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Wait a minute. I had been looking at my medical records. I was struck by strange statistics. Do you know that for over two years, for every 10 patients that consulted me four were overweight? Wait again. For every 10 patients seen, four were obese. Read again. For every 10 patients I examined four were diabetic. Lastly, for every 10 patients I see four are hypertensive. They are not mutually exclusive, they are interwoven. Last week I discussed diabetes mellitus, by the prompting of four people around me who are diabetic.
Again, last week I lost a teenager, who had suffered from diabetes for 10 years. It was not type I or childhood-onset diabetes. She had pancreatitis when she was six years old, which affected her adrenal gland, and insulin production. She developed insulin-dependent diabetes.
According to the girl’s mother, a petty trader, and a widow she was buying insulin humulin 70/30 from 2003. First at N500, then N1000, then N2000, then N2,500, N3000, N4000, N5000, N8,500 and now at N10,500.
Usually, there are 100 units in each vial, and she finishes one vial a week and sometimes she could use two vials. Two months ago she developed fulminating sores on both thighs (injection sites). Then last week she died. She was overweight, in her early life, before she thinned out like a broomstick. Her mother and sisters are obese. Her family induced this week›s write-up.
It is not easy to say what someone should weigh. Typical weight tables show how weight varies with sex and height. But these are usually average figures, taken from actual weights. They are likely to be higher than ‘ideal’ because more people in our society are overweight than underweight.
Some insurance companies have produced figures for “desirable weight”, for each “height and build”, by noting which weights are associated with low death rates. But, though useful, the range of figures is still quite wide.
In the medical statutory book, “An average woman should weigh 60kg and if she is up to 6 six feet tall, she should weigh 70kg. Again on the other hand an average man should weigh 70kg and if he is up to six feet tall, he should weigh 80kg.
This is not cast in stone, especially in this snacks and junk food era where the guzzling of beer and soft drinks has become the in thing. So, perhaps the best way is just for a person to look at himself honestly. Fat soon shows up.
*As an increased skin fold-thickness
*As a stomach bulge
Or as a waist that juts beyond the straight line between your hips and ribs.
Your waist should measure at least two inches less than the deflated chest. Another way is to compare the present weight with weight at the age of 20 years when most people are near their ideal weight. The rise of weight with age in average tables shows what usually happens – but not what is desirable.
Weight problems are on the increase in modern industrial society. Even by the standards of the average people in Nigeria are 10 per cent over their standard “overweight.” Remember I mentioned at the beginning that for every 10 patients that consult me daily, four are overweight; so 10 per cent is a conservative figure. And I would say that 5 million which is over 20 percent of the standard is obese. Some estimates put it at twice this.
Obesity is more common in older people and sedentary workers. Among the poor, it is more common in women. But surprisingly among the well-off obesity is more common in men. Overweight people, and I won’t get tired of saying this, are just not more tired short of breath and physically and mentally lethargic with aching joints and poor digestion.
Overweight people are also more likely to suffer from high blood pressure, heart disease, diabetes, kidney disorders, cirrhosis of the liver, pneumonia, inflammation of the gallbladder, arthritis, hernias, and varicose veins. They have more accidents, are more likely to die during operations, and have higher rates of mortality in general, including three times the mortality from heart and circulatory disease. Someone who weighs 100kg when he should weigh 80kg has his life expectancy shortened by four years.
Some of these effects arise from mechanical causes. The burden of extra weight and its particular location as fat deposits. Others arise chemically from the need to supply more body tissue than normal. The typical infertility of the obese is an example; the spread of hormones over increased body tissue creates problems of conception and, in women, pregnancy including miscarriage and stillbirth. In many cases, reduction to desirable weight removes all the symptoms of the disorder while mortality also sinks back to normal.
Overweight always – without exception – occurs because a person takes in more food energy than he uses up. The bulk of food energy is taken in the form of carbohydrates or fat. Both of these supply calories – the measure of energy, and both are converted to fat deposits. If the calories they supply are more than the body uses. So energy input greater than output equals fat.
But several factors are involved, on each side of the equation. Energy output is divided into energy needed and energy wasted. Energy input is similarly divided into, use and wastage – but more important is the control of total input by the appetite and the various factors that can influence or override that.
Yes, I said excess of input over output equals fat. And you cannot do much about your energy wastage, either input or output. All you can control is what you eat and what you do – your total energy intake and total output needs.
To slim down, you must eat less, and or do more. If your activity is already moderate, it will be hard for you to do more without eating more. But if you are overweight, your activity is probably well below moderate.
Some studies of overweight people suggest that they eat less than others – but do much less. Many overweight people would like to escape the choice of eating less or doing more. Then try to blame something else, outside their control: their heavy bones, their heavy family, their hormones, even their body water level. But-some unforgettable facts:
Variations in bone density cannot account for more than 5kg weight difference.
Though overweight does ‘run in the families’ it may be due more to acquired eating habits than genetic factors.
Hormonal malfunctions can cause obesity, in very rare cases, but these show themselves clearly in other bodily symptoms.
The body water level is very well regulated except in very hot weather and some illnesses.
Besides – even if a person had heavy bones, an inherited tendency to heaviness, hormonal malfunction, and too much water in his body – he would lose weight if he ate less and got more exercise. Hormonal disorders are often the product of obesity. So, a sufferer who slims loses the disorder. Always be medically guided.
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