find great value in this book. The author goes on to explain the physiological basis of digestion and the transformation of various foods into energy. This is followed by a section on the diagnosis of obesity, which stresses the need to exclude (by seeing a doctor) medical conditions that can present as excessive weight gain. Moreover, the chapters on childhood obesity, aimed primarily at parents, and links between mental health and obesity also contain vital information that all health professionals should be aware of.
Ali's book offers a comprehensive look at the causes of obesity and the ways to reverse it. His thoughtful, well-documented book is written in language that anyone can understand. His approach to preventing or reversing obesity is based on rock-solid science. He offers sound advice on working with your physician as you reverse obesity and sound advice on creating good eating habits for your kids. Read this book and make it part of your 40-year plan!
Most Helpful Customer Reviews
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