Obesity in Men
What Is The Truth? What Can Men Do?
Britain’s fattest man, Carl Thompson, was 33 years old and weighed 65 stone when he died in 2015. For those not from Britain, that is 410 kilos or 910 pounds. He was housebound, bed-ridden and alone.
This was a man whose life had moved out of balance, and who ended up in a miserable, early death. This is an extreme example of the issue of obesity in men, but it points towards the truth. Obesity is almost a swear word, it is not something you say about someone to their face. What is obesity? Other than being fat, what is it all about ? Furthermore what does it mean for men, how serious a problem is it?
What Is Obesity?
To emphasize this, in England, one quarter of the population is now clinically obese. Current trends suggest the problem is only going to get worse. Diabetes, heart disease, strokes and other nasty diseases go with obesity. So is obesity is a death sentence? The National Obesity Forum says that our obesity problem could be worse than we think.
People may be unaware that they have a problem with their weight. It is now evident that people under-estimate their weight. We have introduced a term for this, 'normalisation'. That is where obese people think they may be a little overweight and overweight people think they are healthy.
A definition of obesity is that it is "a condition characterized by the excessive accumulation and storage of fat in the body" (Merriam-Webster). It is when a person's weight is higher than what is considered healthy for a given height, as measured by the Body Mass Index (BMI)" (Centers For Disease Control and Prevention).
Looking at my own body, I am fascinated to see that I am obese, with a BMI of over 30, while I feel and look relatively slim. Only this week a friend congratulated me on how I have lost weight and how good I am looking. My belly has gone and I feel fitter than I have for some years. But then obesity is about what is happening not what appears to be happening.
Obesity Categories
So it is important to look at the difference between the three terms used for being above normal weight. They are overweight, obese and morbidly obese. There are subtle variations in the definitions but the following are the most useful:
- Overweight: This is where you have a BMI between 25 and 30. This can cause physical problems but often you don't look particularly abnormal.
- Obese: This where you have a BMI between 30 and 35. The excess weight shows when you are obese.
- Morbidly Obese: This is where you have a BMI of over 35. This is where there is visibly a problem and it is impossible to overlook the situation.
Obesity In Men
The people who are most in denial are men. Obesity levels are similar between the sexes. Women, however, are in the majority in trying to do something about it. This might be down to women experiencing more societal pressure about their body image. This is not always a positive thing, but it might be working for them here.
It may be the case that a woman looks in a mirror and perceives herself as overweight or out of shape. A man might look in a mirror and think how well-developed or great he looks. We need to find ways to address weight as a health risk factor in groups that do not appreciate it. That may have to include targetting men being in a different way.
Men are not ignorant of the dangers of obesity. Of course they know that carrying some extra weight will increase the risk of a heart attack. They know it can cause a stroke. If they knew the whole truth perhaps they would be a little less sanguine. Researchers at Harvard University have been looking at the causes of avoidable cancer deaths. They predict that obesity will surpass smoking as the leading cause within the next 15 years.
Patients will accept a certain degree of risk when it comes to lifestyle. This is part of human nature, especially if they currently feel fit and well. We might be tempted to go skiing and accept the potential risk of a broken bone or twisted muscle. Our health is no different. Few will know, though, that obesity is associated with causing or worsening over 50 co-morbidities. These range from lung conditions, arthritis and gout, to skin problems and cancer.
The Problem With Men
Apart from the above why do men become, and remain obese? Why are men so unwilling to do anything about it?
I had to deal with the issues of diabetes, sleep apnoea and dysfunction. It was no longer just about too much fat!
Historically people have seen obesity as meaning that you are wealthy. There is still a hangover of this attitude for many men, particularly men who are not young any more. Men see it as inevitable in middle-aged men and, thus, acceptable.
Many men reject concern about what they look like, they value their attitude to life far more. There can be a 'macho' attitude to eating and drinking that makes the problem worse. Having a beer with the boys can often be the core source of serious health problems later in life.
Men, being less concerned about their looks, can overlook the problem for many years. Often until it seems to be too late to do anything. This was my problem. It was only when my feet started to go numb that I realised I had a serious problem.
I had to deal with the issues of diabetes, sleep apnoea and dysfunction. It was no longer just about too much fat!
My Health Problems
There are three major health problems for men caused by obesity. They are heart disease, type 2 diabetes and obstructive sleep apnoea. There are also several behavioural/psychological problems, such as erectile dysfunction, negative self-image and depression. Other problems of a more medical nature exist but I will not look at these in this article. If you have concerns about wider medical issues you should consult a medical practitioner.
From the above there are three areas that most interest me. These are the areas where the problems of obesity in men show up the most.
Type 2 Diabetes
This is the most prevalent problem caused by obesity. It is where your blood sugar is outside a normal range. It is a completely preventable condition that many people suffer from without realising. The physical effects can be severe and disabling. They include numbness in the feet and hands and detached retina.
Obstructive Sleep Apnoea
This problem shows itself through bad snoring. The snoring can be so bad that it seems like you have stopped breathing. In practice, this is what happens. Your throat closes and you stop breathing for a short period. Suffering from this stops you getting proper sleep and renders you tired all the time. It exacerbates any tendency to obesity, causing a vicious cycle.
Erectile dysfunction
While many psychological factors can cause this, obesity is a common cause. Many men will mistake the cause in this situation and assume there is something 'wrong' with them. The simple fact is that they have too much fat on their bodies. What they want is to have great sex again.
Damage Caused By Obesity
Overall to understand the damage that obesity can wreak, you have to look under the skin. To most men the term 'overweight' seems relatively harmless. White fat fills up the gaps between vital organs. It compresses them and deposits chemicals that affect normal hormonal function. Hence seriously overweight people are always short of breath, the fat is crushing their lungs and diaphragm.
Equally a lesser known by-product of obesity is liver disease. It is the third most common cause of death for people under 65. Excess alcohol is the big problem in Britain. In America, though, non-alcohol related fatty liver disease (NAFLD) has supplanted it. The British Liver Trust says,
The majority of people with NAFLD are overweight. A build-up of fats called triglycerides causes an excess of fat in the liver. High amounts of these are found in foods high in fat and sugar.
There has been a 400% increase in cases of liver disease over the last 40 years. There has also been a 900% rise in the number of cases of NAFLD treated in Britain over a 28-year period.
Causes Of Obesity In Men
Equally important is that apart from possible of genetic or medical causes, the causes of obesity are simple. They are eating too much, eating the wrong food, drinking too much and not taking enough exercise. In men, the cause is often too much to drink, especially too much beer.
Regular exercise is a constant physical need that we have that we ignore at our peril.
So it comes down to putting excess sugar into your system, to the extent that the liver cannot deal with it. This is results in the body storing it as fat. Contrary to popular opinion it is not caused by too much fat in the diet, but too much sugar.
As a result regular exercise is a constant physical need that we have that we ignore at our peril. This does not mean that you need to undertake intensive workouts at the gym every day. It does mean simple exercise, such as walking, every day.
Cure For Obesity
The cure for obesity is also simple but hard to achieve. It only involves a few steps. It is to...
- eat less.
- change what you eat.
- take more exercise.
This does not mean going on a diet but it does mean changing your lifestyle, and changing it for the rest of your life. It is the need for a real commitment to change that makes the cure so hard for most people to achieve.
Obesity in Men - What Can Be Done?
In conclusion eat less and move more is the conventional answer for the individual, as I have already pointed out. But as a social and political issue obesity creates some complex questions. Obesity is on the rise because modern life has taken us out of balance, and our eating habits have not yet adapted.
There is talk of controlling the media and the right to levy sugar taxes, or ban foods. But the answers are nowhere near as draconian. A re-balancing away from prevention to actual treatment of the obese is the simple answer. Therefore public health messages need to be more bloody in line with anti-smoking campaigns.
We need an emphasis on adult obesity. Focusing on child obesity without addressing their home environment is futile. If we can treat adult obesity successfully we will not have childhood obesity to worry about.
The National Obesity Forum
So it is a challenge we all need to accept; to stop gaping at fat people, and hold up a mirror to our own modest spread.