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Sandeep Chandra, MD FACC is board certified in Cardiovascular Diseases along with Internal Medicine and Nuclear Cardiology. He is an Asst. Clinical Professor of medicine at Emory University Hospital. He received his medical degree in Tennessee and received his training in Cardiology at Brown University in Rhode Island. His practice is currently located in Tucker/Norcross & Alpharetta, GA.
Email , Phone 770-638-1400
Weight and the Woman

Weight loss is not a commercial process, and should not be viewed as an image enhancer. Shedding those extra pounds is a health management issue...

Weight has recently become a major focus in the lives of a majority of the population in the western world as well as in the emerging economies. It has been exploited to the maximum by savvy marketers with a bevy of quick weight loss remedies. This has caused people to strive for weight loss more for aesthetic ends rather than for medical reasons. Consequently, after being frustrated by the failure of multiple quick weight loss strategies, I am seeing a marked reversal in the attitudes of many, which proudly states “Leave me and my Fat alone”.

This is disturbing on many levels. Weight loss is not a commercial process. It should not be viewed primarily as an aesthetic or an image enhancer. It is a medical condition, and should be treated as such. It should not be linked to self-esteem, which suffers when fad diets and weight loss pills fail you. This process should be treated as a health management issue, which is directed by an appropriate team of healthcare personnel, led by your personal physician. Frustration occurs when the perceived ideal weight is not achieved. The importance of maintaining an appropriate weight cannot be undermined. However, each individual’s ideal weight requirements may vary and need to be assessed by qualified health professionals.

Obesity, which is defined as “Weighing more than 20% of your ideal weight”, has always been recognized as a health hazard. It commonly been linked to high blood pressure, diabetes and cholesterol buildup. However, recently there has been a greater understanding of its impact on women. There has been a growing awareness of gender differences in many health related areas. In this article, I will expand on the Health implications of obesity in women.

According to the most recent data from the Behavioral Risk Factor Surveillance System (BRFSS), 20.2% of men (19.6 million) and 19.4% of women (19.2 million) were obese (body mass index [BMI] 30 kg/m2 ), and 6.5% of men (6.3 million) and 8.2% of women (8.7 million) reported having diagnosed diabetes. This clearly states that although equal number of men and women are reportedly obese, women seem to be at a greater risk of developing diabetes.

Obesity and type 2 diabetes are particularly detrimental to women's health. Women with a higher degree of abdominal obesity are especially at risk for diabetes, and diabetic women have disproportionally higher relative risk of coronary heart disease (CHD) than diabetic men.

Obesity is also associated with the incidence of several major cancers specific to women, including postmenopausal breast cancer and cancers of the colon, endometrium, and kidney. Weight gain after the age of 18 years was unrelated to breast cancer incidence before menopause but was positively associated with incidence after menopause. This increased risk with weight gain was limited to women who never used postmenopausal hormones. This suggests that early weight gain clearly increases risk of breast cancer in post menopausal women irrespective of their use of hormones which have been implicated in risk of breast cancer.
In addition, obesity is associated with increased risk of stroke, osteoarthritis, asthma, and sleep apnea in women. Moreover, weight gain in women is associated with decreased physical function and vitality and increased bodily pain regardless of baseline weight. In contrast, weight loss in overweight women is associated with improved physical function and vitality as well as decreased bodily pain. It also impacted the ability to get pregnant. A weight gain of 10 kg since the age of 18 was associated with a significantly increased risk of death in middle adulthood. These results suggest that body weight was directly related to risk of death among these middle-aged women, and lean women had a much lower risk of death. Also, losing the weight improved longevity and quality of life.

The U.S. Surgeon General in 2001 issued a Call to Action, pointing out that "Overweight and obesity may soon cause as much preventable disease and death as cigarette smoking" in the United States. Approximately 300,000 U.S. deaths a year are associated with obesity and overweight (compared with >400,000 deaths a year associated with cigarette smoking).

Obesity is a complex problem resulting from a combination of genetic, behavioral, environmental, cultural, and socioeconomic influences. However, behavioral and environmental factors are primary determinants of obesity, and lifestyle modification has been shown to be extremely effective in preventing type 2 diabetes through moderate weight loss. Because most Americans do not engage in regular physical activity (especially women) or follow a healthy eating pattern, the task of reversing the obesity trend is an enormous challenge. 

Weight loss should be viewed as a medical condition and should be addressed in an organized professional manner by a team led preferably by your physician who knows your medical details. There have been many scientific studies evaluating various diets. Most popular diets achieved early weight loss but failed to sustain it the long term. Also, weight loss in this manner has not shown to reduce risk of the above conditions. An approach that has consistently worked involves a combination of diet, exercise and behavioral modification. Treatment of underlying depression may turn out to be a major factor in the future. Some new trials have shown that a diet high in “Low Glycemic Index food and liquids” has consistently been shown to help and maintain weight loss*. Low Glycemic Index foods by definition are healthy and have a large variety to pick from. Extremely low fat diets have not worked either. Moderate fat with low calorie, low glycemic foods give high satisfaction from hunger with lesser calories. 

Obesity can be very dangerous but can also be an easy risk factor to correct. Some of the most technically sophisticated operations only improve chances of survival by 10-20%. Weight loss can easily increase the odds of living longer by several folds. A little self-discipline today can give you an advantage that no technology can ever hope to offer.

* Please read
DIET: A GROWING DILEMMA for more on low glycemic index foods.

*Disclaimer: The contents are meant for informative, educational purposes only. Formal recommendations can only be made by physicians involved in your care. Please check with your physician before acting on any part of this article.