By Dr. Kevin Wang
Before I start my column, I'd like to remind everyone of a survey I'm conducting. I'm starting a research project in my program to increase awareness of the LGBT community in the medical community. These surveys ask you what you wish or would like your primary care physician to know about our community. Please e-mail me at the address below and I'll send out the materials. Thanks for your help and on to this month's column!
Obesity: America's Raging Epidemic
There's a new disease spreading across the world and it's nothing that spreads by sex, drugs or coughing on someone. In fact, there are some people who wouldn't even consider it a disease or something that requires much attention. It's so bad that Michigan is even considered to be one of the top ten states with the most people afflicted with this disease. The condition that I'm writing about today is obesity.
Now this certainly isn't an article to offend anyone. To be candid about it, I could certainly stand to exercise more, eat better and lose a few pounds. However, considering that the majority of the chronic conditions I treat in my office are associated with obesity, I felt it was my obligation to at least discuss the topic. I'll start off with what the health care professions define as obese, a few general trends and then I'll get down to details.
Obesity is defined as having a Body Mass Index (BMI) greater than 30 kg/m2. All the number does is take your weight and divide it by your height … after a few changes here and there. Other ways to measure include percent body fat and such but the BMI is quick, doesn't involve any particular labs (so no needles!) and gives us a rough estimate regarding your health. And with any number that we come up with, there are exceptions (like the hot butch guy who happens to be short).
Now most people know that being overweight/obese isn't healthy. If it lasts long enough, we know that they get unhealthy, might get heart attacks or have high cholesterol or they might even die. I even held the same assumption until I learned that it was a bit more complicated than that. These sorts of complications sort of sneak up on you and eventually lead to many medical problems that could result in major problems or even death.
The slow weight gain might lead to a small increase in blood pressure. You won't notice this rise in blood pressure. In fact, most people don't unless the blood pressure rises suddenly and to a high level. But as one gains more weight, the blood pressure goes along for the ride. What happens then? As your blood pressure goes up, your heart has to work harder which could lead to heart failure. If your heart gets so weak from working so hard, you could end up having fluid in your lungs leading to problems with breathing. Your kidneys could take a hit and could lead to lots of problems. A sudden increase in blood pressure could lead to stroke – and that is definitely not a good thing!
Obesity can also lead to something called glucose intolerance. It's sort of the step before someone develops diabetes. What happens here is that your body gets resistant to insulin – a hormone that your body makes to let it use the sugar your body absorbs from food (not just candy, but bread and veggies, too). Again, this is a disease that sneaks up on you but, before you know it, you'll be seeing some of the first signs and symptoms – extreme thirst, a big appetite and urinating an obscene amount. If you don't get treated you may end up with something called DKA – Diabetic KetoAcidosis. This is a state where you have so much sugar in your blood that it ends up being toxic leading to lots of problems and may even result in death. Even if you see a doctor and end up getting it under decent control, you still end up with an increased risk of blindness, vessel disease leading to heart attacks and strokes, and neurologic changes that make it feel like someone's placing matches under your feet and in your hands.
Hmm, looks like I ran out of room. I'll discuss this topic again in the next column but let me end with this: these chronic conditions that develop with obesity can improve with weight loss, exercise and a good diet. If you take anything from this column (and the rest of my columns), please see your primary care physician and discuss ways to improve your health. I hope this column finds everyone in good health and spirits and I'll see you next month!
