Make us your home page
Instagram

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

feeling fine

It's time to get serious about obesity

Recently, a 47-year-old woman walked into my clinic for medical evaluation and consultation. Her chief complaint was fatigue when she exerted herself by climbing a flight of stairs or walking quickly. She had multiple medical problems including high blood pressure, diabetes and arthritis. She was 6 feet tall, and weighed just over 300 pounds. So her body mass index (BMI) was 40.7 — well over the obesity definition of 30 and above.

When I suggested her weight was likely at the root of her problems, she frowned. "I am not overweight. This is not fat. I have been an athlete before. See these muscles?" she said, pointing to her not-so-bulging biceps.

"Your BMI is consistent with obesity," I replied. She was upset.

The most common answer I get when I ask people why they are overweight is this: "Beats me. I eat very little, just one meal a day." On deeper questioning, it's clear many of them have no idea how much they really eat.

Others try to convince me they are not obese. "No doc, this is not fat, it is just fluid," is a common excuse. "My parents are big people, so what do you expect?'' and "It could be my hormones," are favorites, too.

In truth, hormonal imbalance and fluid retention account for very few cases of obesity. When I explain the trouble most likely is what they're eating, many people look surprised.

Most patients become uncomfortable when I try to talk to them about their weight. Some think it is demeaning to be branded "obese," believing the word infers judgment and bias. Some even claim they are proud of their unhealthy weight. A recent TV show paraded several very obese young women, seemingly happy with their size.

However, medical statistics tell a totally different story. There is a litany of complications associated with overweight and obesity, including hypertension, diabetes, heart disease, cancer, sleep apnea and arthritis, just to name a few. Even with small increases in BMI, cardiovascular risk goes up. This is why the American Medical Association's House of Delegates voted to recognize obesity as a disease.

U.S. spending on obesity-related condition already tops $190 billion annually. If current trends continue, spending could rise by as much as $66 billion a year, much of which becomes taxpayers' responsibility.

As a nation, we need to ask some hard questions: Why do we overeat? What can be done about it? The answers depend on whom you ask.

"Oh, I am depressed and stressed out after losing my job," one 63-year-old confided recently.

"I have such a sweet tooth," said another patient.

Obesity is rare in countries where food is scarce. It's also rare for obesity to result from a cause other than overeating. Fact is, most people who are obese got that way from eating too much.

America, it is time to wake up. We need to take this condition seriously — already, 70 percent of U.S. adults are obese or overweight.

Behavior modification is the first step. This includes calorie restriction, portion control, healthy choices, regular exercises and stress reduction. In this regard, I applaud NBC for hosting the The Biggest Loser, a show that focuses on such common-sense approaches to obesity.

"Eat less, live longer," should become our new mantra. Unfortunately, eating less in this land of abundance is not popular. Clearly, the national mind-set has to change.

The Japanese have a saying, "hara hachi bu,'' which means, "stop eating when your hunger feels sated.'' Not when your stomach is full or until your appetite is satisfied.

So, the first step to lose weight is to reduce the amount of food you tuck away on a daily basis. Cut down on calories — decalorification, if you like. Try low-calorie veggies and fruits for snacking. And exercise regularly. The final option is bariatric surgery, although it is expensive and inconvenient and comes with its own risks.

We need to face the tough facts about obesity, and take action as a society and as individuals. We have a responsibility to secure a healthy future for our younger generation. As the new AMA president, Dr. Arden Dee Hoven, said in her inaugural speech, "The future of health care is in our hands." And that means all of us should maintain a healthy weight.

M.P. Ravindra Nathan, M.D., is a retired Brooksville cardiologist who volunteers at a community clinic in Spring Hill and speaks at area hospitals.

It's time to get serious about obesity 07/12/13 [Last modified: Thursday, July 11, 2013 4:10pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times

    

Join the discussion: Click to view comments, add yours

Loading...
  1. What you need to know for Monday, July 24

    News

    Catching you up on overnight happenings, and what you need to know today.

    At 1.2 million gallons, the house of Harry Barkett in South Tampa used more water than anyone else in the Tampa Bay region between Jan. 1 and May 31 of this year, when Tampa was in a severe drought. ALESSANDRA DA PRA  |   Times
  2. Discovering the true meaning of Black Forest cake in the German region itself

    Cooking

    The first time I had a taste of the Black Forest, it wasn't by way of cake.

    Black Forest Cake in Germany was granted legally protected status in 2013. It must use the gateau’s original ingredients, including kirsch, a brandy made from fermented sour cherries from the region.
  3. Gov. Scott's tough talk on Venezuela may not turn into economic action

    State Roundup

    TALLAHASSEE — To show his solidarity with Venezuelans, Gov. Rick Scott held a rally in South Florida and repeatedly promised to punish companies that do business with the Nicolás Maduro regime.

    Gov. Rick Scott held a rally July 10 at El Arepazo restaurant to show solidarity with Venezuelans. Scott has said he wants to punish companies that work with the Nicol?s Maduro regime.
  4. Paralyzed patients in Florida fear losing health care at home

    Health

    TAMPA — After a 1999 car crash left Albert Hort paralyzed, he lived for a while in a nursing home.

    Albert Hort, 54, is a quadriplegic and receives care at his Tarpon Springs apartment, thanks to a special state program.
  5. Jordan Spieth wins British Open (w/ video)

    Golf

    SOUTHPORT, England — Someday, perhaps soon, there will be a plaque at Royal Birkdale for Jordan Spieth, much like the one off the 16th hole that celebrates Arnold Palmer and the 6-iron he slashed out of the rough in 1961 to win the British Open and usher in a new era of golf.

    Matt Kuchar plays out of the bunker on the 18th hole and finishes with bogey for 1-under 69. He had a one-shot lead after 13 holes.