Obesity: A Practical Definition

This article (assuming anyone ever stumbles upon) will probably get me in a lot of trouble. Why? Because people have some very strong feelings about obesity, what it means, and how it is defined.

Even though I really don’t plan on going into socio-political aspects of obesity or even the long-term health effects of being obese, I may still catch some heat. This is because I am going to lay down some simple guidelines of how I define obesity, and this may cause some people who never thought of themselves as obese to consider it, and that could anger more than a few. And of course there is the fat-acceptance crowd, who are sometimes reasonable, but have also been known to attack medical journals for discussing facts that make them unhappy.

So what is so revolutionary about my definition of obesity that could lead to all of this anger? Heck if I know, but I always believe in addressing controversy before it appears, so now with that out of the way, we can get into what I want to talk about.

For the majority of Western health organizations (including insurers), obesity is determined by looking at your body mass index (BMI), which they calculate by comparing your height and weight on a chart. That is all they do. They compare two measurements and then determine whether or not you are obese. This ignores a whole range of factors including muscle and bone composition and fat placement. For example, fat carried in the thigh and gluteal regions is not nearly as problematic as abdominal fat. Under the current system, a body builder can be considered obese, regardless of their almost non-existent body fat.

Personally, the only body mass indexing method I trust is water displacement. Even calipers have been shown to give grossly misleading results depending on the skill of the person using them. I feel the only way to determine if someone is obese using the current western methodology is to compare their BMI with their other vitals, such as blood pressure, pulse rate, and respiratory health. And this leads me to the reason I started this post: how it is possible for an individual to look at themselves and find an answer to the question: am I obese?

The first thing to look at is your appearance. Do you have a noticeable spare tire? Are you packing more weight in front than in back? Can you see your toes without craning your neck? Do you like how you look? Are you comfortable with how you look? (These last two questions aren’t as similar as they initially appear.)

Next, is it possible for you to be as active as you like, within reason in accordance with age and history of injury and disease? This is within reason, of course. For example, if you are 65 with two replaced knees, there are going to be some limits. Do you find that your sore feet, knees, and low back prevent you from living a full life? Are you easily winded (even with an inhaler?) Do you have trouble with basic tasks like walking or picking things up? Are you able to climb a hill without your heart racing?

If you answered yes to a significant number of the above questions, then you are probably obese. This isn’t a big deal. Obesity is reversible, and for most people it doesn’t require many expensive life changes. First, stop eating junk food and preservatives. If you can’t identify 90% of the ingredients in a food, don’t eat it. Try not to eat out as much, or if you do, eat at places that make food from scratch. A lot of chain restaurants use preserved foods that arrive mostly prepared and, if nothing else, they contain a lot of salt. If you eat a lot of fake food, you are likely getting overdosed with salt. This is incredibly hard on the body and decreases the function of many organs, increasing fatigue.

Going with this, drink water. You are likely very dehydrated and should drink a ton of water to compensate. Along with this, stop drinking soda. It’s dehydrating and messes with your insulin sensitivity (even in diet form). And water means water, not coffee, not tea, and definitely not juice. Most fruit juices, especially the 10% ones, are basically cola.

Moving on, go for a walk a day. Even 20 minutes of uninterrupted walking a day can lead to massive weight loss over time. Buy an mp3 player or a radio if you don’t have anyone to go with (check out podcasts – every interest in the world is represented and if you can find something distracting enough, you may be able to ease the initial pains of weight loss.) I should also note here that in the initial stages of weight loss, you may feel kind of crappy, as in flu-like symptoms or headaches. This is because, in my educated opinion, fat contains all of the toxins that were in your system when you were gaining the weight, and as that fat gets consumed, those toxins are released. Part of staying hydrated is that it gives your body a way to flush those toxins. If you are dehydrated, those same toxins move into the muscles which can cause more discomfort during training.

Lastly, work on your core. One of the biggest issues for the general public is weak abdominal muscles. This can have an effect on the strain placed on your back, knees, and hips, and can also effect your digestion. Part of how we digest food is through the compressions of our abdominal muscles. As these become weaker and distorted by abdominal fat, digestion becomes less efficient and hunger rises as an effect. A simple core exercise is to sit straight in a chair with your knees and hips bent to 90 degrees and your ankles directly under your knees. Engage your kegel muscles as well as the muscles around your abdomen (picture tightening a corset or buttoning a shirt). Then lift each foot in a marching pattern, using the muscles at your hips more than your legs. You only need to engage the muscles, so only lift the foot an inch or so off the ground.

So hopefully this information eventually helps someone, but if not, it was fun to write.