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Obesity is not a lifestyle choice but a disease

7 min read
obesity

Dr. Tham Kwang Wei, President of the Singapore Association for the Study of Obesity shares with us about the impact of and conditions that obesity can lead to, as well as what fathers should be aware of regarding the disease. This interview was shared on the launch of the “Your Weight Can’t Wait” education campaign in Singapore.

The Singapore Association for the Study of Obesity (SASO) and Novo Nordisk marked World Obesity Day with the launch of the “Your Weight Can’t Wait” education campaign in Singapore.

They shared the results of a recent survey of 50+ overweight or obese adults in Singapore which reflected limited action taken for weight management.

Some findings from the survey include:

  • The majority of survey respondents recognise they have an issue with their weight and intend to take immediate action, yet they are not actively seeking professional help.
  • 20 percent of respondents agree obesity is a medical condition (such as diabetes or hypertension).
  • 25 percent of respondents have an existing medical condition, notably high blood pressure and high cholesterol.
  • 50 percent have the goal of losing weight; yet nearly 33 percent would not consider discussing it with their doctor.
  • Many respondents (33 percent) have not discussed their excess weight or losing weight with their doctors in the past 5 years.
  • The primary reason for not discussing their weight with a doctor is because respondents believe that it’s their responsibility alone to manage.
  • None of our respondents feel that their doctors have that responsibility.
  • 20 percent do not see their weight as a significant medical issue.
  • The most common method that respondents tried was to improve their eating habits and diet as well as exercise with a tracking app to keep track of their progress.
  • For those that did have a discussion with their doctor, only 5 percent followed their doctor’s suggestions successfully; 37 percent were somewhat successful and another 32 percent stopped following the suggestions.
obesity

Based on the survey highlights, we had a discussion with Dr. Tham Kwang Wei, President of SASO about the impact of obesity, and as well as how working with a doctor or trained healthcare can help with weight management or weight loss.

Family of Fathers (FOF): What is obesity and what are the considerations fathers (parents) should be made aware of?

Dr. Tham Kwang Wei (TKW): Obesity is a medical condition in which excess body weight results in risk to one’s health or has resulted in serious health impairments. It is most commonly reflected by having a high body weight for one’s height (body-mass index) or a high waist circumference reflected as excessive abdominal fat accumulation.

Obesity is a chronic medical condition which in turn leads to a multitude of other medical diseases. Perhaps the most closely linked co-morbidity of obesity is T2DM. Like many chronic medical conditions, it causes a burden of disease, reduced in life expectancy and increase in disability.

Obesity is influenced by many factors, including physiological, psychological, genetic, environmental and socio-economic factors.

Research shows that obesity is not a lifestyle choice but in fact a complex disease.

Dr. Tham Kwang Wei, President of SASO

As it is a chronic condition, it is prone to relapsing (commonly recognised as a weight yo-yo). That is because our body defends our weight very fiercely. Very often, one’s genes influence one’s propensity to gain or regain weight (a variable 40-70% contribution) even with the same lifestyle as another person. This means more effort or additional measures may be needed for you or your family member to lose weight.

Most importantly for fathers, it is important to establish healthy habits in your children from a young age. Research has shown that 70 percent of children in Singapore who are obese at age 7 will remain obese as adults and that weight in early childhood seems to determine one’s adult weight.

Being a good role model and creating a home environment which is conducive for healthy living for your children such as healthy sleeping habits, not exposing the child to screen time until older than 2 years of age, reducing screen time and sedentary time with increased physical activity, stress management, and healthy eating such with no sugary beverages, minimal processed food or fried food or fast foods) is one of the best gifts you can provide for your children.

obesity

For future, and soon-to-be fathers, we understand that a mother’s nutrition, weight status or even amount of weight gain during pregnancy can influence a child’s future metabolic programming and tendency to develop obesity and metabolic conditions like type 2 diabetes. Encouraging and supporting your wife to maintain a healthy weight before and during pregnancy and to eat healthily during pregnancy is important.  

FoF: What are the other critical or serious conditions that obesity might be a precursor to?

TKW: There are several conditions including:

  • Type 2 diabetes mellitus which can be rather difficult to control especially when one is obese
  • Heart disease: coronary heart and heart failure
  • Non-alcoholic fatty liver disease which can lead to liver cirrhosis (fibrosis), liver failure and liver cancer
  • Obstructive sleep apnea: may present as snoring but in more serious forms leads to sleepiness in the daytime – falling asleep behind the wheel, low energy, reduced sexual function that can affect self-esteem in men, heart failure
  • Certain types of kidney diseases: glomerulonephritis, kidney stones
  • Certain types of cancers: There are 13 cancers officially linked to obesity, for example, liver cancer
  • Infertility/subfertility and even with assisted fertility, not as successful when one is obese; pregnancy complication rates are higher
  • Children born to mothers who are obese tend to give be overweight and obese with a higher risk of metabolic problems in life
obesity

FoF: For fathers that are overweight, how can their doctors help? Can you share an overview of the steps?

TKW: There are several steps involved from the point of visiting your doctor.

  • Assess how severe the overweight or obesity is including taking the BMI and checking if there are any associated medical conditions
  • Assess the father’s history and lifestyle including weight history, any factors, for example, shift work, poor sleep, change in eating habits, stress, relationships, new babies born; mental health, new medications which may have contributed to the weight gain
  • Gauging the readiness of one to make lifestyle changes to lose or maintain weight
  • Working together to set a weight loss goal or target. Fathers with complications related to obesity may need to lose weight more urgently or lose more weight with medications. For some fathers, weight maintenance may be a more practical goal if they are not ready to commit to weight loss
  • Doctors will prescribe a dietary change and change in physical activity to attain the goal. This might involve a visit to a dietitian
  • At times, medications may be needed if, for example if these fathers have complications related to obesity or if they have experienced weight yo-yo during previous attempts.
  • Where necessary, a psychologist may be brought in if one has many stressors or mental health factors that are contributing to the weight gain

FoF: What is the difference between a weight management and weight loss programme prescribed by a doctor, are they the same thing?  

obesity

TKW: Both terms are usually used interchangeably and often refer to the same thing. There are subtle differences though. A weight loss programme is clearly when someone embarks on a treatment/management plan to lose weight.

Weight management could be about embarking on a healthy lifestyle programme for one to maintain weight after successful weight loss (in this case, one could still be overweight or obese) or maintain at a healthy weight or to become healthier.

There may be factors or situations in a father’s life which are not conducive for the individual to lose weight. Perhaps just stopping weight gain or maintaining weight is the appropriate target until the father is ready to make more drastic changes.

FoF: How can a family get involved in encouraging their family members to seek information from trained healthcare workers?

TKW: Try to understand more about obesity from trained healthcare professionals or on your own. For example, find out the causes, triggers and aggravating factors, that obesity is one of the biggest risk factors of getting diabetes and heart disease and even certain types of cancers. Understand that it is a chronic medical condition prone to relapsing.

By doing this, you will be more understanding of your family’s health and you are being supportive of their measures.

The best thing you can do for your family is not to berate or blame them for who they are or use negative or discouraging language.

By adopting a healthy lifestyle or engaging in family activities which promote a healthy lifestyle are definite ways to help your family member.

Even if one is willing to lose weight, a family environment not encouraging or supportive of healthy lifestyle measures will pose a challenge for an individual trying to lose weight. So, you can set the stage first.

You can find out more on your own first from credible sources and by sharing scientific data with your family in a matter-of-fact way. Encouraging your family member to attend a simple health screening may be a good start.

Often, patients with overweight and obesity come to us when they have a health scare or when their family members (for example, young children or dependents) become a source of motivation for them.

Just keep trying and don’t give up.

FoF: Apart from trained healthcare workers, what other sources of information can fathers refer to?

TKW: The list shared are from information sources that are scientifically based. We observe a boom in various weight loss tools and treatments; some that falsely claim effectiveness. This is a reflection of the dramatic rise in obesity prevalence and hence consumer demand. It is important to ascertain the merit of these treatments or management tools. If one feels more explanation or clarification is needed, perhaps seeing a trained healthcare professional to discuss options is the safest step to take

List of websites provided by Dr. Tham Kwang Wei


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