Obesity – A Complex Multifactorial But Manageable Disease

By Dr Sivuyile Madikana (Herbalife NAB Southern Africa)

A common misconception which was dispelled by the American Medical Association (AMA) in 2013 was that obesity was simply a disorder related to lifestyle with the solution solely being behavioural changes, namely changes in diet and physical activity.

 However the AMA recognised obesity as a chronic disease with many factors and causes at play, which therefore would require individualised and slightly more complex approach in managing it. The complexities start from the very diagnosis of the disease where Body Mass Index (BMI) is the widespread tool used to diagnose obesity. BMI doesn’t take into account ethnic background & is often an inaccurate measure when used on certain body types which don’t necessarily have high fat composition e.g. sportsmen with a shorter but more muscular body type. With time, modifications in terms of diagnosing obesity have been developed with adding the use of waist circumference measurements and having different targets for different ethnic groups.

One can imagine if diagnosing obesity alone is not be simple, then managing it also may not be as simple. Lets start with defining the term obesity and taking it from there. Obesity is a chronic disease where there is excess body fat accumulation that poses a risk to one’s health. The factors found to be related to obesity include an imbalance between calorie intake and expenditure (which is what is commonly known relating to diet and physical activity). Another factor is the environment i.e. not having easy access to healthy and nutritious food or growing up learning unhealthy eating habits. Genetics have been linked with obesity, they can affect how the body changes food into energy & fat storage, they also affect appetite by making one feel hungrier and therefore eating more.

This can form part of syndromes like Prader-Willi (a chromosol disorder which causes life threatening obesity in children). Other underlying medical reasons such as underactive thyroid gland (responsible for metabolism), Cushing’s syndrome (over production of steroid hormones), medications including steroids, some contraceptives, anti-epileptic and antidepressant medication to name a few.

Why should obesity worry us in the first place?
The answer is in the definition, obesity poses a risk to our health. 

Here are some of the health risks associated with obesity: 

• Type 2 Diabetes

 • Cardiovascular disease (stroke and coronary artery disease)

 • Different types of cancers 

• Liver disease • Obstructive sleep apnoea

 • Mental health issues such as depression 

Managing obesity is not a one size fits all approach. The overarching principal is managed weight loss through a balanced and nutritious diet and ridding the body of unhealthy fat.

There are many methods and all have to be tailored for the individual, depending on the causes and factors involved. A healthy balanced diet and physical activity will always be beneficial in managing obesity, not only with weight loss but with general physical and mental health of the individual. What is important to remember is that it’s a chronic disease and therefore the weight loss should be gradual and a multifactorial step wise approach is necessary. 

The best way is to contact a healthcare professional well versed in managing obesity who will thoroughly diagnose, identify causes & risk factors and then come up with a treatment plan and continued follow up tailored to the individual.