Obesity is a growing problem and serious medical condition that impacts millions of individuals worldwide, with a prevalence in the United States now close to 40% for adults. According to the World Health Organization (WHO) worldwide obesity has nearly tripled since 1975 and in 2016, approximately two billion adults were overweight and of these, over 650 million were obese. At this point, most of the world's population live in countries where being overweight and obese results in death at a higher rate than being underweight. Indeed, excess body weight is a problem that needs to be addressed.
Thankfully, there are methods to combat obesity, and in most cases, the condition is preventable. First, it is important to understand what obesity is and how it is defined. Weight status is determined by an individual’s body mass index or BMI. The BMI is calculated using the body weight (kg) divided by height (m2). An individual is said to be of normal weight when the BMI ranges from 18.5-24.9; overweight when the BMI ranges from 25-29.9; and obese when the BMI is 30 or higher. There are also different grades/classes of obesity: 30-34.9 (grade 1); 35-39.9 (grade 2); ≥40 (grade 3; morbid or severe). Although the BMI does not work perfectly for everyone (e.g., those with significant muscle mass may be mis-classified), it does work well to categorize most individuals.
While there do exist genetic, behavioral, metabolic, and hormonal influences on body weight, the major cause of obesity is the simple fact that most individuals take in more calories than they expend through normal daily activities and exercise. The end result is a calorie surplus, which leads to excessive body fat storage. It’s really that simple. Reducing caloric intake and/or increasing caloric expenditure through activity will help combat this problem in nearly all individuals.
In addition to the potential psychological and self-esteem consequences of carrying excessive body weight/fat, many individuals who are obese suffer from musculoskeletal disorders and decreased mobility, leading to a reduced quality of life. In addition, those who are obese are more prone to develop cardiovascular conditions (mainly high blood pressure, heart problems and stroke) and type II diabetes. They may also develop respiratory disorders (including sleep apnea), as well as certain types of cancer (e.g., colon). With childhood obesity, we see that in adulthood there is a higher chance of obesity, premature death and disability.
Considering all the health problems caused by obesity, it is not surprising that the economic burden is significant. In fact, recent estimates indicate that annual expenditures are near $75 billion in the United States alone. These include things such as surgical procedures, healthcare provider visits, pharmaceuticals agents, exercise equipment, memberships to fitness centers, meal services and specialty foods, and dietary supplements.
Lifestyle approaches to address weight loss
Although some individuals resort to medical treatments to address their excess weight, which may include surgery and/or use of prescription drugs (such as appetite suppressants), others prefer to address the problem using non-medical, lifestyle approaches. These primarily include physical exercise and modification of nutrient intake. Both will be discussed below, with additional information presented on the use of dietary supplementation.
Exercise
When it comes to addressing excess body weight, physical activity and exercise are effective methods. Both contribute to overall energy expenditure, which will help to create an energy deficit, coupled with reduced calorie intake. Attempts should be made to increase daily physical activity such as walking, stair climbing, housework, and yardwork. While such activities are of lower intensity than formal exercise, they can help to expend energy. Structured exercise not only expends calories, but it also alters metabolic function, which can favorably impact weight management over time. Regular exercise is certainly something that all able-bodied individuals should be engaged in for purposes of overall health, inclusive of both cardiovascular and resistance exercise.
When it comes to cardiovascular exercise, if serious about weight loss, the goal should be a minimum of three hours per week. Cardiovascular exercise will result in greater caloric expenditure compared to resistance exercise (assuming similar intensities and duration), due to the continuous nature of this work. It will likely yield approximately 100 calories “burned” per 10 minutes of moderate to high intensity activity, although this will depend on the body mass of the individual. Examples of such exercise include walking, jogging, cycling, hiking, stepping, rowing, swimming, and participating in an exercise class.
Pertaining to resistance exercise, the goal should be a minimum of 1.5 hours per week, likely divided into three sessions of 30 minutes—splitting the body parts into different days, to allow for adequate recovery between sessions. For example, you might split the body in half and train lower body and abs on Monday, followed by upper body on Wednesday, followed by lower body and abs again on Friday. Take the weekend off and start the next Monday with the upper body workout and then continue rotating the sessions. This will allow each body part to be trained three times every two weeks. As you advance, you can consider spending more time per session and/or increase the number of training sessions per week. At this point you would also likely alter the body part routine, perhaps splitting the body into more than two sessions.
Much like cardiovascular exercise, resistance exercise will also expend energy but not nearly as much as cardiovascular exercise. However, resistance exercise will help to develop muscle mass, which can help to raise the overall metabolic rate (how many calories you expend at rest). This has been shown in laboratory studies and might lead to a small elevation in resting metabolism.
Resistance exercise can involve free weight, machines, bands, and body weight movements.
For both cardiovascular and resistance exercise, the intensity should be moderate to hard, depending on the individual—understanding that the harder you work, the greater the caloric expenditure and likely, the greater the physiological benefit.
Nutritional intake
Aside from energy expenditure through physical activity and formal exercise, adjusting nutritional intake is of utmost importance. It takes quite an effort to expend 1000 calories through exercise, but those same 1000 calories (or much more) can be easily consumed in one fast-food meal.
While many factors can be at play, in simple terms, to lose weight, individuals should consume fewer calories each day than they expend. The goal for many is 10-20% less than maintenance calorie needs. The type of calories is also important, with the goal of consuming a nutrient-dense diet of high quality
and lean protein, low glycemic index carbohydrate (whole grains, beans), very little sugar (avoid sugar containing beverages), high amounts of fiber, low amounts of fat (but adequate essential fatty acids), high quantities of vitamins and minerals, and a high volume of water (~1 gallon per day). Consuming such foods should be a part of a lifestyle approach to lose weight and maintain the loss.
While mild caloric restriction is generally viewed as the “go-to” method for weight loss, other plans have proven successful. For example, various fasting methods have shown promise, as has a very “clean” vegan diet—consuming no animal products and only fiber-rich clean carbs. Using this plan, calories are reduced by default, likely due to the high fiber intake. Intermittent fasting has become popular in recent years, in which individuals may not modify the type of foods or how much is consumed, but rather, when foods are consumed (usually during a 6–8-hour window during the day). Alternate day fasting is also popular, which involves eating whatever is desired one day, with no food (or very few calories) the next, and so on.
Dietary supplements
Coupled with a whole food diet, use of selective dietary supplements can be helpful. While several “weight loss” products are sold, most contain stimulants that may prove harmful over time to some individuals when used in excess. Other products contain agents to help reduce appetite or increase
satiety (feeling of fullness). A standard wide spectrum multi-vitamin/mineral can be helpful, in particular when calories are reduced. An antioxidant supplement may help to bolster health and immunity, while a probiotic may help to maintain gut health during times of calorie reduction.
Summary
Overweight status and obesity are a worldwide problem and create both a health and economic burden. Lifestyle factors such as exercise, nutritional intake, and dietary supplements can help with weight loss and maintenance over time. Both cardiovascular and resistance exercise are of utmost importance and should be performed by all able-bodied individuals. Whole food nutrition, inclusive of high-quality protein and a variety of vegetables and fruits (to provide vitamins, minerals, and phytochemicals) should be a focus if weight loss is the goal. Possible consideration may be given to the use of intermittent fasting methods to assist in weight loss and maintenance. Finally, selecting dietary supplements can also prove helpful to complement a high quality, whole food diet if the goal is optimal health during weight loss and maintenance.
Disclaimer
The material presented in this article is for general information purposes only. The information is not intended to provide medical advice but rather to provide individuals with information to better understand the value of lifestyle factors to support weight loss and management. Individuals should consult with their healthcare provider prior to beginning any new exercise, nutrition, fasting, or supplementation program. No liability is assumed by CalerieHealth.
