Waist to hip ratio
Another simple tool for determining if you are overweight is to measure your waist and your hip circumferences and then compare the two measurements to each other by dividing the waist measurement by the hip measurement.

Many studies show an association between excessive body weight and various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, sleep apnea, certain types of cancer, osteoarthritis. Other diseases that may be caused by obesity is gout, hypertension, gall bladder disease and gall stones, fatty liver, hernias and vericose veins. As a result, obesity has been found to reduce life expectancy. With rates of adult and childhood obesity increasing, it is viewed as a serious public health problem.

Why do people become obese

• Socio-economic status: ironically people living in western countries with a higher level of income and education are less exposed to the risk of obesity and more inclined to do something about their weight, than the poorer classes who are at great risk.
• Urbanisation and westernisation: In rural, agricultural communities obesity is not common because such populations tend to eat low-fat diets based on unrefined cereals and do a great deal of physical work. When these people move to towns and start eating a western high-fat diet and expend less energy, their risk of developing obesity is high. South Africans are facing an explosion in obesity because such a large segment of our population is rapidly moving to the cities and adopting western eating habits.
• Cultural practices and advertising play an important role in making people regard foods as desirable even if they are ‘fatal’ for weight gain. Family practices are also often to blame when parents use food as a reward or pacifier.
• Genetics can be responsible for 50-60% of the variation in an individual’s amount of abdominal fat. Obesity is known to run in families and if you have one or more obese parents or grandparents then your chance of developing obesity is very great.
• Individual susceptibility is also a factor and there is scientific evidence that certain individuals are less able to burn fat which predisposes them to obesity.
• Modern transport and labour-saving devices such as washing machines and vacuum cleaners make our lives easier, but prevent us from using up energy and contribute to weight gain.

The obese personality

Our psychological makeup plays an important role in either promoting or preventing obesity.

In fact, some experts claim that people who tend to become overweight have a very distinctive type of personality that predisposes them to weight gain.

The main characteristics of this so-called "obesity personality" are believed to be:

Obesity in Adults

Most men have a number of advantages over their female counterparts when it comes to basic physiology and gaining weight. The following factors 'protect' the males of our species against gaining weight:

• Higher basic metabolic rate (i.e. the amount of energy required to keep the body functioning when at rest, or energy used for physiological processes like breathing, digestion etc.). The male basic metabolic rate is 5% to 10% higher than in women of the same weight and height. The higher basic metabolic rate is attributed to differences in body size and body composition (see next point).
• Lower body fat percentage compared to women. The average man has a greater proportion of muscle tissue than the average woman and 50% less body fat. The average man has14% body fat compared to 24% in the average woman.
• Higher maximum oxygen consumption or VO2 max than women, because of the above mentioned higher lean muscle mass and lower body fat percentage.
• The presence of testosterone, the male hormone, that acts as an anabolic agent to promote increased muscle mass.

In view of these positive factors, it would seem that men are actually 'protected' against gaining weight thanks to their physiology. But men do gain weight and 31% or more of men in South Africa were reported to be overweight or obese by the Demographic and Health Survey published in 1998.

Reasons for gaining weight:

• Increased energy intake
• Decreased energy expenditure
• Alcohol consumption
• Stress and depression
• No regular healthy meals

Hormones and body weight:
New insights about the relationship between menopause and weight gain are offered in a study presented this week at the Society for Neuroscience Meeting in New Orleans, USA.

The study helps demonstrate how female hormones seem to play a major role in the worldwide obesity epidemic and may offer new ideas about how to combat obesity.

In women, it has been demonstrated that major weight increases often occur during menopause, the time in a woman's life in which cyclic ovarian function ends and the ovarian hormones oestrogen and progesterone decline.

Obesity in Children

More than 17% of South African children between the ages of one and nine living in urban areas are overweight, according to a report by the Medical Research Council of South Africa.

This is of great concern, as American studies have found that overweight or obese children tend to remain overweight or obese to the age of twenty and are exposed to a 1.5 to 2 times higher risk of being obese adults.

Contributing factors
In the USA a number of factors have been identified which contribute to this epidemic of childhood obesity, namely:

Genetic makeup
If one, or both parents of a child are overweight or obese, the child will be more susceptible to gaining weight. Research shows that a genetic component explains 50-60% of the variations in abdominal fat content in different individuals. It is therefore, true that obesity tends to run in families and that obese parents are likely to have obese children.

Genetic vs. environmental factors
Genetic factors are, however, only partially responsible for the development of obesity. Children with "lean" genes may also become obese if they are exposed to what is known as “an energy overload" or over-abundance of high-energy foods.

However, research indicates that the most susceptible individuals are those with a genetic tendency who are chronically exposed to excess food intake. In other words, children with obese parents and a “fat-prone” genetic makeup who are always overfed will be more likely to become obese than those who have no genetic tendency and are not overfed.

Ethnicity
Certain population groups are more inclined to gain weight than others when they are exposed to a high-fat western diet. This phenomenon has been observed repeatedly when populations exchange their high-fibre, low-fat eating habits to high-fat, high-energy diets as part of urbanisation and westernisation.

In South Africa, we are experiencing this kind of transition on a daily basis as more and more rural people leave their villages to move to the cities. When rural children become city dwellers their diets undergo a radical change as they substitute high-energy snack foods and cold drinks for grains, fruits, vegetables, and sour milk. Ironically, malnutrition and obesity often occur in members of the same family living in disadvantaged communities.

Lack of physical activity
Modern children in contrast to their counterparts of 30 years ago, have become couch potatoes. They expend much less energy on physical activity than ever before. Endless hours of watching TV and playing computer games, are probably the major culprits.

On the other hand, many schools do not have the facilities to permit all their pupils to participate in sport, and other schools only concentrate on their best athletes, while the majority of less sporty children are made to sit on the sidelines. Whereas children in years gone by used to walk or cycle to school, buses and ‘Mom’s taxi’ have become the norm nowadays, thus preventing children from getting exercise on a daily basis.

Changing eating habits
The trend of eating more meals at restaurants, buying take-away-foods and high-energy snacks, the increase in the availability of kilojoule-laden foods at every turn, including tuck shops, large portion sizes and skipping meals due to lack of time, not only contribute to obesity in adults, but also in children.

Psychological factors
Many parents express their love for their children in terms of food. “Eat up, your Mom made this dinner specially for you.” “Don’t cry, have a sweety.” It you have a problem expressing your love for your children, don’t use this confusing type of coercion, as it may make them equate food and love in later life and cause them to gain weight every time they feel unloved or have to cope with a crisis.

Other parents try to exert control over their children by means of food. “Think of the starving children in the world and clean your plate!” Making your child feel guilty when eating is a destructive approach that may distort his or her concept of food for the rest of his/her life.

It is no wonder that our children are becoming more and more prone to overweight and obesity. If children are exposed to energy-rich foods at every turn and not encouraged to exercise, the inevitable result is an increase in body mass. The alarming statistics mentioned above need to be taken seriously and we should do everything in our power to prevent South African children from succumbing to the obesity epidemic.

Combating the problem

Ensure that you are physically active
Be aware of the importance of physical activity in combating obesity, particularly in children. Don’t let your children, or yourself, become couch potatoes. It is so easy to let children watch TV and play computer games all day, because it keeps them occupied and requires much less effort from you, the parents.

Take an interest in the types of physical activity that are available in the modern world. Find out what types of sport are available or if you are not a sport star then participate in other physical activity.

If you live in an area where gym facilities are not available, set an example and either take long walks in the fresh air, or cycle or swim, or be proactive and arrange gym classes or cricket coaching. It is really worth it in the long run and you will benefit from such activities.

Healthy eating habits
Keep an eye on what you and your children are eating - in your own home, at school and at their friends’ homes. Make provision for plenty of healthy snacks - milk, flavoured yoghurt and Yogi-sip, fresh and dried fruit, wholewheat sandwiches or muffins, nuts, cheese and crisp vegetables. Avoid take-away-foods and high-energy snacks, like cold drinks, crisps, pizzas, deep-fried chicken, and chocolate.

Eat balanced meals regularly and do not skip breakfast. Pack nutritious, tasty lunch boxes instead of just buying fast food.

All these dietary and other counter measures require effort on your part in changing your lifestyle habits, which will prevent a whole host of diseases and obesity. Think of it this way: By putting some time, thought and effort into planning your food intake and physical activity, you are ultimately saving yourself the effort and anguish of trying to help children lose weight if they should become obese.