Reversing Chronic Disease Associated With Obesity

We know now that the overweight condition leading on to obesity slows us down, changes our habits, puts a definite strain on our physiologic systems and may gradually or even rather quickly lead into diabetes, cardiovascular and renal disease, and eventually cancer. These are all regarded as chronic diseases, that is disorders that are not immediately life threatening, but which in longer term will exact a considerable toll.

These consequences as they follow on from overweight/obesity are different from person to person, but on average everyone is somehow affected — some more seriously that others, some sooner than others. In general, in the United States persons who are highly overweight or obese incur on average several thousand dollars more in medical expenses when compared with others who have normal weight. The overweight/obese person does not necessarily die earlier than a person of normal weight but is on average sicker than a person of normal weight. Genetics as usual will play an important role as well, protecting some and accelerating the consequences of overweight/obesity in others.

Becoming overweight or obese does not happen overnight, and the changes that occur in our physiology occur slowly as well. The stresses and strains of being 50 pounds overweight for example often do not seem that great when we finally get there as those pounds will have been added quite slowly. However, if you want to see the burden you’ve assumed, pick up a 50 pound sack of potatoes and try carrying around on your back for the day. You will notice the burden it produces. However, if you add just a potato or two to a sack you carry around with you for the next 30 years or so then the overall added 50 pounds won’t seem like quite so much. You will have become used to the added weight very gradually. Your muscles may even get stronger, but generally that won’t happen because you’ll adjust to the added weight by sitting more than you stand or walk about.

As you add weight you have likely eaten or drank many sugary items. Your body will try to help you by suppressing the entry of sugar into cells where it can be metabolized to fat and stored — a complex process we may come back to later. The cells that allow sugar to enter are stimulated generally by insulin and so slowing down the entry of sugar into those cells is mainly about making them insulin resistant. Once insulin resistance starts type-2 diabetes is not far behind. Later other changes in metabolism start occurring and these produce both cardiovascular and renal effects. Overall, the way your body produces and regulates its energy becomes confused. The fat which accumulates puts a general stress on the liver and in turn on other physiologic systems as well as on the strength and stability of the vascular system. Reversing the serious changes that are occurring is a tall order, but it can be done.

As I noted in the last blog post this is preferably done by eating 5-6 times a day, the total amount of calories in which are about 200 – 400 below what you need to get through the day. This is not too hard to do, but it seems so in the beginning. The hard part is thinking through how many calories you burn in a 24 hour day. Once you do that you will find out how much you can eat during the day (200 – 400 less than you burn). You can look this up on the Internet. Everything counts: eating, sleeping, doing housework, exercising, preparing meals and eating them, walking and all other forms of exercise. The more you weigh to begin with the more you burn in an hour — even sleeping. Do the numbers.

If you are very inactive — sleeping and sitting in the couch most of the day while others bring you meals — you’ll have to pick up your activity level. Divide the day into three sections at least: 8 hours sleeping, 8 hours of the equivalent of sitting on the sofa and 8 hours doing something more strenuous. You’ll get your ideas from looking at the tables you’ll find on the Internet. At the beginning you want to get to at least 2500-3000 cal per day. This may not be that hard for many, but it could be. That means the you will need to decide what you can then eat at meals and snacks during the day.

Let’s say you can eat about 2200-2300 calories per day. That will give you about 500 for each meal and about 250 calories for each snack. That’s a good place to start. You could always do a little less for snacks and a little more for meals, say 600 and 150, respectively. Then develop your portions and meals around that. You have many options. Just remember the general rules — no white sugar, no junk food, stay with lots of vegetables and fruits, very little dairy, little or no red meat, some fish, chicken. Whey protein is a good protein supplement. Vegetables and fruits should have a low glycemic index (GI). Drink plenty of water. By eating less more often and drinking the water your basal metabolic rate will increase. Overall, this may be a big change for you. Just get started. See how it goes. Make the necessary adjustments as you move along. Weigh in once a week and after a month or so the scale will help with the next round of decisions.

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