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  • Ann-Sophie Briest, MD

Obesity - a global disease

Obesity is a chronic disease that is defined by excessive body fat. It is a universal AND ‘modern’ problem, affecting large numbers of not only western but most populations worldwide nowadays.

So, let’s have a look at the definition of obesity, some of the causes, possible long-term consequences and finally ways to treat that modern ‘pandemic’ with Yoga and other integrative strategies!


Definition:

To understand the definition of obesity we first have to look at the BMI (body-mass-index). Through the BMI we get an approximate idea of one’s body fat since the BMI is calculated by relating one’s weight to one’s height.

The formula used is:


BMI = (body mass in kg) / (body height in meters)^2


This looks a bit complex but the BMI is actually quite simple to calculate. Just try it.

If the BMI is between 18.5 and 24.9 we talk about normal or ideal weight. With a BMI of 25 to 29.9 one is considered slightly overweight and a BMI over 30 is defined as obesity.


Note: Since the BMI does not take into consideration the source of weight (fat versus muscle mass) very muscular people (i.e. body builders) have a rather high BMI but do not have the same long-term risks as obese people!


Prevalence:

If we look at statistics that take into consideration the number of people whose BMI exceeds 25, the worldwide prevalence of obesity is shocking:

For example, around 75% of the North-American population is falling into this category. If the BMI exceeds 30 the number of affected people drops to - a still alarming - 20-33% of the entire ‘western world’.


Causes:

Let’s look at the most common causes of obesity. Modern research confirms that in most cases obesity is a lifestyle related, chronic problem.

It is often multi-dimensional and takes time to develop. Thus it needs time to be addressed and managed thoroughly. The main causes are:

  • Lifestyle (lack of exercise; unhealthy diet; lack of sleep; increased stress levels)

  • Psychosomatic (emotional and/or binge eating)

  • Others (certain medication such as cortisol; hereditary predisposition)


Long-term complications:

It is important for us to understand that while the BMI of a person generally indicates obesity we also need to understand the fat distribution.

Abdominal obesity which points to visceral fat (fat around the internal organs) is a high risk factor for other chronic diseases.

  • This abdominal fat distribution is sometimes referred to as ‘android’ or central obesity because it is often seen in men (often called apple shape)

  • On the other hand the ‘gynoid’ obesity which is mainly seen in women emphasises the fat distribution on the hips and thighs and is - in its mild forms - less risky for the overall state of health (often called pear shape).

By the definition of the WHO (world health organisation), visceral obesity is present if the abdominal circumference exceeds 88cm (women) or 102cm (men). All these numbers measures are simply an attempt to define boundaries of healthy body mass and fat distribution but should indeed be taken with a pinch of salt, understanding that in reality we find smooth transitions.


Ok, let’s take a deep breath and look at some of the common so-called complications of obesity - they are in fact long term consequences and will most likely in a way or another affect those individuals with chronic obesity:

  • Metabolic Syndrome which includes

-> Type 2 diabetes

-> High blood cholesterol & triglycerides

  • Cardiovascular disease which includes

-> High blood pressure

-> Arteriosclerosis

-> Heart attack

-> Stroke

  • Respiratory problems which includes

-> Sleep apnea

-> Asthma

  • Fatty liver disease

  • Gallbladder disease often leading to surgery

  • Chronic back pain

  • Osteoarthritis often leading to joint replacement

  • Urinary incontinence especially in women

  • Cancer (especially of the esophagus, pancreas, colon, rectum, kidney, endometrium, ovaries, gallbladder, breast or liver)

  • Emotional health issues which includes

-> Low self-esteem

-> Depression


How can Yoga Therapy help:

After reading this long and rather depressing list of complications let’s focus now on healing strategies. Yoga Therapy acknowledges that treating and eventually healing obesity is way more than ‘just losing weight’…


Yoga Therapy offers diverse behavioural , physical and psychosocial effects which are based on a multi-dimensional toolbox. This includes yoga postures (asana), breathing techniques (pranayama), meditation and relaxation practices, lifestyle and dietary recommendations as well as psycho-emotional work.

Check out this study which investigates how Yoga practice supports weight loss: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4995338/


As usual the specific recommendations depend on each individual. However, generally techniques which include the activation of the body's metabolism, deep relaxation practices as well as continuous training of mindfulness and increased self-awareness are cornerstones of an effective treatment in the case of obesity. Therapeutic variations as well as techniques which are gentle on the joints and respect any pre-existing conditions such as high blood pressure are utterly important when putting together a yoga sequence.

A fresh, seasonal and regional diet which omits any processed, fried foods and alcohol will support further weight loss.


Joining a yoga class will also add a psychosocial support which - in some cases - is essential to stay motivated and stabilise the healthy weight and lifestyle. Caring for and supporting one another is a powerful way to become and stay healthy!


In the end, being genuinely comfortable and feeling well in ones

own body is a subjective phenomenon and certainly not merely connected

to numbers and measures!

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