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OBESITY

Excess kilos put squeeze on health

For those who ask if you can be overweight but still fit and healthy, visiting obesity expert Anna Peeters has two short simple answers.

Research indicates every excess kilo is a step towards ill health and disability. Also, fewer than 10 per cent of those who are overweight or obese manage to do enough exercise to meet physical activity guidelines required to maintain health.

“What we know solidly is that there is really a continuum of the relationship between excess weight or waist circumference and outcomes such as diabetes, cardiovascular disease and disabilities,” she said.

In regards to a US review of weight studies that had found those overweight, but not obese, had no increased risk of dying compared to those of healthy weight, Associate Professor Peeters said this result was in direct contrast to earlier studies and had failed to take into consideration the impact of such factors as smoking. Smokers often weighed less but were at a much higher risk of dying.

“My interpretation at the moment is, on the balance of the evidence, I think overweight seems to be associated with increased risk of future mortality,” she said.

And while there were signs the three to five-year life expectancy gap between obese and healthy-weight middle-aged Australians appeared to be diminishing due to advances in medical treatment, the news was not all good.

Research indicated that obese people were likely to start battling physically disabling conditions while still only in their 60s and possibly spent six more years suffering.

Trying to determine if there was a particularly harmful age for carrying excess weight was difficult but the two critical stages of childhood and middle age had been pinpointed in research, said Associate Professor Peeters, who heads Obesity and Population Health at Baker IDI Heart and Diabetes Institute.

Efforts to stem the obesity epidemic had now begun to focus as early as time in the womb.

“If you look at studies of populations, generally speaking, people who develop overweight and obesity maintain that over time,” she said. “So obviously, the earlier you develop it, the more weight you are likely to gain.

“In that sense, early prevention is really critical. The more we can delay the onset, the less extent of severe obesity we are likely to see.”

Brought to WA by LiveLighter, Associate Professor Peeters warned that adult Australians were gaining on average between 0.2kg to 0.5kg a year.

“The other critical area seems to be middle age, as that is another life period where people tend to put on quite a lot of weight and we see really large increases in waist circumference,” she said.

Markers for the need of an exercise and diet overhaul to prevent chronic disease were a body mass index of 25 and above and a waist circumference of more than 80cm in women and 94cm in men. High risk is a waist of more than 88cm in women and 102cm in men.

Associate Professor Peeters said problems in senior years clearly associated with obesity included cancers and there were strong associations with musculoskeletal disease and dementia. The link was either hormonal, metabolic or due to the extra mass carried.

“One of the interesting things as people age, when you get above 60 or 65, is people do not seem to put on so much weight anymore but their waist circumference seems to continue to increase,” she said.

“The jury is still out on what significantly impacts and makes waist circumference increase when weight is not increasing. But the simplest explanation appears to be as people age they lose muscle and with that you lose weight but actually people are still putting on abdominal fat because they are still not exercising or eating unhealthy food.”



