Posts Tagged ‘Obesity’

We Can Improve Our Eating Habits by Returning to Our Roots

November 25th, 2015 at 3:13 pm by timigustafson

It is well known that when immigrants come to the United States and other parts of the Western hemisphere, they quickly adapt their eating styles to ours – especially the young. People from around the Pacific Rim, South America, the Middle East and Africa who were largely raised on fresh whole foods begin to prefer fast food and other highly processed ingredients, often to the detriment of their nutritional health and well-being. The consequences in terms of obesity and diet-related diseases can be devastating.

This is not a new phenomenon. As it happens, I just returned from a two-day conference that was organized by Oldways, a non-profit organization with focus on culinary and cultural diversity around the globe. Its founder, Dun Gifford, a lawyer, politician, developer and restaurant owner, became concerned as far back as the 1980s with the progressive disappearance of many culinary traditions in favor of what he called “techno foods.”

Why does your culture matter when it comes to your food choices, he asked. Because – no matter where you come from – it is not in your heritage to become overweight, diabetic, or develop heart disease and cancer, all the leading causes of death in the modern world. What we all should have in common as our birthright is, by contrast, a healthy heart, a strong body, extraordinary energy, and a long and healthy life – all of which we would be enabled to by access to nutritious and delicious foods.

Instead, many of us have lost their way when it comes to feeding themselves, and it affects those who adopt our lifestyle more recently the most. Part of it is a widespread ignorance and confusion about nutrition and nutritional health.

The conference I mentioned was titled “Finding Common Ground,” a meeting of many of the world’s leading experts and scientists in the field of dietetics. Although it was clear from the start that there would be (and will continue to be) different, and oftentimes conflicting, views on how and what we should eat, there was also a general consensus on a few basic ‘truths’ that could be shared by all participants. Among them were the desire that messages about diets should not be distorted or misleading; that some foods yield greater nutritional benefits than others; and that considerations about food consumption should include environmental sustainability concerns. The latter, as you may have heard, is a major point of contention in the upcoming release of the Dietary Guidelines of 2015.

In addition, there was agreement that reviving certain culinary traditions could indeed have the kind of positive impact the Oldways’ founder envisioned. For instance, much has been made in recent years of the advantages the so-called ‘Mediterranean Diet’ can provide, with its richness of mostly plant-based foods. But also many other cultural heritages from South AmericaAsia and Africa have much to contribute to our rethinking of what it means to eat healthily.

What it ultimately comes down to is not to get blinded by the endless onslaught of diet fads and latest “scientific discoveries,” but to focus on the bigger picture and discern what is tried and true, which we can often find by simply going back to our roots, says Sara Baer-Sinnot, the current president of Oldways. For this, we need to communicate clearly and effectively what constitutes healthy and sustainable ways of eating that all consumers can understand and live by, she says.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (


A Widening Gap Between the Fit and the Fat

November 10th, 2015 at 4:58 pm by timigustafson

More people pay close attention to their physical health and well-being, and yet obesity rates and diseases stemming from weight problems continue to rise. While healthy eating and regular exercise have become commonplace among the educated and affluent, the less fortunate show little signs of improvement regardless of efforts by health experts and government policy makers to change their fate. In fact, studies find that the gap between the fit and the fat keeps widening.

Physical appearance has been an important issue in most societies throughout the ages, but today, how we look has become a reflection of how we live and visa versa, says Dr. Florentine Fritzen, a journalist and historian who studies sociological trends.

Being well-fed was once a sign of wealth, but poor people are now most prone to unhealthy weight gain and related diseases, while the well-to-do enjoy greater fitness and vitality, even longer life expectancy, than ever before.

Life presents itself very differently to these two groups. To which one you belong determines multiple aspects of your well-being, not just how well you eat, Fritzen says.

Your good looks also play a role in how society judges you. For example, if physical beauty and fitness are equated with hard work, discipline and success, overweight can then be identified with laziness and lack of self-control. If slim is thought of as healthy, then fat can be considered as sick.

Numerous studies have investigated how physical appearance plays out in the workplace. Just being overweight can hurt your career, according to Steve Siebold, a self-help coach, business consultant, and author of “Die Fat or Get Tough: 101 Differences in Thinking Between Fat People and Fit People.”
“Many employers look at obese candidates and immediately think, ‘this person failed in controlling their own health, how are they going to run a division,’” he warns.

More and more companies actively encourage their workers to stay on top of their health and offer wellness programs and other incentives, which in turn help them prevent productivity loss and lower healthcare premiums. But, as some have reported, there can also be a lot of pressure on those who ‘don’t measure up.’

What gets too often overlooked in all this is how much easier it is to stay in shape for people who have the necessary means to take care of themselves. What is feasible with a good education, financial security, access to supplies and services, a safe home and neighborhood, etc., can be a never-ending struggle without them. And that is not simply a matter of personal choices.

The Centers for Disease Control and Prevention (CDC) lists a number of determinants that decide whether someone’s living conditions are beneficial or detrimental for his or her health. Only one of them is based on biological factors like age, gender, and genetic predispositions. Only one is based on individual behavior such as diet and lifestyle choices. All others are environmental and circumstantial in nature, meaning they are largely outside a person’s control.

To fully understand the existing health disparities and inequities among the public today, we must take into account the social and economical disadvantages that affect individuals or entire groups in ways they cannot easily influence but expose them to heightened risks, the agency says. To narrow the gap towards greater health equality, it urges aggressive investing in broader access to healthcare services as well as health education.

Obviously, we have a long way to go.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (


Lack of Awareness Heightens Diabetes Risk, Study Finds

July 4th, 2015 at 4:58 pm by timigustafson

Only about 10 percent of people who are at risk of developing type 2 diabetes know about their condition, which makes it hard to take proactive measures while there is still time to prevent the full-blown disease, according to a new study.

Lack of awareness keeps a vast part of the population with elevated blood sugar that is not yet diabetic but can lead to worsening outcomes from making important lifestyle changes, such as cutting back on sodas and sugary foods as well as losing weight and getting more exercise, says Dr. Anjali Gopalan of the Philadelphia VA Medical Center, the lead author of the study.

“People with pre-diabetes who lose a modest amount of weight and increase their physical activity are less likely to develop diabetes. Our study importantly shows that individuals with pre-diabetes who were aware of this diagnosis were more likely to engage in some of these effective and recommended healthy lifestyle changes,” she told Reuters.

The prevalence of type 2 diabetes has dramatically increased in recent years and is estimated by the World Health Organization (WHO) to affect now about 9 percent of the adult world population. It has become the seventh leading cause of death.

Once considered a disease of older adults, it is fast spreading among children and adolescents, primarily in the developed parts of the world like North America and Europe, but also increasingly elsewhere.

Pre-diabetes is considered a precursor to diabetes, a chronic disease that occurs when the pancreas does not produce sufficient amounts of insulin or when the body cannot effectively use the insulin it is provided with. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or elevated blood sugar, is a common result of uncontrolled diabetes that can lead to irreversible harm, including to the nerves and blood vessels.

Although the causes of pre-diabetes and diabetes are well known, there is still much confusion and myth creation among the public that make it difficult to separate fact from fiction.

It is important to understand that diabetes comes mainly in two forms: type 1, which is caused by genetics and perhaps some other factors that are not yet fully understood; and type 2 diabetes, where genetic makeup can also play a role, but which is more often connected to diet and lifestyle.

The latter can usually be prevented or at least controlled through weight management, healthy eating and regular exercise as well as medication where necessary.

Unfortunately, pre-diabetes has no specific signs or symptoms, which makes timely detection so much harder. However, increased thirst, frequent urination, fatigue, and problems with vision can be red flags and should be brought to a doctor’s attention.

Experts recommend that especially people who are overweight, have a family history of type 2 diabetes, suffer from high blood pressure and/or high cholesterol, are over the age of 45, or belong to certain ethnic groups should be tested for pre-diabetes as part of their regular physical, regardless of symptoms.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (


Not One ‘Plus Size’ Fits All

April 23rd, 2015 at 1:20 pm by timigustafson

When it comes to treating weight problems, even experts believe that similar methods can be applied almost universally: Put your patients on a diet, have them engage in regular exercise, and, if all else fails, recommend some surgical procedure. What gets rarely looked at are the differences between overweight individuals that may have led to their unhealthy weight gain in the first place. Only one such study has recently been published, and the results are eye-opening.

For the study, scientists from the universities of Sheffield, England, Harvard, United States, and Toronto, Canada, analyzed medical data of over 4,000 overweight or obese men and women in terms of common and distinguishing characteristics. In the end, they came up with six ‘categories’ or ‘types’ that helped them better understand their subjects’ eating behaviors and lifestyle choices.

The first group was identified as “heavy drinking males” whose excessively high alcohol intake resulted in weight problems. Getting members of this category to limit their consumption of alcoholic beverages would obviously be an important step toward successful weight control.

The second group, named “younger healthy females,” consisted of women who were generally healthy except for their weight issues. Eating patterns and exercise levels were viewed as largely acceptable but were interspersed with bouts of binge eating and occasional heavy drinking, which, again, contributed to weight gain. Remedies hereto would be similar to their male counterparts.

A third type was called “the affluent and healthy elderly,” seniors who enjoyed retirement life a bit too much and paid the price with an unhealthily expanding waistline. Tuning it down a little would be the appropriate strategy.

Another group of older individuals was diagnosed with one or more chronic health conditions like diabetes and high blood pressure, in addition to being overweight. Those “physically sick but otherwise happy” people were often unaware of how their weight aggravated their other ills. Counseling with the aim of diet and lifestyle changes could lead to major improvements in such cases.

Mental dysfunctions like anxiety and depression were also found to be increasingly damaging to people as they grew older. The “unhappy, anxious middle-aged,” as the researchers named this group, often showed a close connection between their inner feelings and their outer appearance, especially in terms of weight. As psychological disorders oftentimes manifest themselves physically, equal attention must be paid to both the roots and symptoms before any progress can be hoped for.

Lastly, the research team focused on those whom they found in the “poorest health.” The prevalence of weight problems and chronic illnesses was especially high in this group, and eating and lifestyle patterns were predictably dismal. Overweight and obese patients of this type require intensive care and should be treated with the most effective methods. Because of the severity of the health conditions typically found in this category, the researchers saw here justification for the clinical weight loss approaches now widely in use.

Obviously, attempts like these to find patterns in complex phenomena have their limits. There might be numerous additional factors leading to weight gain that have not received enough attention in this particular study. But its central take-away is that the overweight and obese are not a homogenous part of the population with the same health needs, says Dr. Mark Green of Sheffield University, the lead author of the study report, in a press release about his findings. If we don’t come up with better solutions and more customized, or as he calls it “bespoke,” forms of treatment, we will continue to fail serving those who need our help most.

As a dietitian and health counselor, I couldn’t agree more. After all, that is what one-on-one counseling entails. But, unfortunately, the system is not set up for this sort of effort. For instance, health insurance companies favor short-term treatments like weight loss surgery over open-ended approaches, including diet and lifestyle coaching. We can only hope that studies like this will eventually bring a different view to the agenda.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (


By the end of this decade, diseases stemming from poor diet and unhealthy lifestyle choices will top all other causes of death worldwide. At the same time, there are no effective policies in place to tackle the most pressing problems such as the obesity epidemic and other so-called non-communicable diseases (NCDs) that are now affecting billions of people around the globe. Even in developed countries, these challenges are not yet fully understood and are not met with the necessary countermeasures to prevent further deterioration, experts say.

One study that analyzed the eating habits of nearly 4.5 billion people in 187 countries found a steadily rising popularity of the “Western diet” – which is dominated by highly caloric, processed foods and sugary drinks – in many parts of the world over the past few decades.

Ironically, the wealthiest regions like Northern America, Western Europe, and Australia have the lowest-quality nutrition standards despite of significant efforts to better educate their populations about diet and health matters.

Global progress in the fight against obesity and nutrition- and lifestyle-related illnesses like diabetes, heart disease, and cancer has been “unacceptably slow,” according to a series of reports in the medical journal The Lancet.

The reasons are multifaceted and not always easily identifiable, experts concede. But it seems clear that the odds against our ability to turn these developments around are almost insurmountably high.

“Today’s food environments exploit people’s biological, psychological, social, and economic vulnerabilities, making it easier for them to eat unhealthy foods. This reinforces preferences and demands for foods of poor nutritional quality, furthering the unhealthy food environments,” the reports say.

Especially the epidemic spread of childhood obesity is of great concern. Oftentimes, together with overeating comes malnutrition, which leads to stunted growth and other developmental problems in young children and adolescents. Many of these early in life occurring damages persist and worsen during adulthood and are hard to undo even with treatment.

“Our understanding of obesity must be completely reframed if we are to halt and reverse the global epidemic,” says Dr. Christina Roberto, a professor of social and behavioral sciences and nutrition at Harvard T.H. Chan School of Public Health and one of the authors involved in The Lancet series. “It’s time to realize that this vicious cycle of supply and demand for unhealthy foods can be broken with smart food policies by governments alongside joint efforts from industry and civil society to create healthier food systems.”

Unfortunately, we have long ways to go in order to achieve this kind of concerted action, not least because there is no universal agreement on the root causes of the obesity crisis and many other related issues.

Policy and environmental changes by themselves are unlikely to address the multiple problems with obesity we are facing today when even the experts can’t agree on how to treat them, says Dr. William Dietz, director of the Sumner M. Redstone Global Center for Prevention Wellness at George Washington University.

“Successful clinical interventions exist, but innovative approaches to delivery of care have only just begun, he wrote in an article also published in The Lancet.

Also, he laments, the medical community is not fully positioned yet to deal effectively with the obesity phenomenon.

“Health professionals are poorly prepared to manage obesity, have biases and unfounded assumptions about obesity, and are inadequately trained in various modalities of obesity treatment.”

All this impairs the quality of care, he says, and if we can’t reach beyond that, we won’t get to the right therapeutic approaches for a long time to come. In the meantime, it’s pretty much every man and woman for him- and herself.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (


Posting Calorie Values on Menus Shows Long-Term Success

November 13th, 2014 at 4:15 pm by timigustafson

The idea that providing more information about food served in restaurants, such as calorie and fat content, would reduce the risk of weight problems has widely been greeted with skepticism and outright rejection. Now a new study presented at the Second Annual Obesity Journal Symposium in Boston showed that calorie labeling on menus can indeed influence the choices people make once they become aware of the differences.

“Calorie labeling helps people understand what’s in their food, and makes them aware of healthier options,” said Charoula Nikolaou, a dietitian and doctoral candidate at the University of Glasgow, Scotland, and lead author of the study report in an interview with Science Daily.

Unlike some of the snapshot surveys taken in the past when calorie posting was first introduced and made mandatory for larger chain restaurants in places like New York City and parts of California and Oregon, this study followed a group of college students over a total period of two academic years, or 72 weeks.

During the first year, calorie information was displayed in cafeterias on campus for only five weeks, while in the second year the practice was continued for nearly the entire time. As expected, the shorter experiment produced little if any changes in the participants’ food choices. However, in the following period, when calorie information was given consistently and was presented in predominant, easily discernable ways, their eating behavior eventually changed, resulting in virtually no weight gain for most of the students.

“We were glad to see that exposure to our prominent calorie labeling for an entire school year did not just reduce weight gain in these students, but eliminated it altogether for the group,” said Ms. Nikolaou.

Prior studies by scientists at New York University and Yale University found that when calorie postings appeared initially, it had no significant impact on restaurant patrons. Half did not even notice or understand the data, even when they were displayed prominently and explained in great detail. Less than a third of those who did take note said it influenced their choices, according to reports by the New York Times.

So why the difference between now and then? Obviously, there are no simple answers, however, there are some clues we can learn from. First, the study involving the college students took place in a controlled environment (the campus cafeterias), and was limited to a relatively homogeneous group (all university students). This does usually not apply to the public at large. Second, as the authors point out, it is the first long-term research of its kind and is likely to produce different results than prior attempts with a shorter view. Third, the whole concept of counting calories as a means of managing one’s weight is now much more familiar and plausible to people, especially the young and the educated, than it was just a few years ago. So researchers have generally more fertile ground to work with.

What this latest study demonstrates, I think, is that providing information in ways people can readily understand and immediately apply in their lives does indeed help facilitate behavioral changes over time, especially if it yields measurable advantages. Some of these changes must eventually happen, even if they don’t seem palatable at first.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (


The True Causes of Obesity Remain Elusive

May 28th, 2014 at 12:21 pm by timigustafson

Despite of modest gains in the fight against the obesity epidemic in recent years, health experts still don’t seem to have a definite answer to what exactly causes weight problems on such a large scale, not only here in the United States but, progressively, around the world.

A new study published in CA – A Cancer Journal for Clinicians examined an array of potentially contributing factors such as changing eating and lifestyle habits, larger portion sizes, availability and affordability of food, to mention just a few.

The latter – availability and affordability – seemingly stand out among possible culprits, according to this study.

Not only are we eating more highly caloric foods, we eat more of all types of food, mainly because food has become much cheaper, nearly ubiquitous, and more convenient to prepare, said Dr. Roland Sturm, an economist at RAND Corporation, a non-profit organization that specializes in public policy research, in a press release that came with the study.

In cooperation with his fellow-researcher, Dr. Ruopeng An, a professor at the Department of Kinesiology and Public Health of the University of Illinois at Urbana-Champaign, Dr. Sturm investigated what percentage of their income average Americans spend on food today, and found that it is proportionally much less than their parents and grandparents had to.

Food in America is cheaper now than it has ever been in history, the researchers concluded. In the 1930s, most people spent about one-quarter of their income on food. In the 1950s, it dropped to one-fifth. Today, it is around one-tenth.

“Not only has the cost of food dropped, but it has become even more available,” wrote Dr. An in the press release. “So a smaller share of Americans’ disposable income now buys many more calories,” he added.

The argument that greater availability and lower prices help increase consumption is certainly valid. Yet, does that really explain why so many people can’t stop eating to the point where they get seriously ill?

I think the picture is much bigger.

The fact is that not all foods are equal. The cheapest items often have the least nutritional value – like processed meals and snacks that are typically high in calories as well as fat, sugar, and salt content. The healthiest kind, on the other hand, like fresh produce, lean protein sources, and whole grains, are not only out of reach financially for low-income families, they are not even always available where they live – in so-called food-deserts.

Besides economic constraints, lack of awareness and education in health matters also plays a role. The public is quite confused about which diet and lifestyle guidelines to follow, considering the oftentimes contradictory messages people are given.

Having cheap and abundant food available by itself should not automatically lead to unhealthy consumption, as the study seems to suggest. As consumers, we are ceaselessly bombarded with food advertisements, prodding us to eat far more than our bodies can possibly need.

In addition, government policies that subsidize large-scale production of commodities like corn and sugar, but give nothing to fresh produce farmers, may keep prices down for some (mostly processed) foods but also contribute indirectly to our public health crisis.

To improve the current situation, the research duo agrees that changing our existing food environment has to be part of the equation. Appealing to personal responsibility alone will not do. Influencing pricing for unhealthy foods through taxation may be one way. But while they don’t reject outright certain forms of intervention through policy changes, they don’t believe those to be effective enough.

Unfortunately, as long as we cannot agree on the causes of the obesity crisis, real solutions will remain elusive as well.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (


Education, the Best Protection Against Obesity and Related Diseases

March 12th, 2014 at 12:43 pm by timigustafson

With growing wealth in many developing countries around the world, diet and lifestyle changes are showing dramatic increases in obesity and related diseases like diabetes, heart disease and cancer. From Central and South America to the Middle East to Asia, weight problems are now among the leading causes of morbidity and mortality. But more than rising standards of living, lack of education seems to contribute to these dismal trends.

In China, India and Brazil, where economic growth has been especially dramatic but has also created vast inequalities in their populations, diet and lifestyle changes have had a particularly profound impact on the risk of obesity, according to one study that investigated the effects of rising incomes on people’s health.

In Mexico, which is considered a middle-income country, prevalence of obesity proved to be the highest among those who were better off financially but had little education. Similar findings were made in Egypt, a low-income country, where obesity has become a fast growing problem, especially among women. Here too, increasing wealth is a predictor – but even more so, lack of schooling.

“For the first time, we have studied the interaction between wealth and education and found they have fundamentally different effects on obesity,” said Dr. Amina Aitsi-Selmi, the lead author of the Egypt study.

Greater exposure of emerging economies to global food markets and rising buying power of consumers lead to these consequences. The best way to prevent this from happening would be to invest in education, especially in women who are in charge of food shopping, cooking, and taking care of the health needs of their families, she said.

“Our study suggests that investing in women’s education protects against this effect by empowering individuals to look after their health,” she said to Science Daily.

As ‘gatekeepers’ in their households, women have the most influence on the nutritional wellbeing of children, which is our best hope for breaking the vicious circle that begins with childhood obesity and subsequent, often chronic, health issues during adulthood.

Scientific evidence leaves no doubt that the environment we live in is largely responsible for the obesity epidemic, Dr. Aitsi-Selmi said. We can only change the environment by changing the behavior of individuals. And that is best accomplished through education.

Obviously, providing even a basic amount of health education in different socio-economic and cultural settings is no easy task in one country, let alone on a global scale. But, as this study and others have shown, increase in literacy and greater opportunities for learning have many benefits and can provide the groundwork for attitude and behavior modifications, including improving eating habits.

It also means that greater affordability of food does not automatically lead to better health outcomes – sometimes to the contrary. Only when people understand how their diet and lifestyle choices affect them, they can make appropriate changes and take control of their wellbeing.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (


A Responsibility Not to Get Sick

February 26th, 2014 at 11:39 am by timigustafson

According to the World Health Organization (WHO), no other current health threats spread as fast as so-called ‘non-communicable diseases’ (NCDs) like obesity, diabetes, heart disease and cancer. What distinguishes these from infectious illnesses is that humans bring them mostly upon themselves through poor diet and lifestyle choices. Nevertheless, the impact is very real and there is no letting up in sight.

How can that be? How can we self-inflict debilitating and potentially life-threatening diseases on a pandemic scale? How can this happen when we have a pretty good understanding of the causes and how they could be averted? And why is it that the countless messages about diet and lifestyle changes produce such meager results?

Unsurprisingly, there is great uncertainty among the experts about how to address these issues. For example, only last year, the American Medical Association (AMA) decided to classify obesity as a “disease,” with the goal to bring greater attention to the urgency of the matter. Yet some have expressed skepticism about the helpfulness of such a move.

In a recent op-ed article in the New York Times, psychology professors Dr. Crystal L. Hoyt and Dr. Jeni L. Burnette, both of the University of Richmond, Virginia, suggested that the classification may in fact be counterproductive because it potentially diminishes incentives to deal effectively with weight problems.

“Calling obesity a disease provides a clear warning of the significant health risks associated with excessive weight,” they wrote. “We wondered, however, if there also might be psychological ramifications inherent in that message. Would it reduce or add to the burden of body-image concerns and shame? Would it empower people to fight back, or lead to a fatalistic acceptance of being overweight?”

They both agreed that stigmatization and discrimination of any kind have no place in how we view obesity and other related health issues. On the other hand, we ought not simply relieve people of all responsibility for their own well-being.

Suggesting that someone’s weight is his or her unfortunate fate, a “fixed state like a long-term disease,” can make efforts of weight loss and dietary improvements seem futile and may indeed undermine them, the professors warned.

As a dietitian and health counselor, I have no problem with declaring obesity a disease, especially considering the complexity of potential causes, some of which are indeed beyond an individual’s control. Having said that, I also believe that the only appropriate response to illness is to make every effort to overcome it as quickly possible. An even better approach would be prevention, so that damages don’t occur in the first place. For this, I believe, we all have a duty, a personal responsibility not to get sick as a consequence of our own actions.

Yes, there is much confusion around diet and lifestyle issues. Many people have given up and are tired of listening to oftentimes inconsistent, if not contradictory, messages. But there is also some certainty. Eating healthily by adding more fresh fruits and vegetables and cutting back on processed foods is part of that. So is observing portion sizes. Regular exercise is a must without question. Reducing stress and getting enough sleep matter as much. All these we know to be true. If we acted upon just this bit of knowledge each and every day, things could improve real fast.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (


Obesity and Health Don’t Go Together, Study Finds

December 7th, 2013 at 3:32 pm by timigustafson

For quite a while some experts believed that a little extra body fat would not necessarily trigger health problems like metabolic syndrome, a cluster of diseases that often accompanies weight gain. There was even talk of an “obesity paradox,” meaning that some people could derive certain benefits from being obese. But all that may just be fantasy, according to a recent study from Canada.

“Obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight,” wrote Dr. Caroline K. Kramer of Mount Sinai Hospital’s Lunenfeld-Tanenbaum Research Institute in Toronto and lead author of the study report.

Whether being overweight is immediately harmful depends on a number of factors, including a person’s genes, activity level, hormonal functions, and the source of calories, said Dr. David L. Katz, founder and director of the Yale University Prevention Research Center, to HealthDay. Fat accumulation, especially when it affects inner organs like the liver, can do serious damage even at low levels, he warned.

The notion that fat and fit are not necessarily exclusive of one another stems in part from studies that found overweight but physically active people to be healthier than normal-weight folks who never exercised.

Also, judging someone’s health status based on body-mass index (BMI) alone has been widely criticized as an inaccurate measure in terms of overall health. Instead, most healthcare providers now prefer waist circumference as an indicator for weight-related health issues.

According to guidelines published by the National Institutes of Health (NIH), overweight people can be considered healthy if their waist size does not exceed 40 inches for men, or 35 inches for women, and if they don’t have high blood pressure, high blood sugar, or high cholesterol.

However, when it comes to obesity (BMI of 30 and above), almost all studies agree that even being relatively fit cannot offset the health risks.

The issue is not so much the extra weight itself but what is called “metabolic health.” For any person – obese, overweight, or normal-weight – to be metabolically healthy, his or her blood pressure must be less than 130/85 mmHg, triglycerides under 150 mg/dL, fasting blood sugar equal to or lower than 100 mg/dL, and HDL (“good”) cholesterol above 40 mg/dL in men and 50 mg/dL in women.

But what about the so-called “obesity paradox,” a finding that overweight and moderately obese patients who suffer from chronic conditions like diabetes or heart disease sometimes outlive their normal-weight counterparts with the same disease? There may be a number of explanations for this, including genetic differences and access to treatment options. Either way, the fact remains that both weight management and fitness are important factors for good health, as is dietary quality.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (

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About timigustafson

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit

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