Obesity Crisis with Dr. Amp

The Obesity Crisis: The Beginning of Uninvited Diseases

Obesity It is one of the chronic non-communicable diseases (NCDs), as well as type 2 diabetes, high blood pressure or cancer. Obesity is a threat that the whole world must fight together, because in addition to having a direct negative impact on physical health, it also has an indirect negative impact on economic and social conditions.

According to the World Health Organization (WHO), obesity is a condition in which the body accumulates too much fat, resulting in abnormalities in various systems in the body, such as obstructive sleep apnea (OSA), joint problems, and other conditions. Weakened immune system Metabolic disorders, high sugar and lipid levels Increased inflammation in the body, risk of type 2 diabetes, cardiovascular diseases (CVDs), and cancer, etc.

Dr. Tanupol Wirulahakarun or Dr. Amp, Chairman of the Board of Directors of BDMS Wellness Clinic and President of the Bangkok Association of Obesity Rehabilitation and Education Promotion Physicians (BARSO) The issue of obesity is raised on the occasion of "World Obesity Day", which falls on March 4, to raise awareness of the dangers caused by obesity and to stop the increase in the obesity crisis.

Obesity crisis

According to data from the World Obesity Federation in 2020, about 1 billion people, or 1 in 7 people, are facing obesity problems, in line with the World Health Statistics 2023 report of the World Health Organization. According to data from the Ministry of Public Health, in 2023, 48.35% of Thai people were overweight and obese.

However, Another age group that should not be ignored is the childhood group because childhood health conditions can affect health conditions and quality of life as adults. For example, a study published in the journal Frontiers in Nutrition in 2023 estimated that children and adolescents with obesity are 5 times more likely to become obese adults compared to non-obese children, with 55% of children obese from school age developing into obese teenagers, and obese adolescents 80% more likely to develop into obese adults and 70% more likely to become obese by the age of 30. The number of children who are overweight and obese has increased significantly. World Health Organization The prevalence of overweight and obese children aged 5-19 years has increased from 4% in 1975 to 18%, or more than 340 million people. In 2016

For Thailand Reports from the Medical and Health Warehouse System Ministry of Public Health In monitoring obesity and obesity in children. In 2023, it was revealed that the prevalence of overweight and obesity was 8.98% among children under 5 years old, 13.68% in children aged 6-14 years, and 13.72% in children aged 15-18 years.

Obesity is fatal, as well as any other disease.

Dr. Amp explained that obesity has many stages, just like other diseases, starting from the absence of symptoms to severe complications, so preventing obesity is better than letting obesity cause illness.

The American Association of Clinical Endocrinologists (AACE) defines obesity as having three main stages:

Phase 0 Adipose tissue condition Adipose tissue, but no complications have been found.
Phase 1 Stages with at least one mild to moderate complication associated with obesity
Phase 2 or the stage with at least one severe complication associated with obesity.

The problem of obesity has a negative impact on physical and mental health, both in the short and long term.Health effects depend on the severity of obesity. They are:

Metabolic consequences

Various disorders that affect waist circumference, high blood pressure, high blood sugar and lipid levels were found. Insulin resistance increases inflammation in the body, which is a factor that leads to chronic non-communicable diseases (NCDs) such as chronic kidney disease, type 2 diabetes, stroke, atherosclerotic cardiovascular disease (ASCVD), and cancer.

Gastrointestinal problems

Obesity is a leading cause of GERD, an increased risk of cholelithiasis due to higher cholesterol levels in bile, cholecystitis, and non-alcoholic fatty liver disease (NAFLD), which are among the risk factors for future cirrhosis and liver cancer.

Respiratory complications

When the body weight exceeds the threshold. Obstructive Sleep Apnea (OSA) causes poor quality sleep, daytime fatigue, reduced productivity losses (absenteeism and presenteeism), or drowsiness while driving a vehicle. Increase the risk of road accidents

Orthopedic issues

Overweight people often have pain in various bones and muscles such as the spine, hips, knees, and ankles, making it difficult to move, difficulty walking, and in the long run, the excess weight will press on the cartilage. One of the causes of knee osteoarthritis

Psychological impact

Obesity affects mental health by increasing rates of depression, social isolation, and less interaction with peers. Weight Stigma can sometimes cause anxiety, stress accumulated within the mind, and manifest negative behaviors such as consuming more than usual (Binge eating disorder), being aggressive, not being able to control one's own tantrums, etc.

The indicator of obesity is body fat mass.

To understand the definition of obesity, Dr. Amp recalled that obesity was originally determined by the Body Mass Index (BMI), where overweight people have a BMI of 25 kilograms per square meter or more, and obese people have a BMI of 30 kilograms per square meter or more. In assessing obesity because it is not possible to assess body composition, such as people with the same BMI. For example, bodybuilders have more muscle than people who lack exercise, so BMI is not recommended as a diagnosis alone.

Dr. Amp recommends that other tools should be used, such as measuring waist circumference, because it can indicate fat accumulation. The risk of metabolic syndrome is that the waist circumference of Asian males should not exceed 90 centimeters (36 inches) and Asian adults should not exceed 80 centimeters (32 inches).

However, Dr. Amp recommends that measuring body composition with a DEXA (Dual-Energy X-ray Absorptiometry) machine to assess the total body fat proportion is the most accurate way to assess obesity. Women should not have a fat proportion of more than 32%, and men should not exceed 28%.

Causes of obesity

People often think that obesity is caused by eating too much and lack of physical activity. Obesity comes from a combination of many causes. Whether it's poor sleep. Abnormal hormonal activity Taking certain medications to the genetic code all affect the body's energy metabolism and hunger and satiety control system.

Hormonal causes

One of the causes of obesity is due to an imbalance in the body's hunger and satiety control, which is controlled by the nervous system and endocrine glands.

An important hormone, leptin, makes the body feel full. This hormone is secreted by fat cells. If we don't get enough sleep, it will result in a decrease in the secretion of the hormone leptin. The craving for food will increase. In obese people, there is leptin resistance, that is, the body does not respond to the satiety signal of the hormone leptin. This makes you feel full and does not stop eating.

The hormone that works in the opposite way, Ghrelin, or the hunger-stimulating hormone, is secreted a lot before meals and decreases when you start eating. In people with obesity The secretion of ghrelin hormone is abnormal, that is, even after eating, the level of ghrelin hormone does not decrease. This causes appetite not to decrease.

Genetic causes

Many times, it is often found that if an adult in the family is obese. Children and grandchildren are also often obese. The genetic code is related to obesity, such as MC4R, POMC, FTO, or Fat Mass and Obesity-Associated Gene, etc.

However, Dr. Amp emphasizes that the genetic code is not the only cause of obesity. More important factors are lifestyle habits, such as family eating patterns, such as having a full table of meals or the amount of food per plate that is too large, and the nature of the food eaten, such as the consumption of foods and drinks that are high in sugar, high fat, or processed foods (processed meats, sausages, sausages, sausages, crunchy snacks, and other foods that are not processed or processed (processed meats, sausages, sausages, sausages, crunchy snacks, and other foods that are not processed or processed foods). Snacks Fast food)

Epigenetics

Although internal factors such as genetics or genes are something that has been with us since birth and cannot be changed. But now there is a science called epigenetics, which is the study of gene expression that is not altered by the genetic code, but is triggered by "lifestyle habits". Affects the body's metabolism Exercise - Increased expression of the PGC1α gene that regulates energy metabolism and mitochondrial formation, and insufficient rest - Decreased activity of the Cry1 and BMAL1 genes associated with an increase in blood levels of the hormone cortisol. It also affects the SCD1 gene, which plays an important role in the process of forming and breaking down fat in the body, etc.

It can be seen that "Lifestyle Habits"Poor diet, insufficient sleep, and lack of exercise are also major factors that contribute to overweight and obesity.

This is to prevent body weight gain. Dr. Amp has introduced 7 simple health care guidelines to stay away from obesity as follows:

Choose to eat 50% vegetables in one dish, 25% good quality proteins such as fish, tofu, nuts, and grains, and the last 25% are whole flour rice such as brown rice.
Avoid foods that are high in fat or low in consumption, especially trans fats and saturated fats such as lean meats. Animal skins, offal, cakes Fast Food Bubble tea Processed meats such as bacon, sausages, ham, jam, sausages, sausages, pork slices, pork sausages, meatballs, etc.
Avoid foods and drinks that are high in sugar, especially those containing High Fructose Corn Syrup (HFCS), such as nectars, soft drinks, syrups, and other drinks. Juices, jams, candies, cookies, ice cream Cakes, pies, etc.
Exercise regularly for at least 150 minutes per week or at least 30 minutes 5 days a week.
Get enough sleep at least 8-9 hours every day and go to bed before 4 p.m. so that the body can secrete hormones normally.
Refrain from drinking alcohol and smoking.
Relieve stress by meditating, walking, or doing activities that calm your brain.

Obesity is a complex matter that occurs due to many factors, so it requires the cooperation of all sectors, including family institutions, educational institutions, the public and private sectors, to modify the lifestyle and environment of Thai people to stay away from obesity.

On the occasion of World Obesity Day 2024, under the concept of ‘Let's Talk About Obesity And.....’ This leaves a gap for everyone to choose important issues related to the obesity prevention campaign. Therefore, the doctor would like to be a part of raising awareness of the dangers of obesity. "Because this is not only about individual health, but about investing in our society, let's start preventing obesity to create a society where our children can grow up to be healthy adults together." Dr. Amp concluded his remarks.

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