New data from Obesity and Disease Development, Sweden, involving over 250,000 men between the ages of 17 and 60 years, has found that those who gain excess weight between 17 and 29 years of age face a greater risk of aggressive prostate cancer and a subsequently higher risk of dying from the disease. The study, yet to be peer reviewed, was presented at the European Congress on Obesity 2023 in early May. The researchers found that men who put on 13kg between 17 and 29 years of age faced a 13% increased risk of aggressive prostate cancer and a 27% increased risk of dying from it in old age.
It is an issue that sits heavy on everyone’s mind and also burdens the public health budget of governments worldwide. Excessive and unhealthy weight gain, often labelled as the modern crisis of obesity, is of major concern to health authorities as it is directly linked to several health problems, diseases and quality of life as well. “Weight gain can lead to elevated blood pressure and cholesterol levels, increasing the risk of cardiovascular diseases like hypertension and atherosclerosis. It can also contribute to the development of respiratory issues, including sleep apnea and asthma,” says Dr Sukhvinder Singh Saggu, director of minimal access, gastrointestinal and bariatric surgery at CK Birla Hospital in Delhi.
Obesity, now categorised as a disease by the World Health Organisation (WHO), has been linked to Type 2 diabetes, hypertension, hyperlipidemia, gastroesophageal reflux disease, obstructive sleep apnoea, varicose vein, liver diseases and certain cancers, says Dr Manoj Jain, consultant for general surgery, bariatric, metabolic and robotic surgeon at Kokilaben Dhirubhai Ambani Hospital in Mumbai. While it isn’t exactly clear how obesity causes cancer, about 4–8% of all cancers are attributed to obesity.
Mental health can also be affected as weight gain is directly linked to an increased risk of depression, anxiety, and low self-esteem. Weight gain during pregnancy can lead to complications such as gestational diabetes and preeclampsia.
Additionally, in some cases, it could lead to infertility in male and females, decrease libido and sexual performance, and erectile dysfunction/ Impotency in male partner.
In India, several factors — lifestyle, cultural, and environmental — contribute to weight gain and the increasing prevalence of obesity, notes Saggu. “The significant cause of weight gain is a shift in our dietary patterns due to urbanisation and economic development. A diet heavy in processed foods, sugary drinks, and bad fats can cause an imbalance of calories and lead to weight gain,” he says. Jain adds that obesity is multifactorial with the common causes being genetic, excess caloric intake, inactive lifestyle, environmental factors, medication, psychological factors, and disease conditions.
“Excess calorie intake is very common. If you eat more than your body requires then you gain weight, and extra calories get stored as visceral fat. Lack of physical activity and exercise, spending long hours on a desk job or watching television for long duration are examples of lack of physical activity. Environmental factors such as easy availability of junk food, processed food and psychological factors such as emotional stress, anger, sadness and binge-eating can all lead to obesity,” Jain adds.
An irregular or insufficient sleep cycle also leads to increased hunger, triggers cravings for unhealthy foods and hampers satiety, points out Saggu. Poor sleep can also lead to higher levels of the stress hormone cortisol, which promotes fat storage, particularly around the abdomen. Weight gain is also a common issue faced by women as PCOS and menopause lead to imbalances in insulin and hormones. Such hormonal shifts can lead to changes in body composition, including increased fat storage.
However, one must bear in mind that it is possible to be fat yet fit. “A professional weightlifter with a height of 5'4" might weigh 77kg but the BMI scale would render her/him obese. The weighing scale does not account for his muscle weight (muscle is heavier than fat) and the levels of strength and power which is allowing her/him to compete in the 77 Kg category,” says AK Abhinav, coach and founder of Namma X-fit in Bengaluru. In a similar vein, a study published in the journal Medicine & Science in Sports & Exercise in January 2019 argued that a single minded focus on weight loss is misguided. Obesity in itself is not the biggest problem but a sedentary and active lifestyle is because “a moderate-to-high level of cardiorespiratory fitness attenuates, or eliminates, mortality risk associated with high BMI (body mass index). The BMI scale was initially introduced to classify populations based on their weight and height but health and fitness science has progressed beyond it, points out Abhinav. “Unfortunately most of us still use this as an indicator of our health,” he says.
While genetic and health factors are a bit more difficult to control, others like inactive lifestyle and poor dietary choices are well within our control and can easily be addressed. Both Saggu and Jain agree that diet and exercise play a vital role in weight management and shedding unwanted pounds. Exercise and nutrition work parallely in weight management. Exercise enhances the body's ability to burn calories and maintain a healthy metabolism, while proper nutrition provides the necessary fuel for exercise and supports overall health.
“Regular exercise helps burn calories, improves metabolism, and builds lean muscle mass. It contributes to creating an energy deficit in the body, which is essential for weight loss. Exercise is important for the improvement of cardiovascular health, enhances mood, reduces stress, and increases overall wellbeing. A combination of aerobic exercises (such as jogging or cycling) and strength training (like weightlifting) is recommended for optimal results,” advises Saggu. Jain suggests 45 to 60 minutes exercise daily. “Your activity routine should include at least one indoor and one outdoor sport. Avoid processed and junk food and liquid calories,” adds Jain.
Nutritionists and medical experts also point out that a balanced diet that provides essential nutrients while controlling calorie intake is also important to manage your weight. “A person who consumes nutrient-dense foods, such as fruits, vegetables, whole grains, lean proteins, and healthy fats, is comparatively healthy and fit. Portion control and mindful eating are essential to prevent overeating. Reducing the intake of sugary snacks, processed foods, and beverages high in calories is crucial for weight management,” adds Saggu. Jain suggests a calorie intake of 1,200 to 1,500 kCal per day, adding that your food ought to have less carbohydrates and more protein.
Above all, says Saggu, it’s important to adopt a sustainable approach that combines regular physical activity with a balanced, nutrient-rich diet to achieve and maintain a healthy weight.