Woman with painted toe nails standing on scales that read 'Help!', things you need to know about obesity, e-Surgery

What is obesity?

Obesity is defined by BMI, a measure that uses the height to weight ratio to determine a healthy weight. For most adults, a BMI over 30 means that you’re obese. This isn’t always the case as BMI does not take muscle mass into account, so often waist circumference is considered. Commonly, a waist circumference of 80cm for women and 94cm for a man is likely to develop weight-related health conditions. Medicating obesity may be necessary as losing weight is not as straightforward as it may seem.

Can an Obese Person be Healthy?

It is often believed that weight is synonymous with health, but that is not always the case. According to a 2014 study, it has been reported that anywhere from one-third to three-quarters of people classified as obese are metabolically healthy. A further 2016 study followed participants for an average of 19 years to conclude that unfit skinny people were twice as likely to get diabetes than fit fat people.

When it comes to health the most important element is what you are eating, not how much, as a 2009 study proved that fructose damages insulin sensitivity and liver function more than other sweeteners with the same number of calories. Therefore, it would be better for your health to eat a caloric surplus of healthy food than a deficit of unhealthy food despite any possible weight gain. As a result, those who are overweight are not necessarily unhealthy.

Why Can’t an Obese Person Just Lose Weight?

Losing weight is not simple. Many believe that it’s down to regular exercise and a healthy diet, but research has shown that losing as little as 3 percent of your body weight resulted in a 17 percent decrease in metabolic rate. This is because the body regulates itself to maintain stable internal conditions so that it can function consistently. Weight loss is not as straight forward as calories in versus calories out. If the caloric intake is decreased then the body adjusts so it doesn’t lose any more precious energy stores. Therefore, by attempting to lose weight you are fighting your body’s automatic response system. As a result, you would be battling constant hunger for the rest of your life.

Obesity can often be the result of a medical condition, it’s not necessarily caused by leading an unhealthy lifestyle. For instance, gout is caused by a surplus of uric acid in the blood which forms crystals around the joints and can leave sufferers with limited mobility. Those who are overweight are at a higher risk of developing gout, but once an overweight person suffers from gout, losing weight becomes increasingly difficult as they are unable to become active.

What Causes Obesity?

Obesity can be caused by an unhealthy lifestyle, but it can also be caused by variables outside of an individual’s control. It can be symptomatic of certain medical conditions. Hypothyroidism is a condition where the thyroid gland produces too little thyroid which leads to a slowdown of the metabolism which often causes weight gain. Cushing’s Syndrome is a condition in which the adrenal glands produce an excess amount of a steroid hormone called cortisol. This leads to a build-up of fat in characteristics sites such as the face, upper back, and abdomen.

Certain medications such as steroids, antidepressants, antipsychotics, high blood pressure drugs, and seizure medications can also cause increased body weight.

How Can Obese People Lose Weight?

Orange pots of pills. The pills in the centre of the image are white and circular. To the left and right of the central pot, the pills re oval and white. | Obesity: What You Need To Know | e-Surgery

Is medication an option? When a lifestyle change isn’t adequate then medication can be used. One drug that is used to aid weight loss is called Orlistat (brand name: Xenical). This functions by preventing the absorption of fats from food. It attaches to the enzymes in the digestive system that breaks down food and blocks about one-third of the fat in your diet. The result of this is that it reduces caloric intake. Orlistat can be obtained from your GP or a registered online service such as e-Surgery.

What Medication can I use to lose weight?

I’m sure you have seen numerous different products that claim to make you lose weight. However, out of all the products currently available, there is not enough evidence to show that any of these are very effective. Whenever shopping for over the counter weight loss aids it is also important to look at the ingredients. A lot of products contain large amounts of caffeine and Gurana extract (which is a herbal stimulant). This can reduce appetite, but usually only works for a short time and the side effects include heart palpitations, increased blood pressure and increased anxiety.

If other methods have failed prescription medication is an option. The drug orlistat (initially available in weaker form over-the-counter as Alli) is very effective at reducing weight. Orlistat, also known as Xenical, works by preventing your body from absorbing about 80% of the fat you consume. This might sound great but remember that Xenical will not be very effective if you consume a lot of sugary foods (which you shouldn’t do anyway). Xenical isn’t a magic cure, but it has helped many patients kick-start weightless and change to healthier eating habits. Find out more about Orlistat on the e-Surgery Health Hub:

The Orlistat Diet: Avoid These Foods

Do weight loss pills really work?

Further Reading

  1. Orlistat | National Institute For Health And Care Excellence
  2. Orlistat Capsules | PatientInfo
  3. Start The NHS Weight Loss Plan | NHS
  4. Obesity and Overweight | WHO