The Weight Today: Understanding Obesity in Modern Life

 

"Why is it so hard to stay fit when there's a gym in every neighborhood and a salad bar on every corner?"

 Does this sound familiar? In a world where Instagram feeds are filled with gym selfies and avocado toast, yet obesity rates continue to rise to almost triple of the

numbers since 1975, with over 1.9 billion adults overweight in 2021, of which over 650 million were obese. Thus, it's clear that the struggle to maintain a healthy weight is real. 

Dear Readers, welcome to "The Weight of Today: Understanding Obesity in Modern Life." This blog is not just about shedding pounds; it's about shedding light on the factors that contribute to obesity in our modern world. From the allure of fast food to the sedentary nature of our digital lives, we'll explore how these factors shape our bodies and our health. Let's unravel the science behind obesity, debunk myths, and discover practical strategies to overcome this. Together, we'll navigate the  complexities of weight management in the 21st century and empower ourselves to make informed choices for a better tomorrow.

Evolutionary Perspective:

Let's take a journey back in time, to when our ancestors roamed the earth as hunter-gatherers. Life was a constant quest for survival, where finding food meant the difference between life and death. During times of plenty, our ancestors would feast on high-calorie foods, storing the excess energy as fat to sustain them during lean times. This ability to store fat was a survival advantage, ensuring they had the energy reserves needed to survive through periods of scarcity.

           Fast forward to the present day, and our modern world is a stark contrast. Food is abundant, and physical activity is often a choice rather than a necessity. Our bodies, however, are still programmed to store fat efficiently, just as our ancestors did. This evolutionary adaptation, which once ensured our survival, now contributes to the "Obesity Epidemic", we face today. Our bodies are simply doing what they were designed to do – store excess energy as fat. It's not a flaw in our biology but rather a mismatch between our ancient genes and our modern environment.

                Understanding this evolutionary perspective is key to addressing the obesity crisis. It reminds us that our bodies are not the problem – it's the world around us that has changed. By recognizing this, we can begin to make changes to our environment and lifestyle to better align with our evolutionary past and improve our health in the present.

Biochemistry of Fat Formation:

When we eat, our bodies break down food into its building blocks, including glucose (sugar) and fatty acids. These molecules are essential for energy and other functions. 

When we consume more calories than we need, especially from sugars and fats, our bodies store the excess energy as fat. This process, called lipogenesis, is regulated by insulin, a hormone produced by the pancreas. Insulin plays a crucial role in fat storage by promoting the uptake of glucose and fatty acids into fat cells. Once inside the fat cells, these molecules are converted into triglycerides, which are the primary form of fat storage in the body.

These triglycerides are then stored in specialized fat cells called adipocytes. Adipocytes have a unique structure, resembling a pouch filled with triglycerides. When we need energy in scarcity of food for long duration, our bodies can break down these triglycerides to release fatty acids for fuel.

          

           It's interesting to note that even when we lose weight through exercise or dieting, the number of fat cells in our body remains relatively constant. Instead of decreasing in number, the fat cells simply shrink as the triglycerides are released from the adipocytes. This means that while we can reduce the size of our fat cells, the number of fat pouches, or adipocytes, remains the same.

Understanding this process is crucial for effective weight management strategies, as it highlights the importance of not only reducing fat cell size but also preventing the accumulation of excess fat in the first place.

Genetic and Hormonal Factors and Lifestyle changes in Obesity:

Genetics:-

Studies have shown that genes can influence several aspects of obesity, including body fat distribution, metabolism, appetite regulation, and the tendency to store excess calories as fat. Certain gene variants can increase the likelihood of weight gain by affecting how the body processes and stores fats and sugars. One of the well-known genetic factors in obesity is the FTO (Fat mass and obesity associated) gene. Variants of this gene have been associated with a higher risk of obesity and increased body mass index (BMI). The FTO gene is thought to influence appetite and energy expenditure, making carriers more prone to overeating and weight gain.

Other genes involved in obesity include the MC4R gene, which plays a role in regulating appetite and energy balance, and the LEPR gene, which is involved in leptin signaling, a hormone that helps regulate energy balance by inhibiting hunger.

Hormones:-

Obesity, a multifaceted condition, intertwines genetic predispositions, lifestyle choices, and hormonal dynamics. Hormones, serving as the body's messengers, intricately regulate appetite, metabolism, and fat storage, influencing body weight and the onset of obesity.

Leptin;

   - Leptin, emanating from fat cells, communicates satiety signals to the brain.

   - Elevated leptin levels in obesity signify resistance, fueling overeating and weight gain.

Insulin;

   - Crucial for blood sugar management, insulin facilitates glucose uptake for energy and fat storage.

   - Insulin resistance, prevalent in obesity, heightens insulin levels, fostering fat accumulation.

Ghrelin;

   - Originating in the stomach, ghrelin stimulates appetite, prompting food intake.

   - Dysregulated ghrelin in obesity amplifies hunger, leading to excessive eating.

Adiponectin;

   - Released by fat cells, adiponectin modulates glucose levels and fat breakdown.

   - Diminished adiponectin levels in obesity correlate with insulin resistance.

Cortisol;

   - As the stress hormone, cortisol's surge under stress influences appetite and fat storage.

   - Prolonged stress and elevated cortisol levels associate with heightened appetite and abdominal obesity.

Thyroid Hormones;

   - Thyroid hormones govern metabolism, impacting weight regulation.

   - Low thyroid hormone levels (hypothyroidism) are linked to weight gain, while high levels (hyperthyroidism) can lead to weight loss.

Sex Hormones (Estrogen and Testosterone);

   - These hormones influence body fat distribution, affecting weight dynamics.

   - Imbalances in estrogen and testosterone levels can contribute to weight fluctuations and obesity.

If we discuss about a major hormone involved, i.e., Insulin, 

Insulin helps regulate blood sugar levels by promoting the uptake of glucose into cells for energy. However, insulin also plays a role in fat storage. High levels of insulin, often seen in individuals with insulin resistance or type 2 diabetes, can lead to increased fat storage and weight gain. Moreover, insulin is involved in the repair mechanism of our body. 

In a normal scenario, about 25% of insulin is released during the day for glucose metabolism and fat storage, while the remaining 75% is released at night for repairing our body tissues. However, in abnormal situations, such as overeating, 75% of insulin is released for glucose metabolism and fat storage. This imbalance means that only 25% of insulin is released at night, which is not enough for repairing our body tissues. This can put the body in a state of physical stress, contributing to obesity and other health issues.

Other than above mentioned factors, there's another factor that plays a crucial role in Obesity. 

Circadian Cycle/Rhythms, also known as a body clock. 

According to our Vedas (in Hindu Mythology), Surya (Sun) has a big role, its rising and setting, both have major impact in our biological cycles, of all kinds. Exposure to natural sunlight helps synchronize our internal clock, influencing our sleep-wake cycle, hormone production, food cycle, etc.

The circadian cycle, our internal body clock, plays a crucial role in regulating various biological processes, including sleep, hormone release, and metabolism, all of which can influence obesity. Disruptions to this cycle, such as irregular sleep patterns or shift work, can have significant impacts on hormonal balance and metabolism, potentially leading to weight gain. 

                 Hormones like leptin and ghrelin, which regulate appetite, are influenced by the circadian rhythm. When this rhythm is disturbed, it can lead to dysregulation of these hormones, increasing appetite and promoting overeating.

            Additionally, irregular circadian patterns can affect metabolic processes, including glucose metabolism and fat storage, contributing to metabolic dysfunction and obesity. Mid-night feeding habits, often associated with disrupted circadian rhythms, can further exacerbate these issues by promoting the intake of calories at times when the body is less prepared to process them efficiently.

 Therefore, maintaining a regular sleep-wake cycle, including avoiding mid-night feeding habits, and ensuring exposure to natural light can help support a healthy circadian rhythm and reduce the risk of obesity.

Obesity and it's Underlying Diseases:-

Obesity is not just a condition of excess weight; it serves as a stalk from which numerous health risks sprout, intertwining with various serious diseases. 

One of the most notable associations is with Type 2 Diabetes, where excess body fat, particularly around the abdomen, can lead to insulin resistance, escalating blood sugar levels. Excess body fat, especially around the abdomen, can lead to insulin resistance, where the body's cells do not respond effectively to insulin. Insulin resistance can result in high blood sugar levels, eventually leading to type 2 diabetes.

Cardiovascular diseases, including heart disease and stroke, also find strong ties with obesity, as excess body fat can clog arteries and elevate blood pressure. The clogging of arteries can manifest in two forms: hard clogs and soft clogs. Hard clogs are composed of plaque buildup, consisting of fat, cholesterol, calcium, and other substances. These hard clogs can narrow the arteries and restrict blood flow, increasing the risk of heart attack or stroke. On the other hand, soft clogs, while less common, are more dangerous. Soft clogs can break off from a point and travel through the bloodstream, potentially causing a blockage in a smaller artery elsewhere in the body, leading to serious complications. In the heart, a soft clog can be especially perilous, potentially causing a heart attack if it blocks a coronary artery. 

      Obesity is also linked to an increased risk of certain types of Cancer, including breast, colon, and prostate cancer. Due to excessive fat accumulation, the hormone cortisol (stress hormone) is released, leading to confusion in the location of hormone release in the body. This confusion can result in the activation of white blood cells (WBCs) that attack healthy cells or self-cells in the body, leading to inflammation. Chronic inflammation can contribute to the growth and spread of cancer. 

           Additionally, obesity's far-reaching effects extend to conditions like sleep apnea, joint pain, fatty liver, and cervical and back pain. This interconnected web of health risks underscores the critical need for lifestyle modifications, including healthy eating habits, regular physical activity, and weight management, to mitigate these risks and improve overall health.

Shattering Myths and Misconceptions Surrounding Obesity:-

In the shadows of misinformation, myths about obesity and its causes lurk, casting doubt on the truth. 

    One common myth suggests that obesity is merely a result of indulgence, dismissing the complex interplay of genetics, environment, and lifestyle.

          Another misconception is that weight loss is simply a matter of willpower, disregarding the biological factors that can hinder or facilitate it. While diet plays a role, obesity is influenced by genetics, metabolism, and environmental factors. It's time to dispel the myth that thin people are always healthier than overweight individuals. Health is determined by many factors beyond weight, including diet, exercise, and genetics. Crash diets, often glorified as quick fixes, are not the answer to sustainable weight loss. Instead, they can lead to nutrient deficiencies and other health issues. 

              Another myth is that once you lose weight, you can go back to your old eating habits. The reality is that maintaining weight loss requires long-term lifestyle changes, including healthy eating and regular exercise. 

Let us break free from the shackles of misinformation and embrace the truth about obesity. By understanding the complexities of weight gain and loss, we can empower ourselves to make informed decisions about our health and well-being. That's the only way possible!!

After delving into the complexities of obesity and its health implications, let's pivot to a proactive stance. It's time to explore practical strategies for both preventing and managing obesity.

 Preventing Obesity Before It Begin:-

In the quest for a healthier lifestyle, it's essential to ask ourselves three fundamental questions: What should we eat?  How much should we eat?  Why are we eating? These questions serve as guiding beacons, illuminating the path to better health and well-being.

 Prevention is the cornerstone of good health, and when it comes to obesity, proactive measures can make all the difference. Embracing a balanced diet is paramount, focusing on whole foods rich in nutrients while limiting processed foods high in sugars and fats. Portion control is key, as it teaches us to eat mindfully and in moderation. Regular physical activity is equally vital, helping to burn calories, strengthen muscles, and improve overall health. Educating ourselves and our communities about healthy habits is essential. Promoting a culture of wellness that values nutritious eating and active living can set the stage for a lifetime of good health. By taking these steps, we can prevent obesity before it begins, ensuring a healthier future for ourselves and our loved ones.

Strategies for Treating or Managing Obesity:-

The severity of obesity is often stratified by Body Mass Index (BMI), a metric calculated by dividing an individual's weight in kilograms by the square of their height in meters. This categorization aids in gauging the extent of adiposity and guiding treatment approaches. Class 1 obesity is characterized by a BMI ranging from 30 to 34.9, indicative of moderate adiposity. Class 2 obesity, with a BMI falling between 35 and 39.9, signifies a higher level of adiposity. Class 3 obesity, also known as severe obesity or morbid obesity, is distinguished by a BMI of 40 or above, representing the most severe form of the condition. Patients with a BMI of 50 or above may be advised to consider surgical interventions, while those below this threshold may be encouraged to focus on weight reduction through lifestyle modifications and healthy living practices. It's important to note that a BMI of 25 or lower is considered ideal, indicating a healthy weight rather than obesity.

 One of the earliest documented instances of weight loss surgery dates back to the 10th century, when the Byzantine physician Paul of Aegina described a procedure known as "intestinal bypass" to treat obesity. However, it wasn't until the 20th century that modern obesity surgery began to take shape.

          Bariatric surgery was first developed in the United States in the 1950s and 1960s. The first recorded procedure was performed by Dr. Edward E. Mason and Dr. Alexander I. Zarins in 1966 at the University of Iowa. They developed the Roux-en-Y gastric bypass, which later became one of the most common and successful bariatric procedures.

In India, bariatric surgery gained popularity much later. The first bariatric surgery in India is believed to have been performed in the late 1990s or early 2000s. Dr. Shashank Shah is considered one of the pioneers of bariatric surgery in India and has been instrumental in popularizing the procedure in the country. Since then, bariatric surgery has become more widely available in India and is now considered an effective treatment option for obesity and related conditions.

      Bariatric surgery operates on two key principles: restriction and malabsorption.

 Restriction involves reducing the size of the stomach, limiting food intake and inducing a feeling of fullness with smaller meals.

 Malabsorption, on the other hand, alters the digestive tract to reduce the absorption of calories and nutrients. 

      Procedures like the gastric bypass combine these principles by creating a small stomach pouch and rerouting the intestines to limit both food intake and nutrient absorption. These surgeries are designed to help individuals lose weight by reducing the amount of food they can eat and the calories they can absorb, leading to significant and sustainable weight loss. Among these techniques of Bariatric surgery, a more advanced technique is "Laproscopic Bariatric surgery" .

         In laparoscopic bariatric surgery, the surgeon makes several small incisions in the abdomen and inserts the laparoscope along with other surgical instruments. The camera on the laparoscope allows the surgeon to see inside the abdomen and perform the surgery without the need for a large incision. This minimally invasive approach reduces trauma to the body, decreases recovery time, and lowers the risk of complications compared to traditional open surgery.

Some people confuse liposuction with bariatric surgery. While both procedures involve fat, they serve different purposes.

         Liposuction is a cosmetic procedure that removes fat from specific areas of the body to improve contours, like fat removal in thigh area, abdomen, arms, face, double chin, etc. It is not a treatment for obesity. 

              Conversely, bariatric surgery is a weight loss surgery designed for individuals with obesity to achieve significant weight loss and improve related health conditions. It's important to understand these differences and consult with a healthcare professional to determine the most appropriate treatment. 

It's important to note that bariatric surgery should be considered as a last resort and is not suitable for everyone. Like any surgical procedure, it carries risks and potential side effects. It's crucial to explore all other options and consult with healthcare professionals before considering surgery.

As we conclude our exploration into the depths of obesity and the transformative potential of bariatric surgery, there's something I would like to say;

       To those who find themselves battling obesity, know that your journey is one of resilience and courage. In moments of despair, remember that each step forward, no matter how small, is a triumph. Your worth is not defined by the number on the scale but by the strength you demonstrate in facing each day.

I urge society to cultivate a culture of empathy and support for individuals struggling with obesity. Let us replace judgment with understanding and stigma with compassion. Together, we can create a world where everyone feels empowered to embark on their journey to health and well-being.

In closing, I thank you for joining me on this enlightening journey. If anybody has any queries or would like further information on this topic, as someone from a medical background, I am here to help. Kindly comment your queries down below in the comment section.

Remember, the path to a healthier life is paved with small, consistent steps. Embrace each step with determination and kindness, for it is these steps that lead to lasting change.

Stay Healthy! Stay Happy!!

                                                      ~Ridhima Kaul