Killing Us Softly

By Estrellita V. Fernando-Lopez, MD

It afflicts man easily-and how. Most people will enjoy the process of being affected by the disorder. It gets into our system by filling ourselves with the "good" caloric dense food teeming all around us, and whiling away our time in front of the computer and the idiot box-the television.

    What is this malady now considered an epidemic affecting people worldwide, a by-product of a modern world overwhelmed by fastfood outlets and technological advances that make people's lives sedentary and result in health burdens that shorten man's life span?

    Look around and see the growing number of people overweight or suffering from obesity. A 1998 survey of the Food and Nutrition Research Institute found that 23.3 percent of Filipinos are overweight, and more than 20 percent are obese. Americans are in a worse state: more than half of them are overweight and 27 percent are obese.

    But how do you know if you are overweight or obese?

Measures of Obesity

    Ideal Body Weight Charts. Obesity is defined as an excess of body fat. Obesity is more than 20 percent of one's ideal body weight (IBW). Overweight is more than 10 percent but less than 20 percent over IBW (Table 1).

    Body Mass Index. Among physicians and health care workers, Body Mass Index is most often used as a predictor of body fat. BMI is the ratio between an individual's weight, and the square of his or her height, and is reported as kg/m2.

    The BMI associated with the lowest incidence of morbidity and mortality, and is therefore considered as normal, is between 18 and 25. Overweight is defined as a BMI between 25 and 30, and obesity, BMI more than 30.

    For Asians, this classification had been modified - the normal BMI is only up to 23, the individual is already overweight if BMI is between 23 and 25, and obese if BMI is more than 25.

    Waist Circumference. For Asians, waist circumference is more predictive of body fat excess, and is most useful if BMI is less than 35. One is considered obese if they exceed the cut-off values of 102 cm for men and 88 cm for women.

    Waist to Hip Ratio. Values are gender-specific: >1.0 for men; > 0.85 for women.

The Burdens of Obesity

    "How cute naman!"

    We often hear this being said of infants and toddlers who are bursting with extra fat, and are walking roly poly. Yes, indeed, they look very good at this early stage, but soon, in grade school, the "cute" description becomes a teasing "tabatsoy" and "Babsky," and worse to a derisive "baboy!" Here begins the psychological burden of obesity, eventually resulting in poor self-image and low self-esteem. Small wonder then that obesity is associated with lower educational achievement, increased unemployment, and underemployment.

    The psychological impact of obesity already overwhelms, but the medical problems linked with it are mind-boggling: increased incidence of diabetes, gallstones, arthritis, hypertension, hypercholesterolemia, and heart diseases, and even cancer, mostly of the reproductive or gastrointestinal organs.

    So next time you feel the craving for another of those cheeseburgers to be downed with refillable glasses of soft drinks and bottomless iced tea, think of these excess calories being converted into fat in your system, bringing you one step at a time closer to that silent, soft killer-Obesity.