Obesity can kill— Expert

March 2, 2014 by Arukaino Umukoro

Odewole

In this interview, Paediatric Endrocrinologist and Associate Professor of Paediatrics, Lagos University Teaching Hospital, Abiola Oduwole, tells ARUKAINO UMUKORO why Nigerians should cultivate healthy eating habits

 What is obesity?

In a lay man’s terminology, obesity means the accumulation of excess body fat, while obese is used to describe someone that is very fat. But obesity is based on one’s Body Mass Index, which is determined by one’s height and weight. For example, the BMI used for a child’s growth chart indicates that any child above the 85th to 95th percentile is overweight. A child above a 95th percentile is an obese child, while a child with over 95 is said to have morbid obesity. This could lead to a serious health condition that can interfere with basic physical functions and increase the risk of developing diabetes, high blood pressure and other health issues. However, the BMI cut-off point is different for an adult. An adult with a BMI of 28 and 30 is overweight; one with 30 to 35 is obese, and an adult with one above 35 is described as having morbid obesity. One who is tall may have the same weight with a short person and may not be obese. Being overweight is different from obesity.

 Are there any age groups that are more susceptible to obesity?

When you think of the age group, if you go to a public school, one hardly finds an obese person. But in a private school, you find out they are there. In a study we conducted for adolescents between the ages of 10 and 18, in public and private schools, we found out that in the public school, only 2.6 per cent were obese, another four per cent were overweight. In total, that is about six per cent. In the private school, over six per cent were obese, while over 18 per cent were overweight, which was about 27 per cent in total. We conducted another study recently for primary schools and didn’t find any one overweight in public schools. But in the private schools, we found out that more than 50 per cent were overweight and obese. Basically, there is no age group that is excluded. It happens to every age group, especially in the urban areas.

 Obesity used to be a problem of developed countries. But recent studies indicate obesity is rising among people living in low- and middle-income countries, especially in urban settings, like you pointed out. Why is this so?

There is a rise in obesity in the urban areas because people in the rural areas expend more energy and effort in doing work which is made easier in the urban areas due to the use of technology. In the urban area for example, one does not have to fetch water from the stream or well like in the rural area, because water flows from the tap easily. Also, there are means of transportation for both public and private uses. So, there is less expending of energy. Our diet in Nigeria is not too bad. After all, that was the diet our forefathers were eating and they did not have high incidence of diabetes and such diseases. Nowadays, apart from not doing much activity, we eat more westernised food, food that are more starchy, fatty and fast foods too. And then, there is much sedentary lifestyle in the urban areas. So, the food accumulated and not used turns into fats.

Also, the westernisation of our culture may be another reason why there is an increase in the number of obese people today. In those days, it was not common to find obese people. It could also be for cultural and traditional reasons. For many decades, people associate obesity with affluence in this part of the world, which is why some people would want to be fat deliberately. For example, when an Efik lady is about to marry, she is put in a fattening room because they feel that fattening is associated with fertility, which is not so. In fact, a fat person would have more problems getting pregnant than someone who has a normal body weight.

 What are the main causes of obesity?

The most common causes of obesity are nutrition and under-activity. There are other medical causes but they are not common. For example, if one has a problem with the angina glands, one could develop what is called the Cushing’s syndrome or disease and may become obese. Some people have problems that may cause them to look obese. Some are short-statured and may look obese in appearance. It has been said also that there are genetic components in some families that make them overeat or become obese. Leptin is a hormone that if it is too low in quantity, one would never seem satisfied with what he or she eats and of course, that person would become fat.

 What is your advice to people who are obese or want to avoid obesity?

We have to go back to eating natural food, fruits and vegetables, and cook with less oil, like our forefathers did. We eat too much westernised food and lead sedentary lifestyles. Processed food is not good because a lot of them have all these substances that are not good for the body and can lead to obesity. Sometimes, there is no time to have regular exercises, even to go out for a walk. Exercise is good because when one is active, one uses up energy and won’t have extra to store as fat.

My advice would be: firstly, one has to increase one’s level of activity. Secondly, eat less of processed food, like bread, eat less of fried food. Boil, roast or grill instead. Grilling is better than roasting, roasting is better than frying. And as much as possible, don’t fry anything you want to eat. Even if you like fried food, try not to eat too much of it. Basically, eating too much of any type of food is not good for the health. As much as possible, we should avoid too much processed food in our regular diet; such as doughnut, meat pie, cakes, and ice cream. Such food should only be eaten as occasional treats, and not as an everyday affair. For people who are already obese, the treatment procedure is for one to realise and accept that one is fat and could pose a danger to oneself. Then, one has to change one’s diet lifestyle and be more disciplined in food consumption.

 Are there available statistics for the number of people that are obese in Nigeria?

I don’t think there has been any current survey on that. Most of the surveys done are generally mini-surveys. But there is no recent survey that says maybe 30 per cent of Nigerians are obese. People simply extrapolate from small surveys. For example, people in the North are not fat because of their lifestyle.

 What are the psychological effects of obesity?

Obesity makes one lazy because of that feeling of heaviness. Although there are some people who are obese but are as active as those who are slim. But medically, people that are obese are prone to diabetes, hypertension, heart disease, high blood pressure and stroke. It could also affect one’s eye sight. Also, obesity could lead to depression, especially for ladies of marriageable age who may feel that being obese makes suitor avoid them.

 Are women more prone to obesity than men?

Yes, women are more prone to obesity than men, especially women who have reached the age of menopause. At that age, the woman experiences changes in hormones and so puts on weight, especially around the middle region.

 Can obesity kill?

Morbid obesity can kill because excess fat could encase the heart and it won’t pump well as it should. Also, it may cause difficulty in breathing because of the fat around the lungs and block other important vessels, and so blood may not flow. Also, obesity on its own, before the development of morbid obesity, can lead one to have hypertension or a stroke and die. Depression from being obese could also lead to infertility and cause a person to commit suicide. Obesity can kill in many ways apart from the fact that morbid obesity on its own can actually kill.