What is obesity?
Obesity is defined as the state of having excessive body fat and of being grossly overweight.
The most common metric for measuring a healthy weight range is the Body Mass Index (BMI). It is calculated by dividing weight in kilograms by height in metres squared (kg/m2).
A higher BMI indicates a patient is more overweight or obese.
Obesity is quickly becoming Australia’s most prevalent modifiable risk factor for chronic disease.
According to the Australian Institute of Health and Welfare, 1 in 3 Australian adults were classified as obese (with a BMI over 30) in 2017-18, increasing from 1 in 5 in 1995.
In addition, almost 75% of men and 59% of women were overweight (with a BMI of 25 or more) or obese.
What causes obesity?
Many factors, both societal and personal, can contribute to obesity.
At an individual level, it can be caused by eating too much, certain medications, stress, poor sleep, hormonal imbalances, and even genetics can cause a predisposition to the condition.
People also make poor choices due to boredom, stress or as an emotional coping mechanism. Damaging behaviours or habits can lead to poor food choices or excessive eating.
Sometimes, healthy portion sizes are not well defined, leading people to develop the habit of eating until feeling satiated after multiple servings.
In society, calorie-rich foods are easily available and often cheaper than more wholesome options. There is no longer a need to perform physically demanding activities for survival and many work and play activities now only require minimal movement.
People are more stressed, have less time for physical activities and often insufficient sleep. Additionally, marketing campaign encourage people to eat more and often make body image problems worse.
Weight loss can be simply defined as consuming less energy than the body expends, although the reality can be much more complex. Weight loss is influenced by hormonal, biochemical, microbial, and circadian influences.
Perth Obesity Surgery understands that no two patients are the same so it is important for health professionals to work with you to identify how the factors can be manipulated in your favour.
Health effects of obesity
An increased BMI is associated with physical, psychological and functional problems.
Serious issues include heart disease and a higher prevalence for type 2 diabetes, hypertension, high cholesterol, and high blood pressure. Sleep apnoea is also related to these problems, as is stroke, heart attack/failure and early death.
Observational studies suggest that higher levels of body fat are associated with higher rates of cancers in the endometrium, oesophagus, stomach, liver, kidney, skin, brain, pancreas, colon, gallbladder, ovaries, thyroid, and breast.
Mental illness including anxiety and depression are more common in obesity as well as musculoskeletal disorders due to the additional wear and strain that heavier weight can put on joints and ligaments.
Weight loss treatment options
Several options are available for losing weight:
- Diet and calorie restriction
- meal replacement shakes and soups (very low-calorie diets)
- appetite suppressants and malabsorptive medications
- Bariatric surgery
Very low-calorie diets can be effective in initiating weight loss, but studies have shown 80-90% of people can’t maintain this loss long-term. This is mainly because our bodies have programmed compensatory processes to stop us losing weight such as higher levels of hunger, less feelings of satisfaction and a craving for high energy and sweet foods.
Bariatric surgery is regarded as a proven approach to enable sustainable and meaningful weight loss, which is achieved through a combination of restriction or malabsorption.
Some procedures involve reducing the size of the stomach so a patient can feel full and satisfied when it is filled with less food.
Other procedures involve changing the digestive system so that food doesn’t go through the first two metres of bowel, where more than 70% of calories, proteins and many vitamins are absorbed, meaning less calories are absorbed from a meal.
Both types of procedures work by reducing hunger and increasing satisfaction, as well as changing the amount of energy used in absorbing food.
Perth Obesity Surgery’s approach
Perth Obesity Surgery’s focus is on health promotion, disease minimisation and taking a rational approach to intervention.
Evidence shows that sustainable control of obesity can be achieved through a holistic lifestyle approach to address the multiple factors that may have led to the situation.
We believe bariatric surgery is an opportunity to break the cycle but forms just one part of an overall treatment plan. Meaningful and sustainable weight loss also requires a change in behaviours and habits.
Perth Obesity Surgery’s weight management package includes sessions with a group of experts who combine their knowledge and experience for your benefit at all stages from the initial assessment through to post-operative care, as well as long-term follow-up to get you back on track in the case of weight regain, which can unfortunately be common at around 3-5 years after surgery.
