By Suzanne MacNevin.

Disclaimer:

This site is meant as a "virtual poke in the virtual fatty ribs". Its a joke meant to provoke thought, but Suzanne MacNevin uses statistics from the Canadian and US governments to show you how real the problem is. If you want to lose weight, do so for the right reason: Your health. Losing TOO MUCH weight is not good for your health. We suggest a healthy balance. Its up to you to decide what that healthy balance is.

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Severe obesity is a serious health condition that can lead to an earlier death. An individual who is 20% heavier than his or her ideal weight (determined by standard medical and insurance data) is considered obese. Severe obesity, more than 100 pounds overweight, occurs when the body stores excess energy in the form of fat. It is a complex disorder that may be the result of biochemical, physiologic, genetic or inherited influences on weight maintenance. Environmental, cultural, socioeconomic and psychological influences may be contributing factors. A variety of medical problems, including high blood pressure, heart problems, diabetes, sleep apnea, depression and arthritis, have been associated with being overweight.

Cardiovascular problems are common among obese people. High blood pressure can lead to the development of heart disease, kidney failure and stroke. Severely obese people are approximately six times more likely to develop heart disease. The heart in an obese person is required to work harder, which can lead to early development of congestive heart failure. Severely obese people often have elevated cholesterol levels in the blood, which can contribute to heart disease and the hardening of blood vessels. Diabetes, which frequently strikes the obese, is another risk factor for developing coronary heart disease.

An overweight person is 10 times more likely to develop Type 2 diabetes (adult-onset diabetes). High blood-sugar levels in diabetics damage body tissues. Diabetes is a major cause of kidney failure and is the leading cause of adult-onset blindness. Diabetes causes over one half of limb amputations and is the third leading cause of death in the United States.

Obesity can also cause respiratory problems. Breathing is difficult as the lungs are decreased in size, and the chest wall is very heavy and difficult to lift. Daily activities such as shopping, yard work, stair climbing and exercise may be hindered by breathing problems.

While obesity does not cause asthma or bronchitis, it interferes with breathing and may aggravate an attack. Obesity, however, may cause sleep apnea, a serious condition that occurs when people stop breathing during sleep. When soft tissue in the throat collapses around the airway, a complete blockage occurs and the person stops breathing. In the long-term, sleep apnea can cause high blood pressure, heart rhythm disturbances and sudden death.

For the severely obese, particularly those over 350 pounds, obesity hypoventilation is a concern. Often associated with sleep apnea, this abnormal breathing condition results in the accumulation of toxic levels of carbon dioxide in the blood.

Musculoskeletal problems, such as low back pain and arthritis, are common among the obese. Because the entire weight of the upper body falls on the base of the spine, the spine may wear out in obese people, resulting in arthritis of the spine or disc problems. Most of the weight of the body is borne by the hips, knees, ankles and feet, which tend to wear out more quickly in obese people, resulting in arthritis. Obese patients have poorer results with joint replacement surgery and some surgeons refuse to perform such surgery on severely overweight people.

Obese people are more likely to have heartburn or gastroesophageal reflux disease (GERD) where stomach acid backs up into the esophagus. Increased stomach pressure from abdominal fat results in a high rate of reflux in obese people.

Urinary incontinence may result from a large, heavy abdomen that causes the valve on the urinary bladder to be weakened. As a result, leakage of urine may occur when coughing, sneezing or laughing.

Venous stasis disease, or diseased blood veins in the legs, may occur in obese people. The pressure of a large abdomen may increase the workload on delicate valves in the veins of the lower legs, eventually causing damage or destruction. Blood in the leg veins, which is normally carried to the heart, backs up, causing higher pressure in these veins. This leads to swelling, thickening of the skin and sometimes skin ulcers.

Obesity may also cause female hormone abnormalities or an alteration in the balance of female sex hormones. Infertility, ovarian cysts, and absent or irregular menstrual periods may result.

In addition to a supervised diet and exercise program, obese individuals may benefit from surgical treatments, which may provide dramatic improvement in their health.

Note to Readers:

For more than a decade, information about overweight and obesity among Canadians has been based on self-reporting. That is, survey respondents reported their own height and weight rather than being measured and weighed.

However, this practice tends to underestimate the prevalence of overweight and obesity.

The 2004 Canadian Community Health Survey: Nutrition (CCHS) collected information from over 35,000 respondents between January and December of 2004, and directly measured most respondents' height and weight. As a result, it is now possible to draw a more accurate picture of the prevalence of overweight and obesity in Canada.

Over 25 years have passed since the 1978/79 Canada Health Survey measured the height and weight of a nationally representative sample of Canadian children and adults. Results from that survey and the 2004 CCHS can be compared to derive a realistic picture of the trend in overweight and obesity over the past quarter century.

This report is the first of two data releases from the survey. The interview for the 2004 CCHS was composed of two distinct sections. Respondents were asked to provide detailed information on all foods and beverages consumed during the past 24 hours. Information collected included the types of foods and the amounts eaten.

Respondents also completed a general health questionnaire which collected information on subjects related to diet such as chronic conditions and socio-demographics, as well as measured height and weight.

Available today are results from the general health portion of the survey. Nutritional information related to foods consumed by respondents will be available in the fall of 2005.

Comparisons to the United States are made using data collected as part of the 1999/2002 National Health and Nutrition Examination Survey.

Among young people, the biggest increases in obesity rates over the past 25 years occurred among adolescents aged 12 to 17, where the rate tripled from 3% to 9%. For adults, the most striking upturns occurred among people who were aged 25 to 34, and those who were 75 or older where the rates more than doubled to 21% and 24% respectively.

Even so, Canada's adult obesity rate was significantly lower than that in the United States. While 23% of Canadian adults were obese in 2004, the rate was nearly 30% south of the border.

Overweight and obesity rates were calculated using the body mass index (BMI), which is calculated by dividing weight in kilograms by height in metres squared.

For adults, a BMI of 25 or more indicates overweight and an increased risk of developing health problems; 30 or more indicates obesity and a high to extremely high risk of developing health problems.

For example, an adult male who is 1.8 metres tall (five feet, 10 inches) and weighs 95 kg (210 pounds) would have a BMI of 30 and be considered obese. Similarly an adult female who is 1.6 metres tall (five feet, 4 inches) and weighs 80 kg (175 pounds) would have a BMI of 30 and also be considered obese.

BMI is calculated using the same formula for children and adolescents. However, the cut-points for being overweight and obese vary by the age and sex of the child. Notable increase in obesity among adolescents

Increases in overweight and obesity were similar among boys and girls. However, trends differed for various age groups.

For example, the proportion of children aged two to five who were either overweight or obese remained virtually unchanged from 1978 to 2004. In contrast, the overweight/obesity rate of adolescents aged 12 to 17 more than doubled from 14% to 29%, while their obesity rate alone tripled from 3% to 9%.

This upturn among adolescents is of particular concern because overweight or obese conditions in adolescence often persist into adulthood.

Rates of overweight and obesity among youth varied across the country, with the highest rates being in the Atlantic provinces.

In 2004, the combined overweight/obesity rate of young people aged 2 to 17 was significantly above the national level in Newfoundland and Labrador, New Brunswick, Nova Scotia and Manitoba. The combined rate was significantly below the national level in Quebec and Alberta

The prevalence of obesity was significantly higher than the national average in Newfoundland and Labrador and New Brunswick.

Overweight and obesity rates of Canadian and American boys did not differ significantly. However, Canadian adolescent girls were significantly less likely than their American counterparts to be obese.

According to CCHS data, children and adolescents who reported eating fruits and vegetables five or more times a day were substantially less likely to be overweight or obese than those who consumed them less frequently. About 4 in 10 children and adolescents (41%) reported that they ate fruit and vegetables five times a day or more.

The survey also found that among children aged 6 to 17, the likelihood of being overweight or obese tended to rise with time spent watching TV, playing video games or using the computer.

Adults: Obesity rates up in almost every age group

During the past 25 years, obesity rates rose for every age group among adults except those 65 to 74. The most striking upturns were among people younger than 35 and those 75 or older.

For instance, the proportion of adults aged 25 to 34 who were obese more than doubled from 9% to 21%. Similarly, the rate among people aged 75 or older rose from 11% to 24%.

In 2004, men and women were equally likely to be obese. However, both the World Health Organizations (WHO) and Health Canada divide obesity into three categories of severity. A higher percentage of women than men were in the most severe class where the risk of developing health problems is considered extremely high.

For both sexes, obesity rates were lowest, around 11%, for those aged 18 to 24. They peaked around 30% among individuals aged 45 to 64. About one-quarter of seniors were obese.

With a few notable exceptions, adult obesity rates did not vary greatly by province. In 2004, the rate for men was significantly above the national level in Newfoundland and Labrador and Manitoba. The rate for women surpassed the national figure in Newfoundland and Labrador, Nova Scotia and Saskatchewan.

Large differences between Canadian and American women

Over the past decade Canada's obesity rates have been based on self-reported data, whereas the United States has derived rates from actual measurements of height and weight since the early 1960s. With the measured data from the 2004 CCHS, it is possible to compare the current prevalence of obesity in the two countries.

Age-standardized results show that 30% of Americans aged 18 or older were obese in 1999/2002, significantly above the Canadian rate of 23%.

Most of this difference was attributable to the situation among women. While 23% of Canadian women were obese, the figure for American women was 33%.

Lifestyle factors: Diet, physical activity and income play a role

As might be expected, the likelihood of being obese was related to diet and exercise. Adult men and women who ate fruit and vegetables less than three times a day were more likely to be obese than were those who consumed such foods five or more times a day.

Although other factors may be driving this relationship, the association persisted when age and socio-economic status were taken into account. However, because the CCHS data are cross-sectional, the causality of this relationship cannot be determined.

Physical activity, too, was related to the prevalence of obesity. People who spent their leisure time in sedentary pursuits were more likely than those who were physically active to be obese.

For example, 27% of sedentary men were obese, compared with 20% of active men. Among women, obesity rates were high not only for those who were sedentary, but also for those who were moderately active. These relationships remained statistically significant when adjustments were made to account for age and socio-economic status.

Socio-economic factors such as marital status, education and income also influenced an individual's chances of being obese. For example, men living in higher income households tended to have higher chances of being obese. Meanwhile, women coming from middle income households had higher levels of obesity.