Obesity still an urgent health problem

Obesity still an urgent health problem

The problem of obesity has reached epidemic levels globally, with the World Health Organization identifying nearly 2 billion overweight adults and at least 600 million of them obese.

In the United States, a significant portion of the population qualifies as overweight and obese. A 2013 Gallup Poll shows most Americans believe obesity to be one of the top three most urgent health concerns facing our nation.

And, according to the Centers for Disease Control, West Virginia is leading this epidemic with one of the highest obesity prevalence rates in the country. As obesity is a well-documented risk factor for hypertension, diabetes and cardiovascular disease as well as other serious medical problems, this is clearly something for all of us to be concerned about.

As a physician and researcher, the first question that comes to my mind is “why do people become obese?” Glib responses like people are “too lazy” or they “eat too much” miss the point that this is an extremely common problem touching on many, if not most, people. Currently, more than one-third of adult West Virginians qualify as obese based on their body mass index (BMI). Clearly, all of these people aren’t lazy or gluttonous.

Although the diet and exercise industries are booming, they are pretty ineffective as a long-term solution for most people. Regardless of the diet, long-term weight reduction and maintenance are not generally achieved by most of the subjects. Exercise regimens also are complicated by recidivism. Most people who begin an exercise program eventually stop. Health clubs often use this fact in their business model, counting on people buying memberships that they simply don’t use.

My personal bias is that this is a biological problem. Human beings were never meant to have unlimited access to food, and the evolutionarily beneficial ability to store nutrition as fat has become a liability.

As this is a biological problem, I believe that we need a biological solution. Recent work has established that obesity represents an oxidant stress state. In lay terms, the balance between oxidants and anti-oxidants is shifted to favor oxidants, and the accumulation of fat ensues. In research labs around the country, including Marshall University, work is ongoing to find a biological solution to this problem. Unfortunately, it isn’t here just yet.

So what to do? I would advocate that rather than deride ourselves, we should seek to change our lifestyles so that we eat less, consume less dense caloric foods and incorporate greater degrees of activity into our lives. Our expectations should be reasonable and achievable. The simple truth is that, although we’d all love to be perfect, a BMI of 35 is a lot better than a BMI of 60.

Although some medical treatments for extreme obesity (e.g., bariatric surgery) have been found to be effective, the simple truth for most of us is that we simply have to find a way to regulate our food intake and physical activity to establish some modest weight loss and avoid additional weight gain in the future.

This article originally appeared in the March 6, 2016, Progress edition of The Herald-Dispatch.


Joseph I. Shapiro, MD

Dr. Shapiro is dean of the Marshall University Joan C. Edwards School of Medicine and a nephrologist with more than 30 years of clinical experience.

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