© 2017 VitalityCardiology

David Freedman Medicine Professional Corporation

6633 Highway #7 East, Markham

Tel: 905.472.7127   email: Ashgrove@cardiomatters.com

398 Steeles Ave West, Thornhill

Tel: 905.881.0334  email: Steeles@cardiomatters.com

The prevalence of obesity has increased over the past 20 years. People can become overweight at any age, although there are certain life milestones (example, for women during menopause or pregnancy) when it is more likely to occur. There has been a growing trend for younger individuals to be overweight. An increasing  tendency to less activity and exercise as well as a poorly balanced nutritional intake in individuals who are susceptible to weight gain ( genetic factors/heredity) may increase one's risk of becoming overweight.  

As a matter of convenience many people have a tendency to eat fast food meals or foods which are rich in "bad fats", and this contributes to the problem. It doesn't help that these foods appeal to the masses in terms of offering what appears to be a tasty product. Other contributing factors include certain medical conditions (ex diseases of the thyroid, adrenal gland, etc) as well as  certain medications (ex. prescription steroids, certain antidepressants,etc). However, usually the reason for these medications is often very important to the patient. So, it's not as though they can simply avoid them.  

 

A poor eating pattern of infrequent large meals may also be implicated in some patients, because this pattern of eating may be associated with  higher blood sugar levels and correspondingly higher insulin levels which in turn may stimulate weight gain.

 

 

Obesity

People mostly think of the visible fat (subcutaneous fat) which is under our skin. But, there is another type of fat (visceral fat) which covers all of our internal organs. It is this fat is particular which is thought to be associated with a risk of developing vascular disease, diabetes, metabolic syndrome,etc.

  •  a pro-inflammatory reservoir adding to the general burden of "inflammation" in the body. .....

There are many disease processes in the body which are thought to be caused by an inflammatory process. For example, there are studies that suggest that vascular disease and diabetes may be caused and maintained  (at least in part) by inflammatory mediators. Fat cells have been shown to release tissue factors called adipokines which appear to stimulate inflammatory activity and appear to correlate with insulin resistance ( which may accompany certain forms of diabetes).  Furthermore, healthy lifestyle measures (eating "healthy", exercise, etc) appear to decrease these markers of inflammation and some studies show that weight loss can improve several of the risks and diseases which I have outlined above.

So, striving for a healthy weight is not just about getting the pounds off. It is equally about regaining a healthy environment for the body's  organs to function in. It appears that there is an ideal range of weight for any given height for every person within which an individual's chance of dying or incurring various diseases may be minimized. This is the target range that people should all strive for.

The physician will often work with the patient to assess their overall risk of death or illness. Assessing  a patient's health risk requires that the doctor consider their :

  • age,

  • height adjusted weight (Body Mass Index, BMI)

  • waist circumference,

  • history of smoking or other addictive substances,

  • blood pressure,

  • cholesterol parameters,

  • fasting blood sugar,

  • exercise/level of activity,

  • family history,

  • etc.

 

Subsequent intervention is based on each patient's level of risk. Several options are available for overweight patients. A good approach necessitates consideration of a balance between eating a healthy diet, a regular exercise program (aerobic, load bearing, and flexibilty) , proper sleep, and a healthy mindset.

Being overweight means a lot more than just the idea that one is carrying an extra burden of weight. Fat tissue may significantly affect many processes in our bodies. 

Studies demonstrate that fat tissue may function as or be involved in:

  • the metabolism of certain sex steroid  and glucocorticoid hormones  ( for example. estradiol is partly produced in adipose tissue via aromatization of certain precursor hormones (ex. testosterone))

  • the production of other important hormone like factors  (for example. tumor necrosis factor, leptin, interleukin factor, etc)

  • a storage depot for energy  

  • cushioning and insulating the body. .......