Why do we put on weight as we age?

Obesity, a subject that applies to many of us, was the topic of discussion at the October meeting of the Health School for the Elderly held at the Hegyvidék Cultural Center.  Peter Pusztai, MD, endocrinologist at the Buda Health Center, lead the discussion that covered possible causes of obesity and the most effective weight loss diet.

When we discuss obesity from the medical point of view, we talk about the relationship between a person’s weight and height.  We can say that a person is overweight if the body mass index (BMI) is between 25 and 30, or greater.  This determination is, however, misleading, since it does not take into account muscle mass.  Obesity may come into consideration when the waist measurement is above 88 cm in women and above 102 cm in men. 

According to the latest European statistics, Hungarians are definitely overweight.

Obesity may be the result of a metabolic-x syndrome characterized by a high insulin level and elevated blood pressure as well as low HDL (“good”) cholesterol. This disorder is often referred to as the “killing disease” since no symptoms appear for a long period of time and its observable sign is the increase of muscle tissue.  We may suspect metabolic syndrome when the waist measurement is above 94 cm in men and 80 cm in women.

Obesity is often the result of badly managed or over-treated Type 2 diabetes and low blood sugar level (hypoglycemia) indicative of danger.  Its symptoms are sudden hunger, a drunken stagger, acetone breath and halting speech.  The sufferers usually try to avoid these symptoms by ingesting fast absorbable carbohydrates which can easily lead to obesity.  Weight gain may also be the result of thyroid insufficiency; however, in this case obesity is rather the result of fluid collecting under the skin.   

Obesity increases the risk of cancer as well as the possibility of contracting chronic kidney or liver disease.  The chances of diabetes are increased eight fold and recovery time following surgery is significantly increased.  Further complications such as arteriosclerosis, high blood pressure, improper blood circulation, brain hemorrhage, heart attack, thrombosis, lower extremity ulcers, gout, osteoarthritis, gallbladder disease and depression as well as sleep apnoe may all be a consequence of obesity.

The first step in the treatment of obesity is to determine the cause.  If the cause is a disorder, it should be treated first, otherwise, a change in life style and diet is advised.  Most important is the normalization of calorie intake remembering that the body requires 25 to 50 kcal per kg of body weight per day depending on the level of physical activities.

This is what we most need to watch since a weight loss diet is built around proper calorie intake.  For example, if we would like to weight 80 Kg and engage in sedentary work, our recommended daily intake should be 2000 kcal per day.  If we are dieting, our daily intake should be less than 1200 to 1500 kcal keeping in mind that 1gm carbohydrate equals 4 kcal, 1 gm protein equals 4 kcal and 1 gm fat 9 kcal.

Our diet should be 45% carbohydrates, 25% protein and 30% fat. With this method, you can lose 10 Kg in 6 months of mostly fat.

We should consume foods low on the glycemic index which are foods that raise the blood sugar level sugar slowly or less.  Most important is daily exercise which may be 30 minutes of brisk walking, exercycle or ballroom dancing.  There are times when medication therapy may be necessary or which the fat inhibitor preparations are the most effective.  

Dr. Pusztai closed his remarks by emphasizing that obesity is not a cosmetic problem but a significant health risk that should be taken seriously.

Source: Hegyvidék newspaper

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