BMI can provide clarity
Obesity is one of the biggest problems of the population of developed countries in the 21st century, but how to understand when overweight is no longer just overweight, but obesity as a disease?
The classification developed by the World Health Organization (WHO), or body mass index (BMI), which is calculated using a mathematical formula that takes into account a person’s weight and height, helps to understand this.
“Here are these cut-offs. A normal body mass index is up to 25, then overweight is between 25 and 30, and then there are degrees of obesity. The first degree of obesity is between 30 and 35, the second between 35 and 40, and the third above 40. That is generally accepted and is actually used in medical records as well,” May explained.
Of course, this is not a perfect indicator, as people can have different body types. Someone’s weight may be higher than theoretically desirable, but it’s made up of muscle, not fat. These are not very common cases.
“If we are talking about a population, about assessing a large part of people, this indicator – body mass index – is quite appropriate,” May concluded.
The body must absorb all the nutrients
In general, the numbers indicating obesity in society continue to grow, and this is a problem in Latvia as well. Lifestyle leads to obesity – too little physical activity and movement, unhealthy diet and stress.
“If we have a short stress as a protective reaction, the body therefore mobilizes – fight or flight, as taught in school, then long-term stress changes hormones, which contributes to obesity. Then there is this sedentary lifestyle. We know that there are very few manual laborers left. Of course , also nutrition. Here, the classic factors are the amount, that people eat too much, more than it should be. Then, of course, there is also what to eat,” Meija pointed out.
The nutritionist admitted that different eras change from time to time in society – one moment people are extremely avoiding products containing fat, the next moment they exclude carbohydrates from their diet, and still others avoid taking absolutely anything that contains sugar.
Adhering to a diet is not a bad thing, but only if during it the body receives all the nutrients it needs, a person feels good and is able to follow it for a really long time.
“Losing weight fixes a lot of things. We recommend that the body receives all the nutrients so that it is harmonious and balanced, but basically, if a person really likes a diet, if it works for him, then many organ systems are often fixed – blood pressure normalizes , diabetes that has not developed, which has been in a borderline state. Of course, the bone and muscle system also has a great burden,” explained May.
Experts should be consulted
If a person struggles with the problem of obesity for a long time, it is still necessary to follow the principles of nutrition that have been previously evaluated by experts.
“A person comes – “I have tried everything.” What is everything? He has read and eaten in such a way that in one diet there is only buckwheat, in the second – only lard, in the third some other strange things, how can a person not live his whole life, of course .
Then he says – “No diet helps me”, but in fact he has not been to a specialist and has not purposefully rearranged his diet. Some people are like that,” said May.
The same goes for physical activity. There are some people who suddenly decide – now I will not eat and run a lot, and I will spend four hours in the gym every day, said May, noting that this is not a long-term solution.
To deal with the problem of obesity, you need to follow a certain program developed with the help of specialists. If even then it is not possible to reduce the weight with diet and physical activities, specialists will recommend drugs that can possibly help in the specific situation, or bariatric surgery, or stomach reduction surgery.
“All this has to be done in specific steps, going through specific stages and involving many specialists, which should be, of course, a program paid for by the state, which, unfortunately, we don’t have. For us, the children only receive it,” May admitted.
Surgery will not be a panacea
On the other hand, surgeon Maksims Mukans clarified that the operation will not be the last thing to be done. Some work will also need to be done after it – it is a process, not a one-time event.
“There must be a certain stage in the algorithm, which should ideally be developed with a specialist, when a person who has gone through the program is motivated and ready to use some additional tool – surgery or medication – to achieve a healthy lifestyle,” explained Mukāns.
If a person’s body mass index is above 35 and obesity has already caused an additional problem, such as high blood pressure, diabetes, or joint problems, this is already an indication that gastric bypass surgery may be necessary.
“Nutritionists, dietitians and psychologists also work together with the surgeon, because people must not only be motivated, but also understand what will happen next. When considering the operation, two things must be put on the scales – if I will live the way I am now, for how long will I live? Also – am I ready to live properly the years of life that the operation will give me, improving my health?” said Mukan.
He discovered that there are patients who disappear from the sight of doctors after surgery, but return again years later, because, not following the necessary lifestyle and recommendations, they start gaining excess weight again.
“There is a so-called honeymoon, the first year or a year and a half, when the weight definitely falls, but if a person has not changed his lifestyle in the meantime, the weight can gradually come back,” emphasized Mukāns.
The surgeon reminded that the stomach reduction operation also has its own risks and side effects, which are important for the patient to discuss with the specialists.
“I want to say really very strongly, and I always say this to patients when I recommend these operations – it is an operation! It is, however, a very serious intervention in the human body. A person must understand what it is and take responsibility himself.
A person thinks that he will pay the money, sleep, the surgeon will work, he will wake up and everything will be fine. He doesn’t have a sense of responsibility for his own body,” May admitted.
This is the part of people for whom not only the excess weight returns after some time, but also the health problems that appeared before make themselves felt again, said May, emphasizing that after the operation, all patients must invest time and work in improving their lifestyle and dietary habits , as well as be under the supervision of doctors – you must regularly pass tests and go for observations.
