American Waistlines: A Growing Problem
You’ve seen the news stories that have certain airlines demanding flyers buy two seats if they appear too large to fit in a traditional airplane seat (and haven’t already purchased two seats). You may have also been tracking stories like New York Mayor Bloomberg’s efforts to control soda size. And despite prior reports (based on NHANES) that suggested obesity is in a static or stable rather than progressive state here in the U.S., a new study published in the medical journal JAMA says that “central or abdominal obesity is a growing problem,” with waist circumference showing significant growth from 1999 – 2012. In fact, the current study suggests that changes in the waist circumference are in excess of what the BMI (body mass index) stable rates suggest. Which means your stomach measurement can grow, even when your overall BMI, or your weight, remains stable. Fat distribution can change and that is a risk factor for serious disease when the fat moves to your mid-section, or when your body shape tends towards apple rather than pear shape.
Why is waist measurement growth so worrisome?
Call it abdominal obesity, belly fat, gut fat, beer belly or enlarged waist size – they all represent excess fat in the subcutaneous (just below skin) layer and excess fat in the abdominal cavity that surrounds organs (where fat should not be found), also called visceral fat. Having excess fat in your abdomen, or an apple-shaped body, is considered a risk factor for heart disease. In fact, having fat in your gut is considered a far stronger risk factor for heart disease than having excess fat anywhere else in the body. Even if you have a normal BMI, having that stomach fat still raises risk of heart disease.
Acceptable waist size
Health experts and current health guidelines recommend that women should aim for a waist size below 34.6 inches and men should aim for below 40.2 inches. At or above those two measurements is considered obese. Over the 1999 – 2012 time period, the waist sizes of men and women grew. The data reviewed involved 32,816 men and women in two seven-year cycles surveyed by the NHANES. The average waist size grew from 37.6 inches to 38.8 inches. Overall, abdominal obesity rose from 46.4% to 54.2%. Women, African-Americans and Mexican Americans had the largest waist size growth.
What is causing this specific type of obesity to progress?
Some experts theorize that sleep deprivation, pesticide exposure, BPA (plastic additive) and certain medications may be responsible to some degree for weight gain in the abdomen. A new study published in the journal Nature suggests that use of artificial sweeteners can change the microbes in your gut and instigate changes in how your body metabolizes glucose (another possible cause of diabetes). We know that obesity is also linked to changes in gut bacteria, so anything that shifts the balance of microbes may instigate risk of obesity. Experts need to determine if some of those microbe shifts specifically cause abdominal obesity.
Applying this new information to your struggles
This is a wake-up call. It is easy to be lulled into a sense of security if you get used to your excess weight situation. It is even easier to become complacent if your weight stays stable, even as your belly grows. It is certainly easy to deny your dire weight and health situation. Rosie O’ Donnell, the talk show host, was in a pattern of denial as she grew larger, until she had a life-threatening heart attack. She recently lost 55 pounds and counting, thanks to a combination of therapy and gastric sleeve surgery. She admits that she ignored her weight by wearing stretchy clothes and not looking in the mirror. After her heart attack, her doctor simply told her that she may not get a second chance again – she is on track to die if something doesn’t change. She is trying very hard to intercept that inevitable outcome.
Many doctors avoid the weight conversation with patients for a variety of reasons. You may send clear signals that you don’t want a weight discussion, you may have actually rebuffed the doctor in his attempts to discuss the risk factors associated with your weight, you may be refusing to get on the scale, or your doctor may feel that if he does bridge the weight discussion, you will go elsewhere. Yet, experts have known for a while, carrying excess weight is dangerous, and “where your fat sits” is especially dangerous, with regards to certain health risks – heart disease and diabetes, among others. I recently saw an interview with the lead singer of a group called the Counting Crows. Adam Duritz has apparently suffered with mental illness for years and has sought help and managed his disease and a very lucrative career. When asked how he managed to accomplish this, since so many artists and regular folk succumb to mental illness and never manage to find their way to a balanced, fulfilling life, he said, “You don’t get to tell yourself later it’s hard and that’s why I didn’t manage it.”
By the time serious heart disease or other serious health issues hit, you may not get the second chance to lose weight or improve your lifestyle. In your case, later may be too late. So recognize your obesity as a serious health condition and seek help. Because later may not be an option.
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