The following information is centered on obesity, and not on merely being overweight. Obesity is defined as an excess of adipose tissue (fat) in the human body, and is one of the most common medical disorders and among the most frustrating and difficult to manage.
A person’s body mass index (BMI) closely correlates with excess adipose tissue and a BMI greater than 30 indicates a person is obese. The BMI is calculated by dividing measured body weight in kilograms by the height in meters squared. Multiple health risks are associated with obesity; these include diabetes mellitus, stroke, and coronary artery disease, as well as early death.
Culture and peer influences also encourages us to eat. The average caloric intake for a woman’s meal is about 500 calories. However, when dining with other women it rises to 800 calories. People who overeat may do so because they are bored, because they are looking for negative attention, or because they want to improve their mood.
For some people it is a way to avoid sexual intimacy. Additionally, familial attachment issues, parenting regarding conflict and food, and family interaction may encourage us to overeat. Moreover, psychological problems stemming from irrational core beliefs and thoughts, or poor self-esteem, poor locus of control, pessimistic thinking and perfectionism can cause us to overeat.
People may feel that being obese is the only thing that they can control and they are not willing to give up this misperceived power. Possibly, they may be unable to overcome social or environmental barriers to prescribed self-care which occurs when the doctor or clinical dietician prescribe a specific diet.
Others may wish to avoid complicated medical plans for weight loss. There may be comorbid medical or psychological disorders that preclude them from losing weight. People turn to food when they are happy, sad and in a state of despair because food is a mood changer. Food brings immediate gratification. Being obese may also justify staying depressed.
Many approaches have been utilized to assist people to lose weight, most include diet and exercise. Low caloric diets and moderate exercise appear to be the most effective in the long run. Vegetables do not cost more than potato chips, fast food, pastries, etc.
Other approaches include medically supervised weight loss programs which provides oversight and education. Even though this may be a more disciplined approach for weight loss, it provides the person with a program that they can continue for years to come. Medication -- both prescribed and over the counter may be used. Medication should be used with caution due to potential side effects.
Bariatric surgery has become increasingly more accessible and results in considerable weight loss. However, there are dangers involved in this procedure. People have been known to die as a result of the surgery. Additionally, some people continue to overeat and regain all they have lost within a year.
Bariatric surgery provides excellent oversight and on-going education. An in-depth psychological evaluation is required to assist the doctor in determining if the patient is a suitable candidate for surgery and that the patient is not looking for a “quick fix.” Attendance in group education is mandatory as is on-going blood work.
Complications from bariatric surgery can include; peritonitis due to anastomotic leak, abdominal wall hernias, staple line disruption, gallstones, neuropathy, marginal ulcers, stoma stenosis, wound infection, thromboembolic disease and nutritional deficiencies.
To avoid the numerous diseases or early death resulting from obesity, please contact your doctor and begin a life free of fat and disease.
Dr. Lynda M. Gantt, Ph.D., is a licensed marriage and family therapist in Santa Maria.
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