The classification of obesity (in adults) is usually based on the measurement of body mass index (BMI).
BMI = weight (KG) divided by height (M) squared.
< 20 = underweight
>20-25 = healthy weight
>25-30 = overweight
> 30 = obese
Obesity and being overweight are the most common nutritional problems in the developed world and are increasing. More the half the Irish population are now either overweight or obese.
Human beings abide by the laws of conservation of mass and energy, and when energy intake and energy expenditure are equal, body weight is maintained. Excess intake over expenditure results in weight gain, so either or both must be altered in order to address any imbalance.
The consequences of obesity include increased risk of coronary heart disease, stroke, hypertension, non-insulin dependent diabetes, arthritis and back pain, breathlessness and respiratory disease.
The management of obesity is complex involving not just dietary and exercise advice but also cognitive and behavioural techniques are important too. Realistic goals must be set. Obese patients may aim to lose 1 KG per week, reducing calorie intake by 1000 kcal a day, below normal, should achieve this level of weight loss. Keeping a balanced diet is important, so aim to reduce fat intake, consume low calorie nutrient dense foods (e.g. fruits and vegetables), increase fibre rich foods contributes to satiety and helps prevent constipation, increase consumption of low calorie drinks. Increased exercise is a useful part of any weight management plan. If you have not exercised for some time or have any illness the level of increased activity should be discussed with your doctor.
Cognitive therapy involves recognising the reasons for the eating patterns that have led to weight gain. Binge eating after alcohol consumption for example can add significantly to calorie intake. It is helpful to understand possible reasons for weight gain before embarking on a weight loss programme.
Healthy eating and a gradual increase in daily activity will help to create the right balance between energy intake and energy expenditure.
John Duffy M.P.S.I.
