Obesity In-depth Information

Obesity In-depth Information

Obesity – Health Warning

Obesity – A Serious Health Danger

According to a health warning about weight, issued by the US Surgeon General, obesity may soon overtake smoking as the leading cause of preventable deaths in the US. The facts are compelling. In America, an estimated 58 million adults are overweight; 40 million are obese (seriously overweight) and 3 million suffer from life-threatening obesity (morbid obesity). Since 1990, there has been a 76 percent increase in Type 2 diabetes in adults aged 30-40 yrs old. As a weight gain of only 11-18 pounds raises a person’s risk of developing type 2 diabetes to twice that of individuals who have not gained weight, the health risks of overweight are obvious.

Obesity Death-Total Controversy

Each year, according to researchers at CDC, an estimated 300,000 Americans die prematurely of disease caused by or related to obesity or being very overweight. However, new data published in JAMA (April 2005) concludes that obesity causes “only” 112,000 premature deaths in America each year – significantly fewer than the original CDC study. Obesity experts now seem to state that, while patients with morbid obesity (BMI 40+) or malignant obesity (BMI 50+) remain at a high risk of premature mortality, regular obesity (BMI 30+) is no more dangerous to health than underweight. Controversy surrounding weight-related disease, comorbidities and premature death seems likely to continue!

  • 80 percent of type 2 diabetes patients are obese
  • 70 percent of coronary heart disease and stroke is related to obesity
  • 42 percent of breast and colon cancer patients are obese
  • Gallstones occur approximately 3 times more often in obese than in non-obese patients
  • 26 percent of obese patients have elevated blood pressure

Obesity Statistics

Eight out of 10 over 25’s Overweight

78% of American’s not meeting basic activity level recommendations
25% completely Sedentary
76% increase in Type II diabetes in adults 30-40 yrs old since 1990

80% of type II diabetes related to obesity
70% of Cardiovascular disease related to obesity
42% breast and colon cancer diagnosed among obese individuals
30% of gall bladder surgery related to obesity
26% of obese people having high blood pressure
Childhood Obesity Running Out of Control
4% overweight 1982 | 16% overweight 1994
25% of all white children overweight 2001
33% African American and Hispanic children overweight 2001

Hospital costs associated with childhood obesity rising from $35 Million (1979) to $127 Million (1999)

Childhood Metabolic and Heart Risks

New study suggests one in four overweight children is already showing early signs of type II diabetes (impaired glucose intolerance)
60% already have one risk factor for heart disease

Surge in Childhood Diabetes

Between 8% – 45% of newly diagnosed cases of childhood diabetes are type II, associated with obesity.
Whereas 4% of Childhood diabetes was type II in 1990, that number has risen to approximately 20%
Depending on the age group (Type II most frequent 10-19 group) and the racial/ethnic mix of group stated
Of Children diagnosed with Type II diabetes, 85% are obese
SOURCE: Wellness International Network Ltd – web.winltd.com

Obesity in Ethnic Groups – USA

Obesity Rates Within Ethnic Groups in USA, Rates of Overweight & Obesity in Minorities

Differing Rates of Excess Weight By Ethnic Grouping

  • In women, overweight and obesity are higher among members of racial and ethnic minority populations than in non-Hispanic white women.
  • In men, Mexican Americans have a higher prevalence of overweight and obesity than non-Hispanic whites or non-Hispanic blacks.
  • The prevalence of overweight and obesity in non-Hispanic white men is greater than in non-Hispanic black men.
  • 69% of non-Hispanic black women are overweight or obese compared to 58% of non-Hispanic black men.
  • 62% of non-Hispanic white men are overweight or obese compared to 47% of non-Hispanic white women.
  • However, when looking at obesity alone (BMI greater than 30), slightly more non-Hispanic white women are obese compared to non-Hispanic white men (23%; 21%).
  • For all racial and ethnic groups combined, women of lower socio-economic status (income less than 130 percent of poverty threshold) are approximately 50% more likely to be obese than those of higher socioeconomic status.
  • Mexican American boys tend to have a higher prevalence of overweight than non-Hispanic black or non-Hispanic white boys.
  • Non-Hispanic black girls tend to have a higher prevalence of overweight than Mexican American or non-Hispanic white girls.
  • Non-Hispanic white adolescents from lower income families experience a greater prevalence of overweight than those from higher income families.

SOURCE: Surgeon General, Official Recommendations.

Costs of Obesity

  • Type II Diabetes ($63.14 Billion)
  • Osteoporosis ($17.2 Billion)
  • Hypertension ($3.23 Billion)
  • Heart Disease ($6.99 Billion)
  • Post-menopausal breast cancer ($2.32 Billion)
  • Colon Cancer ($2.78 Billion)
  • Endometrial Cancer ($790 Million)
  • Hospital costs associated with childhood obesity rising from $35 Million (1979) to $127 Million (1999)

  • Workdays lost: $39.3 Million
  • Physician office visits: $62.7 Million
  • Restricted Activity days: $29.9 Million
  • Bed-Related days: $89.5 Million

SOURCE: Wellness International Network Ltd – web.winltd.com

UK Obesity Statistics

About 46% of men in England and 32% of women are overweight (a body mass index of 25-30 kg/m2), and an additional 17% of men and 21% of women are obese (a body mass index of more than 30 kg/m2 ).

Overweight and obesity increase with age. About 28% of men and 27% of women aged 16-24 are overweight or obese but 76% of men and 68% of women aged 55-64 are overweight or obese.

Overweight and obesity are increasing. The percentage of adults who are obese has roughly doubled since the mid-1980’s.

Overweight and Obesity in Children

The prevalence of obesity increases with age throughout childhood. In 1996, around 13% of 8 year olds and 17% of 15 year olds in England were obese. These levels of childhood obesity are likely to exacerbate the trend towards increased overweight and obesity in the adult population: compared to thin children, obese children have a two-fold increase in the risk of becoming overweight adults.

Socio-economic Differences in Obesity

Obesity is more common in adults employed in manual occupations, particularly in women. A quarter of women working in unskilled manual occupations have a BMI of more than 30 kg/m2 compared to one in seven of those employed in a professional role. Both men and women working in unskilled manual occupations are over four times as likely as those in professional employment to be classified as morbidly obese.

SOURCE: www.dphpc.ox.ac.uk

Global Obesity Trends, Globesity the Growing Epidemic of Chronic Overweight

The worldwide incidence of obesity is increasing. In fact a new word – “globesity” has now been coined to reflect the escalation of global obesity and overweight. In 1998, the World Health Organization (WHO) published a report entitled “Obesity: Preventing and Managing the Global Epidemic”, which classified obesity as a growing epidemic. According to WHO, if immediate action is not taken, millions will suffer from an array of serious weight-related disorders.

Global Overweight Now Rivals Underweight

For the first time, the number of overweight individuals around the world rivals the number who are underweight. Developing nations have also joined the ranks of countries troubled by obesity. A 1999 United Nations (UN) survey found obesity growing in all developing regions, even in countries beset by hunger. In China, the number of overweight people rose from less than 10 percent to 15 percent in just three years. In Brazil and Colombia, the figure of overweight is about 40 percent – comparable with a number of European countries. Even sub-Saharan Africa, where most of the world’s hungry live, is seeing an increase in obesity, especially among urban women. In all regions, obesity appears to escalate as income increases.

Obesity in the West

In the United States, obesity is the most common chronic disease, affecting more than 1 in 4 of all Americans, including children, and its incidence has been steadily increasing for the past 20 years. In Europe, Australia/New Zealand, the Middle East, and the remaining portions of the Americas, the occurrence of obesity appears to be increasing and is now between 10 and 20 percent. The prevalence of obesity is still fairly low in China, Japan, and many countries in Africa.

Global Obesity Levels

Table 1. Percentage of Obese Adults in Europe and Australia

This obesity data is displayed as a guide only, as obesity statistics are constantly updated.

CountryPercentage of Obese MenPercentage of Obese Women

International Obesity Task Force (IOTF)

Causes of Obesity

Causes of Obesity & Excess Body Fat, Genetic Factors, Psychological & Environmental Reasons For Overweight

General Causes of Modern Obesity

Thr risk factors and contributory causes of obesity – a disease of excess body fat characterized by a body mass index of 30+ – include a range of well-documented genetic and environmental factors. But the relative effect of these causes on the development of obesity, remains unclear. Before examining possible causes, note that obesity, especially severe clinical obesity like morbid or malignant obesity, carries greater risks of morbidity and premature mortality than simple overweight.

Problem 1: Diagnosing Causes For Sudden Rise in Obesity Levels

Any explanation of the root causes of the current obesity epidemic must account for its sudden appearance. Six million American adults are now morbidly obese (BMI 40+), almost twice as high as 1980 severe obesity rates, while another 9.6 million have a BMI of 35-40. The percentage of overweight children 6-11 has nearly doubled since the early 1980’s. (Source: US Census 2000; NHANES III data estimates). Thus genetic causes are unlikely to be significant. Because while a predisposition to obesity can be inherited, the fact that obesity has increased so much in the last few decades appears to discount genetics as a major main cause. Also, the fact that each succeeding generation is heavier than the last indicates that changes in our environment are playing the key role.

Problem 2: Separating Genetic Causes From Environmental Causes

Obesity tends to run in families, suggesting a genetic link. Yet families also share common dietary, physical exercise, attitude and lifestyle habits that may also contribute to obesity. Separating these from purely genetic factors is not an easy statistical or diagnostic task.

Environmental Causes of Obesity

In view of the sudden rise in weight levels – which is a worldwide trend as reflected in the new word “globesity” – environmental factors must be the prime cause of modern obesity.

Overconsumption – A Possible Root Cause

Eating too many calories for our enery needs must be a major candidate for the main cause of the modern obesity epidemic. According to Dr. Marion Nestle, Professor and Chair of the Department of Nutrition and Food Studies at New York University, US agribusiness now produces 3,800 calories of food a day for every American, 500 calories more than 30 years ago — but at much lower per-calorie costs. Increases in consumption of calorie-dense foods, as evidenced by the growth of fast-food chains and higher soft drink consumption, also point to a higher energy-intake.

NOTE: For an explanation of how surplus calories – from dietary fat, protein or carbohydrate – are stored as body fat, please see: Body Fat/Adipose Tissue – Why We Gain Fat

Eating Too Many High-Fat or Refined Sugary Foods

The type of food eaten may also play an important role in the rise of obesity. Researchers continue to discover more metabolic and digestive disorders resulting from overconsumption of trans-fats and refined white flour carbohydrates, combined with low fiber intake. These eating patterns are known to interfere with food and energy metabolism in the body, and cause excessive fat storage. Associated health disorders include insulin resistance, type 2 diabetes as well as obesity. Incidence of these “modern” diseases is increasing worldwide.

Reduced Energy Expenditure – A Possible Root Cause

People who eat more calories need to burn more calories, otherwise their calorie surplus is stored as fat. For example, if we eat 100 more food calories a day than we burn, we gain about 1 pound in a month. That’s about 10 pounds in a year. Over two decades this energy surplus causes a weight gain of 200 pounds!

Assessing the contribution of lack of exercise to obesity is hampered by lack of research. According to existing surveys, only 20 percent of the population are frequent exercisers. In addition, only a small minority of children (1 in 5) regularly participate in after-school sports or extra-curricular physical activity. Since 1990, among adults there has been a per capita decline of 15 percent in frequent exercise activity (100+ days per year in any one activity). Among teenagers and adolescents aged 12-17, the plunge is 41 percent.

However, data on correlation between BMI and exercise frequency is almost non-existent, so we are unable to say exactly what effect lack of exercise has on obesity. What we do know is that severe clinical obesity leads to serious mobility problems caused by respiratory and musculoskeletal disorders. Thus the fitness capacity of obese individuals, especially those suffering from morbid obesity, is typically diminished.

Family Influence – A Major Contributory Cause to Obesity

Parental behavioral patterns concerning shopping, cooking, eating and exercise, have an important influence on a child’s energy balance and ultimately their weight. Thus family diet and lifestyle are important contributory causes to modern child obesity, especially at a time of rising affluence. Since obese children and adolescents frequently grow up to become obese adults, it’s clear that family influence also extends to adult obesity.

Genetic Causes of Modern Obesity

Genes affect a number of weight-related processes in the body, such as metabolic rate, blood glucose metabolism, fat-storage, hormones, to name but a few. Also, some studies of adopted children indicate that adopted children tend to develop weight problems similar to their biological, rather than adoptive, parents. In addition, infants born to overweight mothers have been found to be less active and to gain more weight by the age of three months when compared with infants of normal weight mothers, suggesting a possible inborn drive to conserve energy. Research has also shown that normal-weight children of obese parents may have a lower metabolic rate than normal-weight children of non-obese parents, which can lead to weight problems in adulthood. All of this suggests that a predisposition to obesity can be inherited.

However, the fact that obesity has increased so much in the last few decades appears to discount genetics as the main cause. According to Stephen O’Rahilly, professor of clinical biochemistry and medicine at Cambridge University, the influence of genetics on modern levels of obesity is insignificant:

“Nothing genetic explains the rise in obesity. We can’t change our genes over 30 years.”

How is Obesity Measured?

How is Obesity Measured, Fat & Body Mass Index, Height-Weight Measurements, Obesity Chart

How is Obesity Measured?

In recent years, the body mass index (BMI) has become the medical standard used to measure overweight and obesity.

Body Mass Index

Body Mass Index (BMI) can be used to measure both overweight and obesity in adults. It is the measurement of choice for many obesity researchers and other health professionals. BMI is a direct calculation based on height and weight, and it is not gender-specific. Most health organizations and published information on overweight and its associated risk factors use BMI to measure and define overweight and obesity. BMI does not directly measure percent of body fat, but it provides a more accurate measure of overweight and obesity than relying on weight alone.

BMI Not Perfect

BMI is a height-weight system of measurement that applies to both sexes. It’s not a perfect system, because (e.g.) very muscular people may fall into the “overweight” category when they are actually healthy and fit. But it’s a useful pointer for most people.

How is Body Mass Index (BMI) calculated?

BMI is found by dividing a person’s weight in kilograms by height in meters squared.

Body Mass Index Formula

The BMI mathematical formula is:

BMI = kg/m2

Note: To determine your BMI using pounds and inches, multiply your weight in pounds by 704.5, then divide the result by your height in inches, and divide that result by your height in inches a second time.

To determine BMI using pounds and inches

Multiply your weight in pounds by 704.5, then divide the result by your height in inches, and divide that result by your height in inches a second time.

Note: The multiplier 704.5 is used by the National Institutes of Health. Other organizations may use a slightly different multiplier; for example, the American Dietetic Association suggests multiplying by 700. The variation in outcome (a few tenths) is insignificant.

Child Obesity Measured By BMI-For-Age

Obesity in children is measured differently. New pediatric growth charts are used to plot BMI-for-age, which compares a child’s weight with that of other children of the same gender and age.

Who Needs to Lose Weight

Who Needs to Lose Weight, Health Benefits If Twenty Per Cent Overweight

Doctors generally agree that people who are 20 percent or more overweight, especially the severely obese, can gain significant health benefits from weight loss.

Many obesity experts believe that people who are less than 20 percent above their healthy weight should try to lose weight if they have any of the following risk factors: family history of certain chronic diseases such as heart disease or diabetes; preexisting medical conditions such as high blood pressure, high cholesterol levels, or high blood sugar levels; and an “apple” shaped body, in which weight is concentrated around their abdomens.

You do not need to lose weight if your weight is already within the healthy range, if you have gained less than 10 pounds since reaching your adult height and if you are otherwise healthy.

What about children?

Children need enough food for proper growth. Teach them to eat a healthy diet. Encourage them to play actively in a safe environment, and consider limiting television time.

Fat should not be restricted for children younger than two years of age. Helping overweight children should be done carefully, with major diet changes accompanied by regular monitoring of growth by a health professional.

SOURCE: US Dept of Agriculture

Obesity and Weight Loss from Thighs

Obesity & Weight Loss from Mid-Thighs, Low Intensity Walking & Diet Modification

Obesity and Weight Loss from Mid-Thighs

In older obese women, mid-thigh fat deposits are associated with risk factors for cardiovascular disease (CVD), type 2 diabetes and lipid disorders.

A study published in The American Journal of Clinical Nutrition, demonstrated that a regime of low-intensity walking combined with weight loss could specifically reduce mid thigh fat while improving glucose metabolism as well as lipid metabolic risk factors for CVD.

Women with the most mid-thigh fat at baseline lost the most fat and gained the most muscle in this region and realized the greatest improvements in glucose metabolism.

The 24 subjects were all overweight non-smokers averaging 58 years old, were not receiving hormone replacement therapy, and had no overt evidence of any disease. During the 6 month weight loss intervention, the women attended weekly classes led by a registered dietitian who provided them with instruction in the principles of a fat reducing diet conforming to American Heart Association guidelines. Additionally they were encouraged to perform low-intensity walking 3 days per week, with one of the weekly walking sessions performed on a treadmill at an exercise facility associated with the research site.

At the conclusion of treatment, the women’s body weight and body mass index had decreased by an average of 8%; waist and hip circumferences had decreased by 4%; and the walking intervention produced an overall 8% increase in aerobic capacity. There was a significant 4% decrease in the circumference of the midthigh which, when assessed using a CT scan, showed a 16% decrease in fat and a 7% increase in muscle.

The combination of moderate weight loss and increased physical fitness in the mid-thigh area was associated with an array of extended health benefits for the women in this study.

SOURCE: www.aphroditewomenshealth.com 2002

Obesity, Leptin and Blood Clot

Obesity: Leptin Fat Cell Hormone, Risk of Blood Clots

Leptin linked to obesity and blood clots

High levels of leptin, a hormone produced by fat cells in the body, could explain why obese people develop dangerous blood clots – which can cause heart attacks and strokes – more often than people who are not overweight.

Obesity and Blood Clots

The association between obesity and blood clots is well known; but the cause has remained a mystery. Now, new research with mice, conducted by scientists at the University of Michigan Medical School and published in the April 3 issue of the Journal of the American Medical Association, indicates that leptin may be responsible.

Leptin Levels in Obese People

Leptin released by fat cells regulates body weight in part by suppressing appetite. When leptin levels in blood go up, the brain signals us to stop eating. But the system breaks down for those who are grossly overweight. Since they have more and larger leptin-producing fat cells than thinner people, their leptin levels increase substantially with every pound of additional weight gain. When leptin reaches very high levels in the blood obese people become resistant to leptin’s signal – making them increasingly vulnerable to leptin-induced blood clotting.

While it certainly plays a major role,leptin may not be the only factor involved. The link between obesity and cardiovascular disease is very complex, and there is much we don’t know about how other blood clotting factors are regulated in obesity.

University of Michigan Website, 2001

Health Risks of Obesity

Health Complications, Dangers For Mild and Severe Obese Patients

The more obese a person is, the more likely he or she is to develop health problems. Mild obesity involving a body mass index (BMI) of 30+, is less dangerous to health than morbid obesity (BMI 40+) or malignant obesity (BMI 50+). For example, someone who is 40 percent overweight is twice as likely to die prematurely as an average-weight person. This effect is seen after 10 to 30 years of being obese.

Central or Abdominal Obesity Carries Greater Health Risks

Patients with central or abdominal obesity, characterised by excessive visceral fat around the stomach and abdomen, have a higher risk of weight-related disease. Abdominal obesity is one of the core symptoms of cardiovascular disease and insulin resistance syndrome. In women, central obesity is signalled by a waist circumference of about 35+ inches, while in men the danger waist measurement is 40+ inches. Alternatively, check your waist-hip ratio. Women with a waist-to-hip ratio of more than 0.8 or men with waist-to-hip ratios of more than 1.0 are “apples” and are at increased health risk due to their fat distribution.

Increased Health Risk of Premature Death

According to CDC researchers, an estimated 300,000** American deaths a year are related to obesity, but see note, below. The risk of premature death rises with increasing weight. Even moderate weight gain (10 to 20 pounds for a person of average height) increases the risk of death, particularly among adults aged 30 to 64 years. Individuals who are obese (BMI greater than 30) have a 50 to 100 percent increased risk of premature death from all causes, compared to individuals with a healthy weight.

**NOTE: In April 2005, A new study by researchers at the National Institutes of Health (NIH) published in JAMA concludes that obesity kills 112,000 Americans each year – significantly fewer than the original CDC study. Obesity experts now seem to state that, while patients with morbid obesity (BMI 40+) or malignant obesity (BMI 50+) remain at a high risk of premature death, regular obesity (BMI 30+) is no more dangerous to health than underweight. Controversy surrounding weight-related disease, comorbidities and premature death seems likely to continue!

Increased Health Risk of Heart Disease

The risk of heart attack, congestive heart failure, sudden cardiac death, angina or chest pain is increased in persons who are overweight or obese. High blood pressure is twice as common in adults who are obese than in those who are at a healthy weight. Obesity is associated with high triglycerides and decreased HDL cholesterol.

Increased Health Risk of Stroke

Atherosclerosis, or narrowing of the arteries, which may lead to the formation of an arterial blood clot, is an important pre-condition of many strokes. Atherosclerosis is accelerated by high blood pressure, smoking, high cholesterol and lack of exercise. Obesity, especially morbid obesity is frequently associated with a high-fat diet, raised blood pressure and lack of exercise. Thus obesity is now considered an important secondary risk factor for strokes.

Increased Health Risk of Type 2 Diabetes

A weight increase of 11-18 pounds raises a person’s risk of developing type 2 diabetes to twice that of individuals who have not gained weight. Over 80 percent of people with diabetes are overweight or obese. This may account for the newly invented word, “diabesity”®, which signifies the close association between obesity and diabetes.

Increased Health Risk of Cancers

Obesity is associated with an increased risk for some types of cancer including endometrial (cancer of the lining of the uterus), colon, gall bladder, prostate, kidney, and post-menopausal breast cancer. Women gaining more than 20 pounds from age 18 to midlife double their risk of post-menopausal breast cancer, compared to women whose weight remains stable.

Increased Health Risk of Fatty Liver Disease

The main cause of non alcoholic fatty liver disease is insulin resistance, a metabolic disorder in which cells become insensitive to the effect of insulin. One of the most common risk factors for insulin resistance is obesity, especially central abdominal obesity. Studies indicate a correlation between body mass index (BMI) and the degree of liver damage. The higher the BMI the worse the liver disease.

Obesity is a Risk Factor For Chronic Venous Insufficiency

Although obesity is not a direct cause of chronic venous insufficiency, it is an important risk factor. This is because obesity, especially morbid obesity, leads to raised blood pressure, a sedentary lifestyle and musculoskeletal problems (hampering mobility and use of leg muscles), all of which are contributory factors in the development of chronic venous insufficiency. Obese patients also have an increased health risk of other vascular disorders (eg. lower-limb ischemia), caused by inadequate blood flow to the extremities.

Increased Health Risk of Gallbladder Disease

The risk of gallstones is approximately 3 times greater for obese patients than in non-obese people. Indeed, the risk of sympomatic gallstones appears to correlate with a rise in body mass index (BMI).

Increased Health Risk of Breathing Problems

Obstructive sleep apnea (that is, interrupted breathing during sleeping) is more common in obese persons. Obesity is associated with a higher prevalence of asthma and severe bronchitis, as well as obesity hypoventilation syndrome and respiratory insufficiency.

Obesity and Deep Vein Thrombosis

Risk factors for deep vein thrombosis include prior history of the disease, vascular damage, hypertension and predisposition to blood clotting. Although obesity (BMI 30+) has traditionally been recognised as a risk factor for deep vein thrombosis and pulmonary embolism, experts now consider that the evidence supporting this association is inadequate, as much depends on other factors such as history, illness, immobility, and age.

Increased Health Risk of Arthritis

musculoskeletal disorders, including osteoarthritis, are much more prevalent among obese patients, especially patients diagnosed with severe clinical or mobid obesity. Health studies show that obesity is a strong predictor for symptoms of osteoarthritis, especially in the knees. The risk of osteoarthritis increases with every 2-pound gain in weight.

Increased Health Risks For Expectant Mother and Baby

Obesity has a strong detrimental effect on the health of both mother and new-born baby, both during and after pregnancy. Obesity while pregnant is associated with a higher risk of death in both the baby and the mother. It also raises the risk of high blood pressure in the Mom, by 10 times. Obesity during pregnancy is also associated with an increased risk of birth defects, such as spina bifida. Obesity-related health problems occurring after childbirth include higher risk of wound and endometrial infection, endometritis and urinary tract infection.

NOTE: For an explanation of how surplus calories – from dietary fat, protein or carbohydrate – are stored as body fat, please see: Body Fat/Adipose Tissue – Why We Gain Fat

Health Improvements After Weight Reduction

The good news is that losing a small amount of weight can reduce your chances of developing heart disease or a stroke. Reducing your weight by 10 percent can decrease your chance of developing heart disease by improving how your heart works, blood pressure, and levels of blood cholesterol and triglycerides. Studies show that you can improve your health by losing as little as 10 to 20 pounds.

Psychological and Social Effects of Obesity

Emotional suffering may be one of the most painful parts of obesity. American society emphasizes physical appearance and often equates attractiveness with slimness, especially for women. Such messages make overweight people feel unattractive.

Attitude to Obesity and Severe Overweight

One obesity study asked severely obese persons to take a forced-choice questionnaire. That means, they had to make a choice between being at their present weight or having some other given illness. The results were astounding. Although there were some variations, every obese person said that they would rather be blind or have one leg amputated than be at their present heavy weight. Most interestingly, every person would rather be a poor thin person than be a morbidly obese millionaire.

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