The Non Communicable Diseases Survey of 2015, pointed out that around 398,417 people between 25-74 years are overweight/obese in Mauritius. Unfortunately, obesity is responsible for different health problems such as type 2 diabetes, heart stroke, and cancer amongst other. Our consultant, Dr Anjuli Gunness, Diabetologist and Endocrinologist give us an insight on obesity and diabetes – its causes and how to prevent it.
What is Obesity?
Obesity means that a person is carrying too much body fat and weighs too much for his/her height.
Being obese is a problem because it increases the risks of many different health problems. It can make it hard for you to move or do the things that you used to do. Obesity is a very sensitive subjects for many people; they can feel very self-conscious and may find it hard to talk about their weight.
The link between obesity and diabetes:
Type 2 diabetes mellitus (T2DM) is often associated with being overweight and carrying excess body fat. It is important to understand how obesity contributes to the development of T2DM as it will then be clearer as to why losing weight can improve blood sugar control.
The pancreas (an organ producing many hormones) of a person with Type 2 diabetes works normally and produces insulin. Insulin moves sugar from your bloodstream to your muscles, liver and organs… However if you are overweight, the excess fat makes you resistant to insulin – you need increasing amounts of insulin to move sugar out of the bloodstream until the pancreas is no longer able to increase insulin levels and the sugar in the blood starts rising- giving rise to diabetes.
While not everyone who is overweight has diabetes, 80% of people with T2DM are carrying excess weight. Thus, losing weight can have a profound impact in controlling your diabetes. Some people are able to control their blood sugars only with diet and exercise. Furthermore, if you have pre-diabetes, losing 5-7 % of your body weight (which is 4-6 kg for an 80kg person) decreases your risk of developing diabetes by 70%!
The Causes of Obesity:
The causes for obesity are multiple, but the most common reason why people start carrying excess body fat is that they eat more than they burn. Unfortunately, the ‘modern lifestyle’ means that we are less active. Many people sit for long hours at their workplace, use cars/ public transport to travel and even our leisure time is sedentary- such as; watching TV and surfing the internet. We also consume more foods that are dense in calories such as; fast foods, sweets, cakes and juices. This has resulted in very high rates of obesity in the world and with it- diabetes.
There are other causes for obesity including the long-term use of certain medicines such as steroids or some medicines used to treat depression, which can cause a lot of weight gain. Some hormonal problems can also increase the risk of becoming obese. However, it is to be noted that hormonal conditions are to blame for only a tiny fraction of cases of obesity.
Health Risks of Obesity:
Obesity is not just associated with diabetes; it is also linked to many other health problems like high blood pressure, high cholesterol, heart disease (including heart attacks), strokes, sleep apnea (a disorder in which you stop breathing for short periods while asleep), asthma, cancer and problems with fertility.
More worryingly, studies show that people who are obese die younger than people who are a healthy weight. They also show that the risk of death increases the heavier a person is. The good news is that all these health risks decrease when a person starts losing weight.
How to Treat Obesity:
The most obvious way is to change your lifestyle by becoming more active and eating healthier. This can be very challenging to many people as they are quite set in their eating habits and can find it hard to find the time to be more active.
Getting formally assessed by a dietitian can be hugely beneficial as this can help you to learn how to improve your diet yet still enjoy eating a healthy and balanced meal. It is better to have regular meal times and smaller portions than to skip meals. Avoiding sweets and processed snack foods is important along with increasing your intake of vegetables and fruits.
Any physical activity is better than none; even walking can be very beneficial. Start slowly, with short amounts of time dedicated to the activity of your choice and slowly build up from there.
In the last few years there have been a number of new medications to treat diabetes which also promote weight loss. Some of these medications work on the kidneys and stops them re-absorbing sugar so that you lose sugar (and so calories) in the urine. Others work by decreasing your appetite and slows down the digestion of food so that you feel fuller for longer. These new medications are increasing in popularity as they improve not only diabetes but weight and the risk of other diabetes related complications.
However, any weight loss treatment- be they medicines, or even surgery do not take the place of diet and exercise. People who have those treatments must also make healthy changes to their lifestyle in order to lose weight and more importantly maintain it.
There are many health care professionals who can support you and guide you on this journey. With the right help from dietitians, nurses and doctors, you will succeed to be a healthier version of you.