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Straight No Chaser: The United States of Obesity – The Crossroads Between The Pursuit of Health and Happiness

By Jeffrey Sterling, MD September 22, 2018

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Obesity in the United States places many at a crossroad between self-esteem and health.  Often, larger frames are celebrated as more desirable.  Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise.  Of course, our culture embraces and contributes to obesity.  Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport.  I’ve previously discussed the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health.  If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed.  As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.
Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:

Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.

Ideal body weight refers to health, especially heart health, not ‘grown and sexy’ or any other concocted notion of what looks good. So as an example, if you’re a 6 ft tall male, your IBW is 172 lbs. If you’re a female and 5’5”, your IBW is 125. Now before those of you ‘in the know’ tell me there are limitations to IBW and BMI considerations, I’ll stipulate the point and note that doesn’t change the point of this conversation one bit.

‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.
Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
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0 thoughts on “Straight No Chaser: The United States of Obesity – The Crossroads Between The Pursuit of Health and Happiness

  1. There is no question that obesity is a growing issue in our nation and across the globe. The scariest of which is childhood obesity. Currently we live in a world that preaches to kids to love who they are, that “curves” are good, and that you “need meat on your bones.” What would you do/say to these kids that are psychologically taught at young ages that having extra weight is good.

    1. Thanks, T’keyah. It’s a particularly American phenomenon that we eat the way we do. Humans have an internal regulator of fullness as part of our central nervous system (satiety complex). It works pretty well when left to its own devices, but at about age three, we get ingrained into our consciousness “finish your plate”. Following those conscious directions instead of your body’s subconscious cues that you’re full is the start of a long slippery slope. To a different degree the same is true with our habit of sprinkling salt on food before even tasting it. To your question: physical appearance is a different metric than health. We’re too often making the mistake of conceding the battle against obesity by deciding that bigger is better, which perpetuates the cycle. The discussion to have with families is education about nutrition, exercise and health without disparaging anyone’s current size. Once healthy habits are undertaken, the size issues will improve. In additional to better eating habits, being active also protects against obesity. Get them from in front of the TV and computers and back to running and jumping.

  2. Thank you for revisiting the topic of obesity. I am in need of some expert advice. My problem right now, of course, happens to be my bad food choices. However; at one point I was really focused on making better food choices along with exercise and I still didn’t lose any weight. I’m convinced that my underactive thyroid is a contributing factor in keeping me, let’s just call it a little plump 🙂 What can I do aside from proper nutrition and exercise to shed pounds if I have hypothyroidism?

    1. Hi, Tammy. I’ll immediately refer you to your primary care physician or your endocrinologist for care of your individual case, but my first question to you is how compliant are you with your thyroid medication? I’d guess either your meds aren’t ideally dosed or you may may be somewhat noncompliant in taking your meds (I’ll leave the last part for you to answer :-)). If this is the case, your deck is stacked against you no matter what else you’re doing. This evening I’ll be further discussing the caloric balance equation, and please pay attention to the proposed solutions. It sounds like you’re doing better with exercise than the dietary considerations. If that’s the case, you already know the answer to your dilemma. Counting calories may be a good thing for you. Good luck!

      1. Thank you Dr. Sterling. I realize you’re not trying to diagnose/treat anyone via an internet post, but rather to pass on information for healthy living. My end in mind is to get as much healthy information as I can while it’s available from the expert. (smile) Since I am very compliant with taking my thyroid medication, I will be sure to visit my PCP to ensure it is ideally dosed. Thanks again for your input and I am looking forward to future posts as this information has been very helpful to me.

  3. This is such good stuff, Doc! I’m really trying to come to grips with added weight I’ve added in the past couple of years. Thanks for presenting BMI in a uncomplicated, easy to understand way. I have a better understanding of goals I need to set and intend to reach!

    1. Thanks, Annette. Just keep the caloric balance equation in mind. You have to burn an excess of 500 calories more than you take in daily just to lose 1 pound a week. Don’t be a couch potato, and if you have a desk job, keep it moving whenever you can break. Walk the stairs and around the block. Move your arms and legs. Your metabolism needs it!

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