The heavy truth of Obesity: Causes, Complexities, and Solutions
- Kimberly Potter, APRN, FNP-C, IFMCP
- Feb 3, 2024
- 4 min read
Updated: May 4
Let's talk about the epidemic of obesity.
According to the CDC, the prevalence of obesity in the US from 2017-March 2021 was 41.9%. The prevalence of obesity for the same timeframe in 2000 was 30.5%. The numbers are alarming, and they do not reflect the remaining population that is overweight. You only need to sit in a crowded mall or park and observe to see we are becoming a metabolically unhealthy society. Our children are becoming obese too. For ages 2-19 it was 19.7% affecting approx. 14.7 million children. Patients often have many concerns about their weight. Here are a few common questions.
What is obesity?
Obesity is a complex disease of abnormal fat accumulation. It is defined as a BMI (body mass index) of 30 or more. BMI Calculator. Obesity is classified as Class 1- less than 35, Class 2- less than 40, or Class 3 -40 and greater. Overweight is defined as a BMI of 25 up to 29. BMI calculators are a screening tool that moderately correlate but do not calculate actual body fat. There are many factors that may lead to fat accumulation and factors that interfere/inhibit weight loss. They may include genetic/inherited factors, environmental and physiological factors as well as dietary and lifestyle factors. It isn't always just about food.
Why does it matter?
Being overweight and obese as a child or adult is associated with poor metabolic health and increased mortality. Increased risk of coronary artery disease, stroke, and cancer as well as chronic diseases such as Hypertension, High cholesterol, Diabetes, Asthma, Sleep Apnea, Chronic joint pain, Osteoarthritis, Gallbladder disease, and psychological disorders of anxiety and depression are all associated with obesity.
The personal, economic, social, and national security impacts are staggering. At the time of the above-mentioned CDC report, Costs were estimated to be $173 billion in 2019 dollars. And just 2 out of 5 young adults met both the weight and physical fitness requirements to serve in military.
What can I do to lose weight?
Food as medicine. Begin with a healthy mediterranean type diet, lots of colorful veggies, fruits, healthy fats, lean meat. Eat protein! 90-100g daily. Lack of adequate protein will reduce weight loss. No added sugars/processed foods. This is a basic dietary recommendation for everyone whether they are overweight or not. This diet is nutrient dense, maintains healthy blood sugar regulation and feeds the gut bacteria essential to metabolic heath.
Move. Take a walk after dinner daily. After dinner walks stimulate muscle, improves digestion, lowers blood pressure, regulates blood sugar, burns calories, lowers stress, and improves sleep. All of which is necessary for weight loss.
Is it because I'm eating too much?
No. Often eating well and exercise does not help. There are many factors that may influence weight gain/inhibit weight loss. They may include hormone imbalances, existing insulin resistance and hyperinsulinemia can affect weight loss, genetic/inherited factors, environmental and physiological factors as well as dietary and lifestyle factors. It isn't always just about food.
What is GLP-1?
There are several medications on the market for weight loss. In recent years, Wegovy, Ozempic, Liraglutide, and Tirzepatide (dual GLP-1/GIP) have received a lot of press and are in demand. They are in a class called GLP-1 agonists (glucagon-like peptide). GLP-1 is a short chain amino acid that decreases hunger hormones and increases satiety hormone. The drugs have been around for the past 20 years. In diabetics they stimulate the pancreas to secrete insulin production. In non-diabetics with normal glucose, the pancreas is not stimulated. The medications have improved over the years from daily injections to once weekly injections. Wegovy and Zepbound is approved for weight loss, Ozempic and Mounjaro is approved for Diabetes type 2. Semaglutide is the active ingredient of these drugs and is often compounded. GLP-1 agonists assist the body to be more insulin sensitive by promoting more insulin secretion from the pancreas. The drugs are very effective.
What do I consider before starting these weight loss drugs?
Contraindicated for anyone with a history of Medullary thyroid cancer, pregnant or nursing.
Chronic life-long obesity - drugs designed for long-term commitment to achieve sustainable weight loss. 2 years or more for some.
Weight gains due to perimenopause or late life pregnancy. 6 months may be sufficient
Side effects commonly include nausea. Adherence to dietary restrictions is essential to reduce/avoid side effects.
Intestinal transit time is slowed; you may need a supplement to prevent constipation.
Risks?
muscle loss due to reduced protein related to reduced hunger and food intake. Loss of muscle, hair and skin elasticity due to rapid loss. Muscle burns calories and regulates glucose. Contraction removes sugar from blood to provide energy. Losing muscle reduces weight loss.
Severe side effects and gastroparesis related to improper/overdosing.
Using medication for weight loss is a medical treatment and should not be obtained without medical supervision.
Want to know more? Contact Proactive Functional Care. A practitioner can help uncover any underlying problem that may be inhibiting your ability to lose weight.
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