Why are we so fat? The world commemorates the first World Obesity Day

Why being overweight is so bad for your health

THE first World Obesity Day took place on Sunday, 11 October this year. The objective of the new initiative was to lead and drive global efforts to reduce, prevent and treat obesity.

According to the World Health Organisation (2014), about 2 billion people worldwide are overweight. Of those, 98 million are considered severely obese, which means they are more than 45 kilograms over their ideal body weight or have a body mass index (BMI) greater than 40..

Obesity is not only an important cause of morbidity, disability and premature death (WHO 2004), but increases the risk for a wide range of chronic diseases, including hypertension, coronary heart disease, various cancers and diabetes. In fact, a high BMI is thought to account for about 60 per cent of the risk of developing Type 2 diabetes.

Co-morbidity with diabetes is so common that Dr Francine Kaufman, a US Endocrinologist, researcher and professor, has coined a new term for the condition: diabesity.

“The prevalence of diabesity, both worldwide and in South Africa, is increasing at an alarming rate,” says Dr Shenaz Seedat, Endocrinologist and Senior Medical Advisor at Novo Nordisk South Africa.

“Of particular concern is the rapid increase in prevalence among children and adolescents. Even a generation ago, obesity and diabetes in youngsters was rare, but this has changed dramatically as more and more people have moved from rural areas to cities, where their lifestyle habits have changed significantly.”

City dwellers are, as a rule, much more sedentary than their rural counterparts and, for many, the only exercise they get is on their commute between the kitchen and the couch. Add to this the cornucopia of high-fat, high-sugar processed foods that now form such a large part of the urban diet and the ‘supersize me’ fast-food culture, and the risk of developing diabesity skyrockets.

It is, indeed, sobering to know that every kilogram of excess weight is associated with a 9 per cent increase in the risk of developing diabetes.

“If no-one in the population were overweight or obese, the prevalence of diabetes in South Africa would be about 1 per cent of the population,” says Dr Seedat, “which would represent approximately 540 000 people. As it is, the prevalence of diabetes in this country is 8.3 per cent, which represents some 4.5 million people.”

Unfortunately, treatment outcomes are affected by what is known as ‘the rule of halves’.

According to this prevalence formula, which was first developed in the early 1990s, only half of the people living with diabetes are diagnosed, and only half of those who are diagnosed receive professional medical care. In turn, only half of those receiving medical care achieve their treatment targets, and only half again live a life free from diabetes-related complications. This means that only 6.25 per cent of people living with diabetes are experiencing an optimal outcome.

One of the greatest challenges in healthcare today is therefore to break the rule of halves by raising awareness of diabesity, increasing diagnosis rates and improving access to both care and treatment options.

“It goes without saying that the challenge is enormous,” says Dr Seedat. “The good news, though, is that keeping to a healthy weight significantly reduces the risk of developing diabetes. This is particularly true of Type 2 diabetes, which is triggered by a combination of genetic and lifestyle factors.”

Type 2 diabetes is by far the most common form of diabetes, accounting for 90 -95 per cent of all cases. It is characterised by insulin resistance and/or relative insulin deficiency. As this type of diabetes usually has a slower onset and progression than Type 1 diabetes, it often remains undetected for many years, and diagnosis only occurs when a complication arises or a routine blood or urine glucose test is performed.

“With this in mind, we are encouraging people who are overweight or obese to visit their doctors or local clinics and to have a test for diabetes,’ says Dr Seedat. “And whether positive or not, the best thing they can do for themselves is to reach and maintain a healthy weight. Their healthcare professionals will advise them of the correct diet and exercise regimen to follow.”

More than 13 000 South Africans died from complications related to diabetes in 2014, making the condition one of the Top Ten causes of death in South Africa.

World Obesity Day is an initiative of the World Obesity Federation.

“There can be no doubt that diabesity is a silent killer,” concluded Dr Seedat, “but it is preventable – or even reversible – if one sticks to a healthy weight.”

Calculate your BMI using the handy calculator on the World Obesity federation’s web site at: https://www.worldobesity.org/resources/calculate-your-bmi/.

Further information on healthy weight levels is available on the World Health Organisation’s web site at: https://apps.who.int/bmi/index.jsp?introPage=intro_3.html.