Nowadays its hard to walk on the street or even in the neck of the wood and fail to see a couple of people with expanded waistlines. Wherever you go, there is no doubt that we are in the midst of an obesity epidemic that’s proving difficult to manage. A researcher based in South Africa, whom expert advise i shared yesterday, says as a result, the rates of hypertension, heart disease, type 2 diabetes and sleep apnoea will continues to rise, along with social stigma directed at those who struggle to control their weight. Indeed, I agree with her and as I shared a story about a female friend who can hardly get a bloke talking to her let alone having any interest with her expanded body, the stigma on overweight and obese people will increase further. Back to researcher, she says there is emerging evidence that obesity has a strong genetic basis where a mutation changes the gene sequence and alters the production of protein or epigenetic basis where the sequence is normal but the expression or reading of the gene is altered. She added that once a certain genetically determined weight is reached, the body defends it vigorously. This means that although someone with clinical obesity can lose weight and keep it off for twelve or twenty four months, the weight is likely to be regained in the longer term.To understand the physiological defence mechanism of body weight, individuals have to review how their body regulates their food intake. In her explanations to the blogger, weight is controlled in the hypothalamus, a small area at the base of the brain, located in the midline, behind the eyes. Within the hypothalamus are nerve cells that, when activated, produce the sensation of hunger.In close proximity to these cells is another set of nerves that, when activated, take hunger away.According to her, our desire to eat, therefore, is determined by which of these two types of nerves dominate at a particular time.
Therefore, what controls the activity of these key nerve cells and decides which group prevails and either makes us hungry or suppresses our hunger is circulating hormones that can influence the desire to eat. She advises that when someone loses weight through lifestyle changes, such as reduced calorie intake and increased physical activity, the levels of some of the hunger-controlling hormones change, making the individual want to eat more. The net result is increased hunger that these changes persist for over a year.The body also becomes more fuel efficient, with energy expenditure decreasing per day below the baseline.She says in order to maintain weight loss, the individual must substantially increase their energy expenditure and fight the feeling of hunger. It’s not surprising that most give up and her work has seen her interact with hundreds of such people.It follows that to assist with weight maintenance, changes in lifestyle alone aren’t enough, the issue of increased hunger needs to be addressed.On the other hand, she says there are drugs and hormones that are currently undergoing research but these may take several more years to become available to the people who want to reduce their waistlines. In this gloomy picture for the obese patient, weight-loss surgery is currently the only treatment that has been demonstrated to result in long-term weight loss.She added that each operation has its benefits and risks. Gastric banding has the lowest rates of complications during the operation, but requires the most intensive follow up later on.When it comes to Roux-en-Y surgery, it has the highest operative risk but is easier to manage after surgery and gives patients the best chance to eliminate their type 2 diabetes. The researcher noted that sleeve gastrectomy is a new procedure and its long term durability remains unknown to the medical fraternity.She believes that weight loss surgery isn’t suitable for all obese patients and should be only considered by those who are severely obese, with a body mass index of 40 or above, or those with a body mass index of 35 who have severe complications such as diabetes or sleep apnoea. The difficulty with which the clinically obese can lose weight and keep it off, the researcher says people must aim to prevent obesity from developing in the first place. Your blogger learnt that as a tween, but its never too late to learn for those who are overweight or obese.