Obesity and bipolar disorder affect millions of individuals around the world, and when they happen together, managing both can become a difficult challenge. Knowing how these two conditions work and interact can help identify effective treatment strategies and improve the quality of life for the affected individuals.

In this blog, we will answer the most common questions associated with obesity and bipolar disorder, the link they share, and discuss what treatment options are available for those managing these conditions.  

What Is Bipolar Disorder?

It is a mental health condition that causes drastic and extreme mood swings, this can include episodes of mania (high energy, elevated mood) and depression (low energy, sadness). These mood swings or “shifts” can affect someone’s behavior, energy levels, and ability to carry out day-to-day tasks. This disorder usually requires long-term management with a combination of medications, therapy, and lifestyle adjustments. 

It’s important to note that it is more complex than just mood fluctuations; it can impact a person’s mental and physical health, relationships, and quality of life overall. When it happens alongside being overweight, it becomes an even greater difficulty, and the challenges can be even more profound. 

How Is Obesity Linked to Bipolar Disorder?

Research has shown that there is a more high and prevalent chance of overweight individuals with bipolar disorder. Various factors can be said to contribute to this link, this can include:

• Medication side effects: Certain types of medications used to manage this condition such as specific mood stabilizers, and antipsychotics, can cause weight gain, and can lead to future issues such as being overweight. 
• Inactivity during depressive episodes: During these periods of depression, some individuals facing this disorder may experience low energy and lack of motivation, decreasing physical activity, which can cause weight gain over time. 
• Emotional eating: Individuals with this condition may turn to food for comfort during these depressive episodes, this can increase the risk of developing unhealthy eating habits and being overweight. 
• Difficult sleep disturbances: inconsistent sleep patterns and schedule, this is common for individuals dealing with this condition and has been linked to certain metabolic changes that can cause weight gain. 

How Does Obesity Affect Bipolar Disorder? 

Obesity can directly affect the symptoms of bipolar disorders and make its condition more challenging to manage alone. Individuals who are overweight may experience some increased mood swings and fatigue, and it presents a challenge in managing their mental health.

In addition, obesity has been noted to be linked to lower levels of attachment to treatment plans. Thus this can lead to a higher frequency of mania episodes or depression, creating a ruthless cycle. 

However, obesity is known to be shared with numerous health complications, these can include diabetes, hypertension, and heart disease. All of these conditions can add to the physical and emotional burden of individuals living with this condition, further influencing their well-being. 

What Are the Treatment Options for Obesity and Bipolar Disorder?

Both obesity and bipolar disorder require a complete treatment, with a comprehensive, multidisciplinary approach to both. Medical professionals work closely with patients dealing with these conditions, developing tailored treatment plans for each patient to combat these conditions without intensifying the other. The following are some treatment strategies that are normally used to treat these conditions: 

Medications 

While medications are important for treating bipolar disorder, some of them can contribute negatively to weight gain. It’s crucial to speak with a medical professional about what medications can be prescribed or if there are any other options or alternatives available.

Certain types of medications may have a lower impact of causing weight gain and changing to some of these options might be an alternative for some individuals. Always make sure to consult a doctor or health professional before making any decisions on changing medications. 

Changes in Diet

A healthy diet is vital for both controlling obesity and bipolar disorder. Emotional eating and unhealthy eating habits can contribute to weight gain, consulting with a dietitian or working together with a nutritionist can significantly help.

Opting for a diet rich in whole foods, lean proteins, fruits, and vegetables can greatly improve both mental and physical health. Removing processed foods and sugars from your diet can also improve and regulate your mood and energy levels. 

Exercise 

A routine of physical exercise can greatly benefit both obesity and bipolar disorder. Doing exercise makes the body release endorphins, which can aid in stabilizing mood and also can improve health overall. In addition, physical activity plays a critical role in weight management, as just average activities like walking or even swimming can make a significant difference over time. 

Cognitive Behavioral Therapy (CBT)

Therapy with CBT can aid individuals in catching these negative thought patterns and behaviors, being especially effective in managing emotional eating and mood swings in bipolar disorder. Provide patients with efficient strategies to handle the emotional challenges of managing obesity and bipolar disorder. 

Bariatric Surgery

For some individuals struggling with being overweight and who have not yet been able to successfully lose weight via just diet and exercise alone, bariatric surgery can help achieve a significant and sustainable weight loss that improves both physical and mental health. 

At LIMARP, our team of medical professionals and certified surgeons can offer a wide range of options for bariatric surgery, customized to each patient and their unique needs and health goals. 

Can Treating Obesity Help Improve Bipolar Disorder?

If considering bariatric surgery, it is crucial for patients to work hand in hand with their mental health providers, medical professionals, and bariatric surgeons. To make sure that there is complete coverage of health and can help to make the decision and recover. 

With a combination of psychological therapy, diet, exercise, and if needed, bariatric surgery, it’s possible to improve mood and increase energy levels, as well as minimize the chance of having mood swings. Additionally, weight loss can greatly help reduce the risk of other health conditions that may make managing them more difficult. 

Contact

LIMARP is here to help, contact us today to schedule a consultation and learn more about our personalized treatment options and how we can help you achieve your wellness goals and quality of life. By working together we can achieve long-term success and improve your life.

Resources 

If you wish to learn more about these conditions or to get more information about what treatments are available and what can be done, try the following links to sources of reputable institutions that focus on treating these conditions. Remember to talk to a medical professional before deciding on what treatment options are best for you and your specific case, and to achieve all of your goals towards a healthier life. 

• National Institute of Mental Health (NIMH) 
• Obesity Action Coalition 
• American Psychological Association 

According to the world atlas obesity and despite countless efforts to highlight its importance, the numbers of people suffering from obesity continues to rise and it’s expected that by 2035, the number of people with a high BMI (BMI ≥25kg/m²) is expected to exceed the phenomenal number of 4 billion people, compared to 2.6 billion in 2020. Illustrating a significant increase from 38% to over 50% worldwide. With such staggering numbers, we are compelled to dissect each stepping stone that has brought us to this critical worldwide crisis. 

Obesity represents a clear predisposition to present any metabolic disease, including type 2 diabetes, dyslipidemia, and a host of heart-related conditions that not only affect the quality of life but are leading causes of death, this translates into over 2.6 billion people living with the looming risk of having this serious health issues solely because of obesity.

While the surge in obesity is undeniable and designating a specific factor would make the job to eradicate obesity much easier, as it is widely accepted to be the result of a multifaceted and complex labyrinth. Two principal players have taken center stage: environmental factors, often termed obesogenic environments, influenced by variables such as energy intake and physical activity, which have demonstrated the potential for lifestyle changes to prevent and combat obesity, and genetic factors. Genetic contributions offer an explanation for the absence of a universal formula for obesity prevention.

The field of genetics in relation to obesity has undergone significant evolution, as a burgeoning body of research underscores the pivotal role of hereditary predisposition.

This newfound understanding posits genetics as a linchpin in our endeavor to confront, mitigate, and eventually eradicate obesity.

Gene vs. Jeans: Unraveling the Hereditary Health Puzzle.

As we untangle the genetic foundation of obesity, we open the door to understanding why some individuals can effortlessly shed pounds and sustain weight loss through diet and exercise, while others grapple with a formidable challenge. This insight not only broadens our horizons for alternative approaches but also beckons us to scrutinize this issue through the lens of hereditary health.

Within the vast landscape of obesity research, specific genes have emerged as key components in various pathways central to our appetite, the regulation of satiety, and the broader sphere of metabolic health. Genes like BDNF and MC4R play intimate roles in processes related to appetite and satiety regulation, while others, including FTO, RPTOR, and MAP2K5, intricately influence energy metabolism and lipid management. Simultaneously, TCF7L2 and IRS1 take center stage in insulin secretion and the complex world of adipogenesis, the formation of fat cells.

While our quest for a specific gene alteration responsible for obesity is an ongoing pursuit, expanding knowledge from the human genome acknowledges the likelihood of a polygenic foundation, where multiple genes, rather than a solitary gene, are connected to this complex issue. This is the result of the cumulative effects of distinct variants that we continue to learn about.

Gut Microbiome and Genetics:

Here is where the fun begins, as we learn about the relationship between our genes and gut microbiota. The latter being a diverse compound of microorganisms that play an important role in our health’s most critical functions, such as the absorption and metabolism of essential nutrients, the synthesis of vital vitamins, and the regulation of bile acids. Research also confidently shows that along with environmental factors, our genes exert a profound influence on the composition and functionality of our gut microbiota.

Recent studies have shown that the expression of polymorphic genes on and activity of the gut microbiota share an intricate relationship in our hereditary predisposition that can alter the genes that manage our weight susceptibility, playing the pivotal role played by the microbiota in shaping our health and predisposition to metabolic diseases. Furthermore, within the realm of obesity, malnutrition surfaces, bringing with it deficiencies in essential vitamins and minerals. These deficiencies, exacerbated by alterations in the gut microbiota’s production of essential vitamins, pose a significant threat to our health.

Obesity is intrinsically linked with gut microbiota impairment and micronutrient deficiencies.

Significantly, bariatric surgery, which results in significant weight loss and improvements or remission of obesity-related health issues, have been proven to contribute to changes from the gut microbiota in favorable manners for its composition and essential functions.

Conclusion

As our knowledge about our hereditary health continues to evolve, we encounter the symbiotic bond between our genes and the gut microbiota. This intricate community of microorganisms, residing within our gastrointestinal tract, wields a profound influence over our health, learning that we might have a genetic predisposition from a wide range of genes that help poblate our microbiome. Its pivotal role in the absorption and metabolism of essential nutrients, the synthesis of vital vitamins, and the modulation of our immunity are subjects that have been widely studied 

In conclusion, our exploration of the genetic and microbial dimensions of obesity is far from complete but it keeps growing. The multifactorial nature of this global epidemic continues to intrigue us, propelling further research and investigation. It is within the intricate layers of genes, microbes, and the choices we make that we will unearth the answers to the obesity enigma. 

Contact Us Today

Our team is ready to help you. At LIMARP, patients will always receive warm, sincere and professional
answers. For a free evaluation please call us at (619) 270 8823, fill out a contact form at
our website, or message through any of our social media pages.

• World of Obesity. (2023). World of Obesity Atlas 2023. URL: https://s3-eu-west-1.amazonaws.com/wof-files/World_Obesity_Atlas_2023_Report.pdf
• Keller M, Svensson SIA, Rohde-Zimmermann K, Kovacs P, Böttcher Y. Genetics and Epigenetics in Obesity: What Do We Know so Far? Curr Obes Rep. 2023 Oct 11. doi: 10.1007/s13679-023-00526-z. 
• van der Meer, R, Mohamed, SA, Monpellier, VM, et al. Genetic variants associated with weight loss and metabolic outcomes after bariatric surgery: A systematic review. Obesity Reviews. 2023; 1-17. doi:10.1111/obr.13626
• Cuevas-Sierra A, Ramos-Lopez O, Riezu-Boj JI, Milagro FI, Martinez JA. Diet, Gut Microbiota, and Obesity: Links with Host Genetics and Epigenetics and Potential Applications. Adv Nutr. 2019 Jan 1;10(suppl_1):S17-S30. doi: 10.1093/advances/nmy078. PMID: 30721960; PMCID: PMC6363528.
• Goodrich J, Waters J, Poole A, Sutter J, Koren O, Blekhman R, Beaumont M, Van Treuren W, Knight R, Bell JT, et al. Human genetics shape the gut microbiome. Cell 2014;159(4):789–99.
•   Richards AL, Burns MB, Alazizi A, Barreiro LB, Pique-Regi R, Blekhman R, Luca F. Genetic and transcriptional analysis of human host response to healthy gut microbiota. mSystems 2016;1(4):e00067– 16.
• Pascale, A.; Marchesi, N.; Marelli, C.; Coppola, A.; Luzi, L.; Govoni, S.; Giustina, A.; Gazzarusco, C. Microbiota and metabolic diseases. Endocrine 2018, 61, 357–371
• Ciobârcă D, Cătoi AF, Copăescu C, Miere D, Crișan G. Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status. Nutrients. 2020 Jan 16;12(1):235. doi: 10.3390/nu12010235. PMID: 31963247; PMCID: PMC7019602.

Obesity in children is a complex issue influenced by a web of interconnected factors, and understanding its various layers is paramount to addressing it effectively. One comprehensive framework that illuminates the multitude of influences on excessive weight in children is the Six “C’s” model. This model encapsulates environmental, personal, behavioral, and hereditary aspects, adaptable to every stage of children’s growth, from infancy to adolescence. [1] 

The Six “C’s” represent Cell, Child, Clan, Community, Country, and Culture. Each “C” corresponds to a different level of influence. For instance, during the preschool years, we can observe how obesity-predisposing genes (Cell), excessive media exposure (Child), parental dietary choices (Clan), peer food choices (Community), economic factors at a national level (Country), and cultural norms regarding portion sizes (Culture) all work in tandem, potentially leading to weight problems in children. [1] 

Early Obesity: A Global Challenge with Long-Term Implications 

High adiposity in children continues to rise worldwide. The World Health Organization (WHO) estimates that at least 1 in 5 children is overweight, with 41 million children dealing with obesity. In Mexico, 1 in 20 children under the age of 5 and 1 in 3 between the ages of 6 and 19 are overweight or obese. This places Mexico among the top countries for childhood obesity globally, a problem that is more prevalent in northern states and urban communities. [2] 

The determination of weight issues into adulthood is affected by different factors, like the presence of corpulence in one’s parents, the severity of obesity, and the age of the child at the time of diagnosis.

An older age at the hour of diagnosis is related to a higher probability of excess weight continuing into adulthood. Subsequently, most children with an overabundance of weight are probably going to keep on being impacted by this condition in adulthood. [3] 

Causes of the Obesity Epidemic 

The most influential factor in childhood having excessive weight is when a child’s parents deal with obesity; this fact means children are more likely to face excessive weight as adults. Parental obesity can even predict a child’s future weight, especially for children under 3 years old, more so than the child’s current weight [4]. But that’s not the only factor, other multifactorial causes, including biological, psychological, environmental, and social factors. [4] 

The Hidden Toll of Childhood Obesity 

Various medical problems that were once viewed as principally predominant in grown-ups are progressively influencing children because of excess weight, which can bring about a scope of short and long-term medical conditions, including cardiovascular, respiratory, muscular, endocrine, psychological wellness, and gastrointestinal/liver circumstances. [5] Here we cover a few of the complications of obesity in children. 

• Heart Problems Excessive weight in children is connected to a few huge cardiovascular worries, for example, insulin resistance, raised cholesterol levels, and hypertension, which can likewise influence the coating of veins. Besides, children with excessive weight are at a much more serious gamble of developing hypertension, roughly three times more probable than their friends without obesity [5]. High blood pressure can prompt kidney harm and increase the gamble of stroke, representing a significant danger to their drawn-out well-being [6]. 
• Respiratory Disease Excessive body fat in children can lead to excess fat deposition in the throat and neck area, obstructing the airway during sleep. This blockage principally prompts obstructive sleep apnea (OSA) in children, bringing development challenges, conduct issues, diminished mental capability, and a raised gamble of heart issues, insulin resistance, and weight gain. [5] 
• Psychosocial Impact Children who deal with obesity are bound to encounter anxiety and depression compared with those without[7]. Additionally, girls appear to be at a higher risk of developing anxiety and depression than boys with excessive weight [7]. Besides, children are at a more serious risk of being exposed to harassment and battling scholastically, which can have dependable impacts on their adulthood. [5] 
• Infection SusceptibilityExcessive weight negatively impacts metabolic regulation and, consequently, immune response. Fat accumulation in the body prompts metabolic irregular characteristics that can cause chronic inflammation and disrupt the functioning of immune cells, making individuals more susceptible to immune-related health issues. [5] 
• Childhood CancerEpidemiological examinations have uncovered a huge connection between higher weight records (BMI) in youth and puberty and a more prominent probability of creating different tumors in adulthood. These malignant growths incorporate leukemia, Hodgkin’s infection, colorectal disease, and bosom malignant growth. [8] 

The explanation for this relationship relies on the impact of high adiposity on inflammatory processes, hormonal imbalances, and insulin resistance, all of which can promote the development of cancerous cells.

Contact Us Today

At LIMARP International Center of Excellence for Obesity, located in Tijuana, we offer integral obesity treatments that include a medical, nutritional, psychological, and behavioral approach. If you would like to know more about what you can do to treat or prevent obesity, call us or send us a message today for an online appointment.

References 

• 1. Harrison, K., Bost, K. K., McBride, B. A., Donovan, S. M., Grigsby-Toussaint, D. S., Kim, J., Liechty, J. M., Wiley, A., Téran-García, M., & Jacobsohn, G. C. (2011). Toward a developmental conceptualization of contributors to overweight and obesity in childhood: the Six-CS Model. Child Development Perspectives, 5(1), 50–58.  https://doi.org/10.1111/j.1750-8606.2010.00150.x
• 2. Salud y nutrición. (2016). UNICEF.  https://www.unicef.org/mexico/salud-y-nutrici%C3%B3n#:~:text=1%20de%20cada%2020% 20ni%C3%B1as,norte%20y%20en%20comunidades%20urbanas. 
• 3. Kumar, S., & Kelly, A. S. (2017). Review of childhood obesity. Mayo Clinic Proceedings, 92(2), 251–265. https://doi.org/10.1016/j.mayocp.2016.09.017 
• 4. Thomas-Eapen, N. (2021). Childhood obesity. Primary Care: Clinics in Of ice Practice, 48(3), 505–515. https://doi.org/10.1016/j.pop.2021.04.002 
• 5. Mohamed, M. a. S., AbouKhatwa, M. M., Saifullah, A. A., Syahmi, M. H., Mosaad, M., Elrggal, M. E., Dehele, I. S., & Elnaem, M. H. (2022). Risk factors, clinical consequences, prevention, and treatment of childhood obesity. Children (Basel), 9(12), 1975. https://doi.org/10.3390/children9121975 
• 6. Robinson, C., & Chanchlani, R. (2022). High blood pressure in Children and Adolescents: Current perspectives and strategies to improve future kidney and cardiovascular health. Kidney International Reports, 7(5), 954–970. https://doi.org/10.1016/j.ekir.2022.02.018 
• 7. Lindberg, L., Hagman, E., Danielsson, P., Marcus, C., & Persson, M. (2020). Anxiety and depression in children and adolescents with obesity: a nationwide study in Sweden. BMC Medicine, 18(1). https://doi.org/10.1186/s12916-020-1498-z 
• 8. Weihe, P., Spielmann, J., Kielstein, H., Klusmann, J., & Weihrauch‐Blüher, S. (2020). Childhood obesity and cancer risk in adulthood. Current Obesity Reports, 9(3), 204–212. https://doi.org/10.1007/s13679-020-00387-w 

The overweight and obesity issue is worldwide considered an epidemic and, consequently, a public health problem. Defined as a person whose body mass index (BMI) >30 kg m2, the population with obesity has grown exponentially since 1980, where in 2014 at least 13% worldwide experienced this issue [15].

Weight is a difficult issue to understand—more so to intervene. Weight is a result of a myriad of genetic and environmental factors [15]. In today’s western society, weight loss or maintenance can seem countercultural due to positive energy balance being the norm and the prevalence of high caloric foods (high energy intake) [6], and the commonality of a sedentary lifestyle (low energy expenditure) [15]. Successful weight loss is defined as a person who decreases >10% of their total weight and maintains it for >1 year [6].

Most who try to, or successfully do, lose some weight, are typically condemned to regain the same amount or even more [4].

The person who loses and regains weight can do so one or several times in their lifetime: This repetitive pattern is known as weight cycling, or, more commonly, the yo-yo effect.

Weight Cycling and the Yo-Yo Effect

Weight cycling, firstly coined by Kelly D. Brownell (Yale University) as the “yo-yo effect” [15], refers to “the cyclical loss and gain of weight, resembling the up-down motion of a yo-yo” [12].

Weight cycling implies more than only the frustration of not being able to sustain the weight just lost, but frequently it also entails health deterioration.

Those who experience a constant yo-yo effect have been shown to suffer from cardiovascular risk factors, such as blood pressure, heart rate, sympathetic activity, and circulating levels of glucose, lipids and insulin” [12]. Likewise, metabolic detriment has been registered in the form of indirect impact, since weight cycling has been correlated with weight regain and this, in its effect, with metabolic syndrome symptoms [13]. Even immunological detriments have been registered, by the alteration of the intestinal barrier after long periods of yo-yo effect, increasing thus the permeability and allowing toxins to leak into extraintestinal tissues and circulations [14].

Successful effort of avoiding weight cycling in the first year after weight loss is crucial for long-term weight maintenance [6]. Specifically, those who maintained their weight loss in the first two years were 50% less vulnerable to experience a yo-yo effect [7].

Intrinsic to weight cycling are the following traits, which have been observed to provoke a yo-yo effect in individuals:

• Impulsivity: Thos with higher impulsivity rates are more prone to weight cycling due to higher
  prevalence in restrictive-binge patterns [5]. Likewise, impulsivity has been linked with unhealthy
  food choices such as those high in fat, salt and sugar [4].
• Highly Restrictive Diets: Known as the restrictive-binge pattern, it has been shown time and
  again that those who partake in highly restrictive/hypocaloric diets tend to overindulge once either the desired weight is lost or can no longer withstand the restrictiveness [8]. Thus,restraint eaters often experience the yo-yo effect [4].
• Hyperprocessed Food Consumption: The habit of consuming highly palatable and energy dense foods, typically enriched in saturated fats, salts and processed sugars, may lead to weight gain regardless of weight loss attempts. If your diet after weight loss comprises these types of foods, you will more than likely experience a yo-yo effect [9].

Long Standing Weight Loss and Maintenance

Restricting one’s diet by periods of fasting has gained popularity in the last decades [1], and although caloric restriction has been shown to contribute to weight loss [2], the risk of weight regain is high [3]. Moreover, as if weight cycling weren’t enough, this yo-yo effect caused by strict hypocaloric and posterior hypercaloric intake may also reinforce unhealthy eating patterns.

It has been shown that those who practice fasting periodically usually follow-up with unvoluntary weight regain [3]. Simply speaking, this is due to a decrease followed by an increase in caloric intake. The following have been shown to effectively prevent weight cycling and yo-yo effect:

• Adequate Diets: Although “dieting” can have a negative connotation, a tailored meal plan which
  combines low-fat/carb intake and resistance or interval training has shown to be effective in
  weight control and prevention of the yo-yo effect [6].
• Physical Activity: Exercise has been shown to protect against weight cycling and the yo-yo effect
  due to its effectiveness to produce a negative caloric balance, thus reducing weight, and a
  positive impact in cardiovascular fitness, insulin sensitivity glycemic control of type 2 diabetes,
  blood pressure and depression [11].
• Bariatric Procedures/Surgery: Among the many types of weight control treatments, bariatric
  procedures or surgery “is the only one efficient therapeutic strategy against obesity” [6]. These
  procedures have constantly proven to be the most effective way to lose and control weight [10].

Weight Loss Surgery in Tijuana, Mexico

At LIMARP, International Center of Excellence for Obesity, we offer an integrative bariatric program, with a multidisciplinary approach, for the treatment of obesity. Our program includes a surgical intervention —like a gastric sleeve, a gastric bypass or a duodenal switch—, or a non-surgical intervention —like an intragastric balloon—, along with psychological counselling, nutritional guidance, personalized fitness routines, and long-term follow-up.

For our patients traveling from abroad, we also offer accommodation in our next-door hotel, the
luxurious Grand Hotel Tijuana, and transportation to and fro the airport and the hotel.
Our clinic is one of the only centers in Mexico that have been certified as a Center of Excellence by the Surgical Review Corporation. Our lead surgeon, Dr. Liza María Pompa González is certified as a Master Surgeon and Surgeon of Excellence by the same organization, and she is the first female surgeon to be awarded with this recognition.

Contact Us Today

Our team is ready to help you. At LIMARP, patients will always receive warm, sincere and professional answers. For a free evaluation please call us at (619) 270 8823, fill out a contact form at our website, or message through any of our social media pages.

References

• [1] Janaswamy, R. et al. (2022). A narrative review on intermittent fasting as an approachable measure for weight reduction and obesity management. Cureus, 14(10), 1-8.
• [2] Vasim, I. et al. (2022). Intermittent fasting and metabolic health. Nutrients, 14(3), 1-15.
• [3] Muhammad, H. F. L. et al. (2018). The yo-yo effect of Ramadan fasting on overweight/obese
  individuals in Indonesian: A prospective study.
• [4] Meesters, A. (2014). The relationship between impulsivity, weight concern and the yoyo-effect in healthy women. Maastricht Stud J Psych Neuros, 3, 9-21.
• [5] Pierce-Messick, Z. J. (2019). Impulsivity and limited access to palatable foods in rats [Master’s Degree Thesis, Wake Forest University].
  https://wakespace.lib.wfu.edu/bitstream/handle/10339/93935/PierceMessick_wfu_0248M_11323.pdf
• [6] Contreras, R. E. et al. (2019). Physiological and epigenetic features of yoyo dieting and weight
  control. Front Gen, 10(1015), 1-12.
• [7] Wing, R. R. et al. (2005). Long-term weight loss maintenance. Am J Clin Nutr, 82, 222S-225S.
• [8] Jiang, K. (2021). Review on binge eating disorder: Theories, influencing factors and treatments. AdvaSoci Scie Huma Rese, 561, 574-8.
• [9] Kistenmacher, A. (2018). Food addiction: A cost-effective treatment proposal within a developing country context [Master’s Degree Thesis, University of South Africa].
  https://uir.unisa.ac.za/bitstream/handle/10500/24503/dissertation_kistenmacher_a.pdf?sequence=1&isAllowed=y
• [10] Gulinac, M. et al. (2023). Long-term effectiveness, outcomes and complications of bariatric surgery.World J Clin Cases, 11(19), 4504-12.
• [11] Cox, C. E. (2017). Role of physical activity for weight loss and weight maintenance. Diabe Spectr,30(3), 157-60.
• [12] Rhee, E. J. (2017). Weight cycling and its cardiometabolic impact. J Obes Metab Syndr, 26(4), 237-42.
• [13] Ran-Chin, Y. et al. (2021). The effects of weight fluctuation on the components of metabolic
  syndrome: A 16-year prospective cohort study in South Korea. Arch Publ Health, 79(21), 1-9.
• [14] Li, W. et al. (2023). Weight cycling based on altered immune microenvironment as a result of
  metaflammation. Nutri & Metab, 20(1), 1-14.
• [13] Ran-Chin, Y. et al. (2021). The effects of weight fluctuation on the components of metabolic
  syndrome: A 16-year prospective cohort study in South Korea. Arch Publ Health, 79(21), 1-9.
• [15] Brownell, K. D. et al. (1991). The heterogenity of obesity: Fitting treatments to individuals. BehavThera, 22, 53-77.

Have you noticed that some veins look different to others? Some are more noticeable depending on where they are on the body, others are bigger or wider than others, and some may look darker. Veins are blood vessels that bring deoxygenated blood back to the heart and there are several external reasons why they may become more visible, such as exercise, tight clothing, the weather, weight, skin color, genetics, and age. There are also underlying medical conditions that can cause the sudden exposure of veins, such as chronic constipation and blood clots.

Other medical conditions that can cause swollen veins include chronic venous insufficiency, superficial thrombophlebitis, and varicose veins. Patients from all different backgrounds arrive at LIMARP® because they’re looking to improve their quality of life and embark on a healthier path. Our multidisciplinary team, led by Dr. Liza María Pompa González, offers different health services to help you reach your weight goals and beat obesity: from diet and exercise plans, to psychological guidance and bariatric surgery. When it comes to varicose veins, a doctor will determine the severity of the condition and prescribe the necessary treatment so the patient begins or continues leading a healthy lifestyle. 

This article will mainly focus on providing more information on varicose veins, like their causes and symptoms, as well as the different treatments available to reduce their size or get rid of them altogether.

As always, we’d like to remind you that every case is different and to get the best treatment for you, it’s important to schedule an appointment with a doctor. 

What are varicose veins?

Varicose veins are twisted, enlarged veins and any vein that is close to the skin’s surface can become varicose. They mostly affect the veins in the legs because standing and walking increase the pressure in the veins of the lower body[1].

For many people, varicose veins and spider veins, a mild variation of varicose veins, are simply a cosmetic or aesthetic concern. For other people, varicose veins can cause aching pain and discomfort and they can lead to more-serious problems. It’s common for varicose veins[2] to appear on the legs and feet and they may be blue or dark purple, as well as lumpy, bulging or twisted in appearance.

The condition is very common, especially in women, and around 25% of all adults have varicose veins.

Causes and Symptoms

There are several reasons why varicose veins appear, mainly they occur when veins aren’t functioning properly. Veins have one-way valves that prevent blood from flowing backward and when these valves fail, blood begins to collect in the veins rather than continuing toward your heart; thus, the veins enlarge. Varicose veins often affect the legs and since they are the farthest from the heart, gravity makes it harder for the blood to flow upward[3].

Weak or damaged valves can also lead to varicose veins. This is how circulation works: arteries carry blood from the heart to the rest of the body and veins return blood from the rest of the body to the heart. To return blood to the heart, the veins in the legs must work against gravity.

Muscle contractions in the lower legs act as pumps, and elastic vein walls help blood return to the heart. Tiny valves in the veins open as blood flows toward the heart, then close to stop blood from flowing backward. If these valves are weak or damaged, blood can flow backward and pool in the veins, causing the veins to stretch or twist[4].

There are also several risk factors that can increase a person’s chances of developing varicose veins, such as:

• Age: Aging causes wear and tear on the valves in the veins that help control blood flow, causing the valves to allow some blood to flow back into the veins, where it collects.
• Sex: As we’ve mentioned, women are more likely to develop the condition. Hormonal changes before a menstrual period or during pregnancy or menopause might be a factor because female hormones tend to relax vein walls. Also, hormone treatments, such as birth control pills, might increase the risk of varicose veins.
• Pregnancy: During pregnancy, the blood volume in the body increases. This change is good for the growing baby, but can also enlarge the veins in the legs.
• Obesity: Being overweight puts added pressure on veins.
• Standing or sitting for long periods of time: Movement helps blood flow and being sedentary can increase the chances of developing this condition, as well as other serious ones.

Do Varicose Veins Hurt?

There are many ways to identify if a person has varicose veins, such as veins that are dark purple or blue, and that appear twisted and bulging, like cords on the legs. Varicose veins don’t usually hurt, but if they’re becoming painful or uncomfortable, they most likely include other symptoms like a heavy feeling in the legs; burning, throbbing, muscle cramping and swelling in the lower legs; worsened pain after sitting or standing for a long time; itching around one or more of the veins, and changes in skin color around a varicose vein.

It’s very rare to have complications that arise due to varicose veins, but it’s important to identify them in order to prevent and treat them:

• Ulcers: Painful ulcers can form on the skin near varicose veins, especially near the ankles. A discolored spot on the skin usually begins before an ulcer forms. 
• Blood clots: Veins deep within the legs become enlarged and might cause leg pain and swelling. 
• Bleeding: Veins close to the skin burst and although this usually causes only minor bleeding, it requires medical attention.

Prevention and Treatment

Like all medical conditions, there are several ways to prevent and treat varicose veins. However, it’s important that a doctor carries out a proper examination in order to determine the best treatment for the patient. First, the doctor will examine the patient’s legs and visible veins, as well as ask if they’re experiencing any pain or discomfort.

In order to determine the necessary treatment, they may also want to do an ultrasound to check the patient’s blood flow. This is a noninvasive test that uses high-frequency sound waves, allowing the doctor to see how blood is flowing in the veins.

Depending on the location, a venogram may be done to further assess the veins. During this test, the doctor injects a special dye into the patient’s legs and takes X-rays of the area. The dye appears on the X-rays, giving the doctor a better view of how the blood is flowing. Tests such as ultrasounds or venograms help ensure that another disorder like a blood clot or a blockage isn’t causing the pain and swelling in the legs and that in fact, the patient has varicose veins.

When it comes to treatment, there are many ways to reduce the appearance of varicose veins. According to Stanford Medicine[4], there are several types of treatment, such as home treatment, which is usually the first step to treat these veins and prevent them from getting worse. The patient may be told to wear compression stockings, elevate their legs, avoid long periods of sitting or standing, and add an exercise routine to their daily activities. 

If these types of home treatment do not work, there are other procedures that can be a more effective treatment, for example:

Laser treatment

Laser energy is used to scar and destroy varicose veins, which is called ablation. Simple laser therapy treatment is done on small veins close to the skin, such as spider veins, and is usually used outside of your skin. Endovenous laser therapy treatment uses a laser fiber inserted into the vein, making the vein close up.

Ligation and stripping

Another type of treatment consists of cuts or incisions are made over the varicose vein so that the vein is tied off (ligated) and removed (stripped).

Phlebectomy

This treatment consists of several tiny cuts made in the skin through which the varicose vein is removed. This treatment is also called stab avulsion.

Radiofrequency treatment

Radiofrequency energy is used inside a vein to scar it and close it off. This treatment can be used to close off a large varicose vein in the leg.

Sclerotherapy

This treatment consists of a chemical being injected into a varicose vein to damage and scar the inside lining of the vein, causing the vein to close. This treatment usually works best for small veins.

Keep in mind that all of these treatments cause discolor and scarring on the skin and that there may be other underlying medical conditions that are causing varicose veins. If so, other treatment will be needed to address the complications that are causing this condition on a person’s skin.

Contact Us to Learn More

If you want to learn more about varicose veins and the available treatment, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1, 4] “Varicose veins”. https://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/syc-20350643. (Accessed May 23, 2023). 
• [2] “Varicose veins”. https://www.nhs.uk/conditions/varicose-veins/. (Accessed May 23, 2023).
• [3] “Varicose Veins”. https://www.healthline.com/health/varicose-veins. (Accessed May 23, 2023).
• [4] “Treatment for Varicose Veins”. https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/varicose-veins/treatments.html. (Accessed May 23, 2023).

Obesity is a chronic disease that affects billions of people worldwide, and recent studies have shown psychology and obesity are more related than we think. Scientists have researched the effects of mental health in overweight people since obesity has led to a multitude of health concerns. While the physical ramifications of obesity are widely recognized, its impact on mental health is often overlooked.

Obesity has become a pressing public health issue worldwide. According to the World Health Organization (WHO)[1], the global obesity rate has tripled since 1975.

In 2020, more than 2 billion adults were overweight, with 650 million classified as obese. These statistics show a significant situation that demands immediate attention.

Obesity and mental health

Research consistently demonstrates the profound impact of obesity on mental health Studies have revealed that individuals with obesity are at a higher risk of developing various mental health disorders, including depression, anxiety, and eating disorders[2].

Several comprehensive reviews have suggested that between 20% and 60% of persons with obesity, and extreme obesity in particular, suffer from a psychiatric illness. Let’s delve into some pertinent statistics:

Depression and Obesity

Patients with depression are now seeking nutritional support as well as psychological or psychiatric help. In some cases, they might change their diet to make the right food choices and avoid certain ingredients, but these lead us to question what is the right diet and which is not? As far as we have researched, there is no right or wrong diet, but there are indeed some foods to avoid for depression and help with obesity.

A strong correlation exists between depression and obesity. Research has shown that individuals with obesity are approximately 55% more likely to develop depression during their lifetime compared to those of normal weight.

In adolescents, the risk increases to 58%[3]. These numbers are concerning and emphasize the need for comprehensive healthcare interventions.

Anxiety and Obesity

According to the National Institute of mental health, anxiety disorders are the most common mental illness in the United States. That’s 40 million adults—18% of the population—who struggle with anxiety. Anxiety and depression often go hand in hand, with about half of those with depression also experiencing anxiety[4].

While therapy, medication, and self-care practices are essential in managing anxiety, we often overlook the impact of our diet on our mental well-being to avoid obesity. Some researchers have explored the relationship between anxiety and the food we eat and how making mindful choices can support a calmer and more balanced state of mind, including reducing the chances of being diagnosed with obesity.

Anxiety disorders are another mental health issue associated with obesity. A study found that obese individuals are almost twice as likely to develop anxiety disorders compared to their non-obese counterparts[5]. The increased prevalence of anxiety further underscores the importance of addressing the psychological impact of obesity.

Psychological Effect of Eating Disorders and Obesity

While eating disorders are typically associated with low body weight, they can also affect individuals with obesity; in fact, disordered eating is common among persons with obesity. Also, binge eating disorder (BED) is commonly observed in those struggling with weight issues, and it consists of the individual consuming a large amount of food in a brief period of time (less than 2 hours) with no control. Approximately 30% to 40% of individuals seeking weight loss treatment have BED[6]. This complex relationship between obesity and eating disorders highlights the significance of a holistic approach to mental health

As we see, obesity and mental health disorders often exist in a vicious cycle, exacerbating each other’s effects. The psychological distress associated with obesity can lead to emotional eating and unhealthy coping mechanisms, perpetuating weight gain. The physical and social consequences of obesity, such as body image dissatisfaction and weight stigma, can significantly affect the mental well-being and state of mind of the individual with obesity.

Thus, it is essential to highlight childhood obesity since it has become a major concern worldwide, and its implications for mental health are equally alarming as obesity in adults. Obese children and adolescents are more likely to experience poor self-esteem, social isolation, and bullying. These psychological challenges can persist into adulthood, compounding the overall burden of obesity on mental health

Implementing mindful eating at home and educating children at school can have a significant impact on the statistics since obesity has become a global health crisis, affecting millions of people worldwide. While the physical consequences of obesity are well documented, the psychological impact often remains underappreciated and misunderstood, until recent studies appear.

The negative effects of obesity are not only physical, now the effects are visible in the mental health of the individual. Beyond the struggles with weight and related health issues, adults with obesity face a host of psychological challenges that can significantly influence their quality of life in this modern society.

Some of these situations can lead the individual to perceive stigma, isolation, present body image dissatisfaction, depression, and anxiety.

• Stigma and social isolation: Obese individuals often experience pervasive weight-based stigmatization and discrimination, leading to profound social and emotional consequences. They may face negative stereotypes, bias, and ridicule, which can erode self-esteem, self-worth, and body image[7]. These experiences can lead to social isolation, withdrawal from social activities, and an increased risk of developing mental health disorders such as depression and anxiety.
• Body image dissatisfaction: Body image dissatisfaction is prevalent among individuals with obesity. Society’s unattainable beauty standards and the constant bombardment of media messages emphasizing thinness exacerbate feelings of inadequacy and self-consciousness. This dissatisfaction can result in low self-esteem, negative body image perception[8], and an increased likelihood of developing eating disorders such as binge eating disorder or emotional eating.
• Depression and anxiety: Obesity and mental health, as we previously mentioned, are extremely connected, with depression and anxiety being common comorbidities. The psychological strain of obesity, coupled with the physiological effects, can contribute to the development or exacerbation of these mental health conditions. Living with obesity can lead to a vicious cycle where emotional distress can drive overeating, weight gain, and further deterioration of mental well-being.
• Emotional coping and self-esteem: Food can serve as an emotional coping mechanism for individuals with obesity. Emotional eating, driven by stress, boredom, or negative emotions, becomes a coping strategy to temporarily alleviate psychological discomfort. However, this pattern reinforces reliance on food for emotional regulation, often enhancing the obesity cycle. As a result, self-esteem and self-efficacy suffer, further exacerbating the psychological impact of obesity.
• Reduced quality of life: According to the National Library of Medicine, obesity can significantly impair an individual’s overall quality of life[9]. The physical limitations it imposes, such as reduced mobility, increased fatigue, and chronic pain, can restrict participation in daily activities and hobbies, leading to frustration and feelings of helplessness. Social interactions, intimate relationships, and career opportunities may also be affected, diminishing overall life satisfaction and fulfillment.
• Medical adherence and treatment challenges: Psychological factors play a critical role in the success of weight management interventions. Obese adults often encounter difficulties adhering to treatment plans due to emotional and psychological barriers. These challenges may include lack of motivation, emotional eating, body image issues, or previous unsuccessful attempts at weight loss. Addressing the psychological aspects of obesity is vital for designing effective treatment strategies and providing the necessary support.

In conclusion, the psychological effects of obesity in adults extend far beyond the physical health implications, as well as its origin, the unique factors such as genetics, lifestyle and health conditions, and obesity causes are particular. The emotional burden, stigma, and social isolation experienced by those living with obesity can be hard since it affects their mental well-being, self-perception, and overall day-to-day.

Recognizing and addressing the psychological challenges of obesity in today’s world is essential in promoting holistic and effective interventions, fostering a supportive environment, and reducing the burden for individuals struggling with this complex condition. It is crucial to promote empathy, understanding, and evidence-based approaches to help individuals overcome the psychological barriers associated with obesity and improve their overall well-being.

Addressing the mental health implications of obesity requires a multi-faceted approach, involving healthcare professionals, policymakers, and society as a whole. By understanding the magnitude of the problem and implementing comprehensive interventions, we can strive to improve the well-being of individuals affected by obesity and foster a healthier future for all.

Contact Us to Learn More

If you want to learn more about the psychology of obesity, mental health and its statistics, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] “Obesity and overweight”. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (Accessed June 27, 2023).
• [2, 5, 6, 8] Sarwer DB, Polonsky HM. The Psychosocial Burden of Obesity. Endocrinol Metab Clin North Am. 2016 Sep;45(3):677-88. doi: 10.1016/j.ecl.2016.04.016. PMID: 27519139; PMCID: PMC6052856.
• [3] Blasco BV, García-Jiménez J, Bodoano I, Gutiérrez-Rojas L. Obesity and Depression: Its Prevalence and Influence as a Prognostic Factor: A Systematic Review. Psychiatry Investig. 2020 Aug;17(8):715-724. doi: 10.30773/pi.2020.0099. Epub 2020 Aug 12. PMID: 32777922; PMCID: PMC7449839.
• [4] “Nutritional strategies to ease anxiety”. https://www.health.harvard.edu/blog/nutritional-strategies-to-ease-anxiety-201604139441 (Accessed June 27, 2023).
• [7, 9] Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. Am J Public Health. 2010 Jun;100(6):1019-28. doi: 10.2105/AJPH.2009.159491. Epub 2010 Jan 14. PMID: 20075322; PMCID: PMC2866597.

Obesity is a chronic disease that involves many factors, including health, economics, and lifestyle. Being overweight or obese are similar conditions that might affect everyone in society, no matter gender, race, role, or age. However, certain populations, including children and young adults, are more vulnerable to suffering from these conditions. In North America and all over the world today, we see increased levels of obesity that are higher than in previous years.

This makes us question and analyze quite closely the way in which people’s lifestyle has changed and those changes have undoubtedly been more pronounced in the past 30 to 40 years. It also gives us an opportunity to understand the problem better, as well as a better chance to come up with a solution: healthy eating. But what does that mean? Maybe regulated portions, less junk food, and more vegetables and fruits? We’ll discuss it in more detail in this article.  

The Role of Food Portion Control 

Food portion control refers to the practice of managing the quantity of food[1] you consume in each meal or snack. It involves understanding appropriate serving sizes and adjusting your intake accordingly. Portion sizes in restaurants, coffee shops, movie theaters, and packaged foods have significantly increased over the years, which makes us believe it could be a normal serving, now called “portion distortion”[2] being one of the main contributors to being overweight.

Larger portions often result in overconsumption of calories, fat, and sugar, contributing to weight gain and obesity. 

Overeating, even nutritious food, can lead to weight gain and a host of associated health problems. On the other hand, consuming smaller portions can help you maintain a healthy weight, reduce the risk of chronic diseases, and increase energy levels. Learning to recognize and control portion sizes is vital for maintaining a balanced diet plus a healthy lifestyle.

Daily Serving Size and Portions in Today’s World 

As we mentioned above, in today’s fast-paced world, where oversized portions and super-sized meals have become the norm, maintaining a healthy diet can be challenging. Thus, portion control plays a crucial role in achieving and maintaining a healthy weight, as well as promoting overall well-being. Worldwide obesity has nearly tripled since 1975 and portions have changed drastically; a clear example is the massive size of soft drinks, French fries, and foods like hamburgers, we can easily find today.

The serving size on a food label may be more than or less than the amount you should eat[3]. That’s because how many calories you need each day to maintain your weight or lose weight may depend on:

• Your age
• Your current weight and height
• Your metabolism
• Whether you’re male or female
• How active you are 

However, you can start a balanced diet with proper recommendations or the right meal plan for you (you can ask your nutritionist or your doctor). For example, here we list some recommendations that every person should include and reduce in their daily diet according to the Dietary Guidelines for Americans 2020–2025[4]. 

• Mostly fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products.
• A variety of protein foods such as seafood, lean meats and poultry, eggs, legumes (beans and peas), soy products, nuts, and seeds.
• Low added sugars, sodium, saturated fats, trans fats, and cholesterol.
• Take into consideration your daily calorie needs according to your age, gender, weight, and height. 

It’s important to note that these guidelines may not be suitable for everyone, so the right portion or meal size should always be personalized. It is always a good idea to consult with a healthcare professional or registered dietitian to get personalized advice based on your specific needs and health conditions.

The Plate of Good Eating

The plate of good eating is a visual representation of a balanced and healthy meal, often used to guide individuals in making nutritious food choices. While there are different variations of the plate depending on cultural and dietary preferences, one widely recognized example is the MyPlate model, developed by the U.S. Department of Agriculture (USDA)[5]. Here’s a minimal example of the plate model:

• Fill half your plate with fruits and vegetables
• Make a quarter of your plate whole grains
• Include a quarter of your plate with lean proteins
• Add a serving of dairy or alternatives
• Include a small amount of healthy fats

Remember that the plate of good eating is a general insight, and individual dietary needs may vary. It’s essential to consider factors such as personal health goals, allergies, and cultural preferences when planning your meals. Consulting with a registered dietitian can provide personalized recommendations based on your specific needs.

Some Food Portion Guidelines

• Try to read food labels, pay attention to serving sizes mentioned on food labels, and adjust your portions accordingly. Be mindful of the number of servings in a container to avoid unintentionally consuming more than recommended.
• Use smaller plates and bowls, and downsize your dishware to create an optical illusion of a fuller plate. Using smaller plates and bowls can help control portion sizes and reduce the tendency to overeat.
• Practice mindful eating, slow down, and savor each bite of your food. Focus on the flavors, textures, and aromas of your food, promoting a more satisfying eating experience. Eating mindfully allows you to tune into your body’s hunger preventing you from overeating.
• Portion pre-plate, so instead of serving family-style at the table, plate your meals in the kitchen. This strategy prevents mindless second servings and encourages portion awareness.
• Fill half your plate with vegetables because they are low in calories and high in nutrients. By filling half your plate with colorful vegetables, you automatically reduce the space available for larger portions of calorie-dense foods[6].
• Be conscious of liquid beverages like sodas, juices, and alcoholic drinks, which can contribute to excessive calorie intake. Opt for water, unsweetened tea, or other low-calorie alternatives to fulfill your thirst without adding extra calories.
• Creating a meal-prep routine, planning and preparing meals ahead of time can help you make healthier choices and control portion sizes. Create a balanced meal plan and use portioned containers to pack your meals for the day.
• Share your goals with a friend, or family member, or join a community that focuses on healthy eating. Having support and accountability can keep you motivated and help you stay on track.

Food portion control is a powerful tool for achieving and maintaining a healthy lifestyle. By understanding the significance of portion sizes and adopting practical strategies to control them, you can make positive changes in your diet. Remember, healthy eating is not about deprivation but rather about balance and mindful choices. 

By paying attention to portion sizes and making conscious decisions, you can enjoy a wide variety of foods while nourishing your body and achieving your health goals. Start small, stay consistent, and watch how portion control can change your life positively. 

At LIMARP® one of the main life lessons our patients learn is portion control. The commitment they make when they decide to have bariatric surgery allows them to have almost automatic control of their portions, but we do not leave it at that. We also offer a clear pre and post-op eating plan, vitamin supplementation specially designed for the bariatric patient, and counseling on how to tell real portions from the “inflated” portions of today’s market.

Contact Us to Learn More

If you want to learn more about food portions, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References:

[1, 3] “Food Portions: Choosing Just Enough for You”. https://www.niddk.nih.gov/health-information/weight-management/just-enough-food-portions. (Accessed May 25, 2023).

[2] “Serving Sizes and Portions”. https://www.nhlbi.nih.gov/health/educational/wecan/eat-right/distortion.htm. (Accessed May 25, 2023).

[4] “Dietary Guidelines for Americans, 2020-2025”. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf#page=31. (Accessed May 25, 2023).

[5] “What is MyPlate?”. https://www.myplate.gov/eat-healthy/what-is-myplate. (Accessed May 25, 2023).

[6] “Healthy Eating for a Healthy Weight”. https://www.cdc.gov/healthyweight/healthy_eating/index.html#:~:text=Emphasizes%20fruits%2C%20vegetables%2C%20whole%20grains,%2C%20trans%20fats%2C%20and%20cholesterol. (Accessed May 25, 2023).

Obesity is a chronic disease that gradually affects adults of all ages and children, and it goes beyond being overweight. There are different methods to treat obesity or to prevent it, but living in the 21st century and being exposed to its technological advances are a great risk factor. Obesity leads to the triggering of chronic diseases and although many methods have been developed to prevent this disease or to lose weight, it all depends on the patient’s conditions, age, lifestyle, and/or biological inheritance[1].

Next, we will list some tips that can be useful for anyone with obesity, however, this does not mean that it is a personalized treatment, since the comprehensive plan for you to make the changes in your life must be guided by an expert. You can schedule a consultation with us if you want to lose weight or consider it necessary to prevent obesity. Now let’s go over the following 7 tips.

1. Obesity or excess weight

First, you must recognize if you have obesity to start treatment or in case of being overweight to prevent obesity:

Adults

For adults, WHO defines overweight and obesity as follows:

• Overweight: Body mass index (BMI) equal to or greater than 25
• Obesity: BMI equal to or greater than 30

Afterwards, you should be aware that if you want to change your physical condition, you will have to make some changes in your lifestyle, such as:

• Changing your diet
• Exercising or doing any type of physical activity.
• Changing daily habits
• Taking medication to lose weight
• Undergoing a type of bariatric surgery

2. Reduce your calorie intake

This step is the most important to lose weight. Along with the team of specialists you can review your eating habits. to see how many calories you are consuming and where you can cut back. There is a chance that the portions you are eating are larger than you thought. You may also find that you are eating a lot of fast food, sweets, or drinks that contain a lot of sugar. With the help of the doctor, you can establish how many calories you should consume daily to lose weight. The ideal calorie intake to avoid becoming overweight is between 1,000 and 1,600.

It is important to reduce the number of calories you consume and eat in a healthier way to lose weight. The safest way to reduce our weight is to lose between 1/2 and 1 kilogram per week. This way, you will also avoid gaining weight again. Do not try to use drastic methods and unrealistic changes to your diet, such as crash diets, as this does not work.

3. Less is more

One way that you can satisfy your appetite and eat fewer calories is to use the concept of energy density. Food contains a certain number of calories in a certain volume. A high energy density means that there are a lot of calories in a small amount of food. Some foods that have a high energy density are desserts, sweets and processed foods. Fruits and vegetables have a low energy density, so the serving is larger and contains fewer calories. When you eat larger portions of low-calorie foods, you control your cravings and won’t feel guilty about overeating.

4. Create a healthy diet plan

Your diet will be healthier if you eat more plant foods, such as fruits and vegetables. It’s also important to eat more protein that comes from plants, such as beans, lentils, and soybeans[2]. A good habit that you can acquire to prevent obesity is to eat red meat only once a week and try to eat chicken, fish or turkey the rest of the week. Try to use low-fat dairy products. Limit the amount of salt and sugar you use. It is important that the fat you consume comes from healthy sources such as olives, safflower oils, and nuts.

5. Avoid fad diets

Unfortunately, with the rapid access to information and the infinite options of diets and weight loss plans, these alternatives are used by many overweight or obese people as a quick alternative, but these “miracle” diets do not work. Fast diets cause you to lose weight very quickly, but it is very easy to gain it back. Only healthy eating habits will allow you to lose weight and keep it off for longer.

Your doctor will also give you advice to maintain a dietary behavior, and through the nutritionist or chef of the multidisciplinary team, they will teach you how to prepare low-cost healthy foods so that the act of eating becomes a conscious activity.

6. Exercise

A big part of any treatment to prevent obesity is to increase the amount of exercise you get. People who have been able to lose weight and keep it off for more than a year exercise regularly, even just walking is very helpful[3]. Increasing the amount of exercise you do has the goal of making your body burn more calories than you consume, along with many other benefits.

The number of calories you can burn will depend on how often, for how long, and at what intensity you exercise.

If you do it regularly you will lower your body fat level. Examples of aerobic exercise are: walking, biking, climbing stairs, or swimming. According to the American College of Sports Medicine, people who are overweight should get at least 150 minutes of moderate-intensity physical activity a week to prevent further weight gain.

To lose weight considerably, you should do between 250 and 300 minutes of exercise a week. You may have to gradually increase the amount of exercise you do and divide the time into several daily sessions. Increase by five to six minutes per session each day. Your goals must be ones that you are going to be able to achieve so that you do not give up. Ask your doctor for advice on which exercise routine is right for you.

Any physical movement you do during the day can be useful to prevent overweight and obesity, so it is important to pay attention to making small changes in your daily routine. For example, here are some tips that can help you move more:

• Park your car far from the entrance of the place you’re going to.
• Put more energy into your home activities.
• If you have a garden at home, tend to it daily.
• Get up from wherever you’re sitting and move.
• You can use a digital step counter to keep track of your daily movement.

Contact Us to Learn More

If you want to learn more about how to prevent obesity and change your daily habits to have a better lifestyle, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] “Some Myths about Nutrition & physical activity.”. https://www.niddk.nih.gov/health-information/weight-management/myths-nutrition-physical-activity. (Accessed June 6th, 2023).
• [2, 3] “Finding a Balance of Food and Activity”. https://www.cdc.gov/healthyweight/calories/index.html. (Accessed June 6th, 2023)

Obesity is a complex disease that is not caused by one single issue. Many things factor into the equation that leads an individual to gain weight to the point of threatening their health, such as the environment they grew up in, underlying medical conditions that prevent them from maintaining a healthy weight, or sedentary lifestyles. Whichever the risk factors may be, obesity has become a global problem that affects millions of people of varying ages.

Obesity affects everyone around the world with data suggesting that “the number of obese people in the world has tripled since 1975 to roughly 30% of the total population”[1], and this number continues to rise. Just as there are many causes for obesity, there are also many risk factors that may arise if a person is battling with extra weight. This disorder is one of the leading causes of death because it dramatically decreases a person’s life expectancy.

Obesity puts people at higher risk for several diseases or illnesses, such as: diabetes, heart disease, osteoarthritis, sleep apnea, strokes, and high blood pressure. 

People of all ages, in both Mexico and the United States, are facing an obesity epidemic and subsequent risk factors, which helps explain the rise in popularity of bariatric surgery. Many people from all over the country come to our Tijuana clinic to learn more on how to reduce obesity risk factors and lead the life they want. At LIMARP®, they’re attended by a top-notch team of doctors led by Dr. Liza María Pompa González, and together they ensure that whoever walks through our doors has a successful journey toward recovery and a healthier lifestyle.

While weight loss surgery is helpful, knowing the risk factors that contribute to obesity can help you avoid the need for surgery. Dyslipidemia refers to unhealthy levels of one or more kinds of lipid (fat) in your blood. As you may have noticed from the other articles available on our website, we usually cover how certain diseases or illnesses are directly linked to obesity or being overweight. However, there are other conditions that can affect everyone, regardless of their weight. Dyslipidemia is one of them, as it can be caused by several factors that go beyond the lack of a healthy diet or an active lifestyle.

For this article, we will take a closer and deeper look into dyslipidemia, its causes, symptoms, and available treatments.

The doors of our Tijuana clinic are always open and we receive patients with different backgrounds from both sides of the border. Our multidisciplinary team at LIMARP®, led by Dr. Liza María Pompa González, is here to help you understand the effects of having dyslipidemia, as well as provide all the necessary tools and information to ensure that you lead a healthier lifestyle. 

As always, we’d like to remind you that each case is different and the information presented in this article is general. If you haven’t been diagnosed with dyslipidemia, make sure to visit a doctor first before taking any medication or applying drastic changes to your lifestyle. The treatment should be catered to your needs, as its main objective is to help you be healthier and avoid any life-threatening complications. 

Dyslipidemia: What Is It?

As we briefly mentioned in this article’s introduction, being diagnosed with dyslipidemia means having unhealthy levels of one or more kinds of lipid in your blood. To have a better understanding, it’s important to provide more information about what this condition entails. Dyslipidemia is the imbalance of lipids such as cholesterol, low-density lipoprotein cholesterol, (LDL-C), triglycerides, and high-density lipoprotein (HDL)[2]. 

It’s also important to know what lipids are to better understand how their imbalance, either organic or inorganic, can cause dyslipidemia.

Lipids, such as cholesterol or triglycerides, are absorbed from the intestines and are carried throughout the body via lipoproteins for energy, steroid production, or bile acid formation[3]. If a person is diagnosed with dyslipidemia it may be due to high LDL levels, it can also mean that their HDL levels are below average. 

LDL cholesterol is considered the “bad” type of cholesterol because it can build up and form plaques in the walls of the arteries. This can lead to too much plaque in the arteries of the heart and can cause a heart attack. On the other hand, HDL is the “good” cholesterol because it helps remove LDL from your blood.

Triglycerides are stored in fat cells and come from the calories that don’t burn right away. If a person eats more calories than they burn, it’s possible that their triglycerides levels increase. High LDL and triglyceride levels put people at a higher risk for heart attack and stroke, while low levels of HDL cholesterol are linked to higher heart disease risks.

There are two types of dyslipidemia: primary and secondary. The former is inherited, while the latter is acquired or developed from other causes, such as obesity or diabetes. Dyslipidemia can also refer to levels that are either higher or lower than the normal range for the aforementioned blood fats[4]. 

Dyslipidemia Symptoms 

There are no evident symptoms for dyslipidemia and blood tests are required in order to determine if a person has this condition. If dyslipidemia goes undiagnosed and untreated, it can bring forth serious complications, such as cardiovascular disease, which can be symptomatic. High LDL cholesterol levels are associated with coronary artery disease, the blockage in the arteries of your heart, and peripheral artery disease , which is blockage in the arteries of your legs.

The former can lead to chest pain and eventually a heart attack, while the main symptom of the latter is leg pain when walking. According to one study[5], “the prevalence of dyslipidemia increases with age. In 2005-2008 an estimated 33.5% of U.S. adults older than 20 years of age had high LDL-C levels. Of these individuals with elevated LDL-C levels, only 48.1% received treatment, and 33.2% had their LDL-C controlled. The prevalence of LDL-C control seemed to be the lowest amongst individuals that were uninsured, Mexican American, or having income below the poverty level”. 

Risk Factors

While primary dyslipidemia is inherited, there are several risk factors or behaviors that can increase the chances of a person developing this condition. Among the most prevalent ones, we have smoking cigarettes, obesity, consumption of foods high in saturated fat and trans fat, as well as high alcohol consumption. 

Other medical conditions that can raise your dyslipidemia risk include:

• Type 2 diabetes
• Hypothyroidism
• Chronic kidney disease

Obesity and Dyslipidemia

According to one study[6], obesity is a risk factor for the development of cardiovascular disease, but it appears that much of this effect is accounted for by obesity inducing dyslipidemia, diabetes, hypertension, and inflammation. While dyslipidemia is not inherent to obesity or having excessive weight, researchers have found that “abnormalities in lipid metabolism are very commonly observed in patients who are obese. Approximately 60-70% of patients with obesity are dyslipidemic.” [7]

At LIMARP®, we offer an integrative treatment plan that adjusts to the needs of each patient. If you or someone you know currently struggles with obesity or is looking for a way to lose weight in a healthy way, our doors are always open for people from all over the country and across the border. After an initial consultation, we’ll determine the best way to begin your treatment, which may or may not include weight loss surgery. There are many ways to treat obesity and lose weight, including plans that focus on eating healthy and improving the patient’s overall health.

Treating Dyslipidemia

Whether the patient has obesity or not, it’s very important to treat dyslipidemia as soon as it’s diagnosed and avoid any complications, such as coronary artery disease and peripheral artery disease. Treatment for dyslipidemia include:

• The use of statins to reduce LDL levels by interfering with cholesterol production in the liver.
• Cholesterol medication, like fibrates, to be taken with or in place of statins.
• Lifestyle changes, like exercising and starting a healthy diet.

Contact Us to Learn More

If you want to learn more about dyslipidemia, as well as its symptoms and available treatment, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

[1] “Most Obese Countries 2022”. https://worldpopulationreview.com/country-rankings/most-obese-countries. (Accessed April 4, 2023).

[2] Pappan N, Rehman A. Dyslipidemia. [Updated 2022 Jul 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560891/ 

[3] Rader DJ, Hoeg JM, Brewer HB Jr. Quantitation of plasma apolipoproteins in the primary and secondary prevention of coronary artery disease. Ann Intern Med. 1994 Jun 15;120(12):1012-25. doi: 10.7326/0003-4819-120-12-199406150-00008. PMID: 8185133.

[4] “Dyslipidemia: What You Need to Know”. https://www.healthline.com/health/dyslipidemia. (Accessed April 24, 2023).

[5] Centers for Disease Control and Prevention (CDC). Vital signs: prevalence, treatment, and control of high levels of low-density lipoprotein cholesterol–United States, 1999-2002 and 2005-200. MMWR Morb Mortal Wkly Rep. 2011 Feb 4;60(4):109-14. PMID: 21293326.

[6] Bays HE, Toth PP, Kris-Etherton PM, Abate N, Aronne LJ, Brown WV, Gonzalez-Campoy JM, Jones SR, Kumar R, La Forge R, Samuel VT. Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association. J Clin Lipidol. 2013 Jul-Aug;7(4):304-83. doi: 10.1016/j.jacl.2013.04.001. Epub 2013 May 31. PMID: 23890517.

[7] Feingold KR. Obesity and Dyslipidemia. [Updated 2020 Nov 2]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK305895/

Obesity is a complex disease that is not caused by one single issue. Many things factor into the equation that leads an individual to gain weight to the point of threatening their health, such as the environment they grew up in, underlying medical conditions that prevent them from maintaining a healthy weight, or sedentary lifestyles. Whichever the reason may be, obesity has become a global problem that affects millions of people of varying ages.

Obesity affects everyone around the world with data suggesting that “the number of obese people in the world has tripled since 1975 to roughly 30% of the total population”[1], and this number continues to rise. Just as there are many causes for obesity, there are also many consequences that may arise if a person is battling with extra weight. This disorder is one of the leading causes of death because it dramatically decreases a person’s life expectancy. Obesity puts people at higher risk for several diseases or illnesses, such as: diabetes, heart disease, osteoarthritis, sleep apnea, strokes, and high blood pressure. 

This article will focus on how obesity can cause back pain, especially in the lower part; we’ll also explain what these conditions entail, as well as how to treat and alleviate the symptoms that may present themselves.

Patients from all different backgrounds arrive at LIMARP® because they’re looking to improve their quality of life and embark on a healthier path. Our multidisciplinary team, led by Dr. Liza María Pompa González, offers different health services to help you reach your weight goals and beat obesity: from diet and exercise plans, to psychological guidance and surgical intervention. 

Obesity impacts everyone in a different way and the comorbidities that come along with it can vary from person to person, but we still recommend that you talk with your doctor if your back pain is severely affecting your overall health.

A Quick View Into Obesity

Before going into more detail about the link between obesity and back pain, we’d like to offer more information about obesity. This condition is an abnormal or excessive accumulation of fat that can cause illness and significant risks for your health. Obesity can be calculated by a variety of tests, including simple ones like measuring your body mass index (BMI). Patients with a BMI over 25 are considered overweight and patients with a BMI over 30 are considered obese, a trained physician can help you determine if your weight is at an unhealthy level.

The harsh reality is that obesity is a public health issue that is on the rise worldwide, affecting an increasing number of adults and children every year. Obesity is the result of excess fat stores within the body that cause systemic inflammation, it generally occurs when you consume more calories than you burn through daily physical activity or exercise. Many patients who are overweight or obese also have a genetic predisposition for the disease. A person is more likely to be obese if one of their parents is obese, or if their family has a similar, unhealthy lifestyle.

There are many complications, both mental and physical, that can present themselves when a person has obesity. When it comes to mental and emotional effects, a 2018 study[2] noted that “between 20% and 60% of persons with obesity, and extreme obesity in particular, suffer from a psychiatric illness”. 

There are also physical effects, such as hypertension, high levels of triglycerides, type 2 diabetes, coronary heart disease, risk of stroke, gallbladder disease, osteoarthritis, sleep apnea, many types of cancer, and back pain.

Back Pain: Symptoms and Causes

Back pain can vary from person to person; it can be just a muscle ache or a shooting or burning sensation. The pain that begins in the back can radiate down to the legs, making it more unmanageable and increasing the possibility of a person being unable to move freely. There are many risk factors to back pain[3], such as:

• Age: Back pain is more common with age, especially after age 30.
• Lack of exercise: Unused muscles in the back and abdomen can lead to back pain.
• Diseases: Some types of arthritis and cancer can contribute to back pain.
• Improper lifting: Using the back instead of the legs can cause pain.
• Smoking: This may occur because smoking causes coughing, which can lead to herniated disks. Smoking also can decrease blood flow to the spine, increasing the risk of osteoporosis.

The Link Between Obesity and Back Pain

We’ve talked about the link between obesity and knee pain in another article available on our website. Now, we’ll go over how obesity can create or worsen back pain, as well as other problems with the musculoskeletal system, which consists of bones, joints, cartilage, ligaments, tendons, and muscles. 

If a person has obesity and is experiencing back pain, it may be due to the excess weight in the body, which can affect the pelvis, back, and knees. Some medical experts[4] have stated that as a person gains more weight, their pelvis is being pulled forward, straining the lower back. This can lead to symptoms such as pain, soreness, and tightness.

The excess weight in a person’s midsection can also cause the spine to tilt and become uneven, making back muscles overcompensate thus creating more back pain, as well as other problems.

Obesity can also contribute to the worsening of existing musculoskeletal conditions; for example, people with herniated discs with excess weight can exacerbate and accelerate the progression of the injury. 

Obesity not only affects the health of a person with back pain, but also the effectiveness of treatment. People who are obese and undergo surgery to treat a spine condition have worse surgical outcomes and a higher rate of complications[5].

How To Reduce Back Pain

If a person’s back pain is due to them having obesity, the first step is to lower their weight. This can be done through exercise and diet changes, both of which should be approved by a doctor, especially if they have other comorbidities or delicate health. Our team at LIMARP® includes nutrition and fitness experts that help guide our patients through their weight loss journey, ensuring that it’s safe and effective. Physical therapy can be another option to treat back pain to build strength and improve their posture, movement, and flexibility. Combining this therapy with guided exercises can boost their metabolism while burning calories and losing weight, as well as increase flexibility and mobility.

There are also surgical options. If a patient is dealing with obesity, it’s highly likely that their doctor will recommend bariatric surgery if any initial diet and/or exercise plans fail or are insufficient when it comes to seeing results. Each patient’s case is different, so the plans recommended by your doctor and nutritionist may vary from person to person; they might also change according to the changes the body goes through in order to adapt to its new necessities or medical needs.

The surgical options a bariatric doctor may recommend include:

• Gastric sleeve – This procedure reduces stomach size by as much as 80%. The remaining portion of the stomach is shaped into a tube or sleeve, limiting what a patient can eat and providing a faster feeling of fullness. 
• Gastric bypass – During a gastric bypass, the stomach is divided into two pouches and the intestinal tract is redirected toward the upper part of the stomach, this restriction means there is less room for food. In addition there is less absorption of sugars and fats.
• Mini gastric bypass – This procedure has the advantage of creating a single union between the new stomach and the intestine, it provides restriction and limits the absorption of sugar and fats in the bypassed sections of the intestine, with the advantage of being faster and technically easier, with one single connection.
• Duodenal switch procedure – This procedure involves doing a gastric sleeve and rerouting the small intestine starting at the duodenum, which makes it a restrictive but highly malabsorptive surgery. 

Contact Us to Learn More

If you want to learn more about morbid obesity and back pain, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] “Most Obese Countries 2022”. https://worldpopulationreview.com/country-rankings/most-obese-countries. (Accessed February 24, 2023).
• [2] Sarwer DB, Polonsky HM. The Psychosocial Burden of Obesity. Endocrinol Metab Clin North Am. 2016 Sep;45(3):677-88. doi: 10.1016/j.ecl.2016.04.016. PMID: 27519139; PMCID: PMC6052856.
• [3] “Back Pain”. https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906. (Accessed February 24, 2023).
• [4, 5] “The Connection Between Obesity and Lower Back Pain”. https://www.endeavorrehab.com/2021/07/09/the-connection-between-obesity-and-lower-back-pain. (Accessed February 24, 2023).

It’s no question that the number of people who are overweight, when it comes to worldwide population, is increasing. The most recent data suggests that “the number of obese people in the world has tripled since 1975 to roughly 30% of the total population”[1], and this number continues to rise. However, before reaching obesity, many people struggle with being overweight due to different circumstances. The projections shared by the World Health Organization (WHO) display that at least one in three of the world’s adult population is overweight. 

Many things factor into the equation that leads an individual to being overweight, such as the environment they grew up in, underlying medical conditions that prevent them from maintaining a healthy weight, or sedentary lifestyles. Whichever the reason may be, being overweight has become a global problem that affects millions of people of varying ages. The effects of being overweight can range from self-esteem issues to physical issues, and even develop into obesity, which is why it’s important to engage in healthy practices. However, it has also been demonstrated that being overweight is not the same as being unhealthy. 

Our multidisciplinary team at LIMARP®, led by Dr. Liza María Pompa González, is here to help you understand the effects of being overweight, as well as provide all the necessary tools and information to ensure that you lead a healthier lifestyle. We will discuss the several effects of being overweight in this article, as well as what constitutes being overweight, and if it’s possible to be healthy despite having an above average body mass index (BMI). 

As always, we’d like to remind you that each case is different and the information presented in this article is general. If you recognize any of these symptoms or have experienced any uncomfortable side effects due to being overweight, please contact your doctor as soon as possible to determine the exact cause.

How to Know if You’re Overweight

According to the Centers for Disease Control and Prevention (CDC), if a person has a BMI that ranges from 25 to 30, they’re considered overweight[2]. However, there are other signs that may indicate that a person is overweight and it’s important that a healthcare professional helps determine whether a person is healthy or not. For example, waist circumference can be another factor that determines if a person is overweight or not. The fatty tissue found inside the abdomen is called visceral or abdominal fat and it interferes with the body’s endocrine and immune systems. It can also cause inflammation and contributes to obesity-related complications, including heart disease and diabetes[3].

Other signs that may help a person determine if they’re overweight are fatigue, chronic snoring, and swollen joints. Sometimes, the excess weight is a consequence of other underlying medical conditions, such as polycystic ovary syndrome (PCOS), hypothyroidism, and Cushing’s syndrome.

The Effects of Being Overweight

Now that we know more about what constitutes being overweight, let’s go over some of the effects it can have on a person’s mental, physical, and emotional wellness. When it comes to mental and emotional effects, a 2018 study[4] noted that “between 20% and 60% of persons with obesity, and extreme obesity in particular, suffer from a psychiatric illness”.

These effects seem to be stronger for women than men, perhaps because of society’s emphasis on thinness as a characteristic of female beauty.

Anxiety, another mental health condition, has also been shown to have negative effects on overweight people, especially in social situations[5]. When it comes to social effects, mainstream standards that are perpetuated by social media, television, and movies have not been kind to people with obesity or to those who do not fit the norm. They’re either the punchline to cruel jokes, stigmatized by those around them, or completely shut off from certain activities due to their weight.

There are also physical effects, such as hypertension, high levels of triglycerides, type 2 diabetes, coronary heart disease, risk of stroke, gallbladder disease, osteoarthritis, sleep apnea, many types of cancer, and joint pain.

Can You Be Overweight and Healthy?

According to Harvard Health[5], there are certain parameters that can classify certain overweight people as metabolically healthy despite having a high BMI, such as:

• A waist size of 40 inches for a man or 35 inches for a woman.
• Normal blood pressure, cholesterol, and blood sugar.
• Normal sensitivity to insulin.
• Good physical fitness.

It’s also important to note that BMI is not always the best indicator to determine if a person is healthy and that can be seen when muscular people are labeled as overweight due to their mass index. If a person is overweight, it’s important to take into account other aspects of their health before deeming them unhealthy, as the extra weight tends to have different effects from person to person.

Contact Us to Learn More

If you want to learn more about the effects of being overweight, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References:

• [1] “Most Obese Countries 2022”. https://worldpopulationreview.com/country-rankings/most-obese-countries. (Accessed February 19, 2023). 
• [2] “Defining Adult Overweight & Obesity”. https://www.cdc.gov/obesity/basics/adult-defining.html. (Accessed February 19, 2023). 
• [3] “OVERWEIGHT AND OBESITY: Symptoms and Diagnosis”. https://www.nhlbi.nih.gov/health/overweight-and-obesity/symptoms. (Accessed February 19, 2023).
• [4] Sarwer DB, Polonsky HM. The Psychosocial Burden of Obesity. Endocrinol Metab Clin North Am. 2016 Sep;45(3):677-88. doi: 10.1016/j.ecl.2016.04.016. PMID: 27519139; PMCID: PMC6052856.
• [5] “Overweight and healthy: the concept of metabolically healthy obesity”. https://www.health.harvard.edu/blog/overweight-and-healthy-the-concept-of-metabolically-healthy-obesity-201309246697. (Accessed February 19, 2023). 

Throughout the years, obesity has been a common source of discrimination and stigma in almost all social settings; from family circles, school environments, and the workplace, people with obesity face an unfair amount of discrimination due to their weight and nothing else. 

Both discrimination and stigmatization can make a person suffering from obesity quite miserable. Stigma has to do with the negative attitudes obese people face; they often include stereotyping, such as thinking obese people are lazy or of weak character.

Stigma also encompasses name calling, physical aggression, and being ignored or targeted in a negative way.

Discrimination refers specifically to an unfair or unequal treatment of the person. This includes, but is not limited to, denying a person a job because of their weight, being denied a promotion or a service. Weight is not an indicator of your ability or qualifications, but employers may be increasingly wary of hiring overweight employees because of how it might impact their bottom line.

Another type of weight discrimination can be seen in the medical field, as it has often been reported that patients who are obese or overweight do not receive the same kind of medical attention or constantly deal with negligence. Obesity is a multifactorial disease and, unfortunately, there are physicians all over the world who perform one operation after another and send patients’ home with no more than a goodbye or even a follow-up treatment. Surgery alone cannot solve such a sensitive problem and the bariatric patients must learn about the foods that promote greater wellbeing and how to manage the thoughts and behaviors that triggered their obesity. Comprehensive care is the only thing that will allow the obese patient to reach his or her goals and live a full and healthy life.

At LIMARP®, we make sure to treat every patient that walks through our door with the care and dignity they deserve. We believe that everyone, no matter their weight, should be treated with respect, especially when they’re seeking medical help to improve their quality of life. We know that the solution for obesity cannot rely on a single action such as a surgery, which is why we offer nutrition and psychological services as part of our integrative program. Many of our patients have dealt with some type of discrimination due to their weight and our multidisciplinary team includes psychologists that help them deal and overcome whatever issues that may be hindering their mental health.

For this article, we’d like to discuss weight discrimination in healthcare and in the workplace by providing examples and statistics.

It will take great societal change to stop weight discrimination and the best we can provide in this article are steps on how to improve your self-esteem and step away from the negative noise that hinders your mental health. However, we understand that more drastic steps need to be taken in order to put an end to weight discrimination at a larger scale. We recommend you speak to professionals, in both the legal and psychological fields, if you’re dealing with intense or unmanageable weight discrimination. 

Weight Discrimination: What is it?

Weight discrimination refers to the unequal treatment of people purely associated with their weight and it’s not the same as weight stigma or bias, which is concerned solely with negative attitudes towards people who are overweight but does not include negative actions[1]. This type of discrimination is very common in Mexico and in the United States, two countries where obesity is on the rise. One study, which only focused on weight discrimination in the United States, found that weight discrimination was more prevalent than discrimination due to ethnicity, sexual orientation and physical disability[2].

Other studies[3] found that women are more likely to be discriminated against due to their weight than men with the differential percentage points exceeding more than 5% in comparison.

This is an important point to keep in mind because women also face more discrimination due to their gender, so they’re more exposed to mistreatment than men. There is also direct and indirect weight discrimination. In the former, people are mistreated explicitly because of their weight and whomever is inflicting the discrimination is being blatant about it; on the other hand, indirect weight discrimination knowingly puts an overweight person at a disadvantage in comparison with others.

Weight Discrimination in the Workplace

These types of discrimination, both direct and indirect, are very prevalent in the workplace. Unlike other types of discrimination, such as gender, race, and sexual, there are no federal laws currently in place that protect obese or overweight people from workplace discrimination, and although more people are growing more conscious of the harm that these injustices can inflict on other people, many fatphobic practices still go unnoticed by many.  

According to one source[4], 93% of employers would rather hire someone of average weight instead of someone who is visibly overweight despite their qualifications and in some cases, if theory were hired, employees would have to meet certain weight guidelines in order to have access to healthcare. It’s also been proven that overweight people tend to earn less money than their peers of average weight and are less likely to be offered promotions, if they’re even given the job in the first place[5].

Other aspects within a workplace environment where obese or overweight people can face disadvantage or discrimination include:

• The interview and hiring processes 
• Disciplinary actions
• Unjust contract terminations
• Promotions within the company

Despite a growing awareness of how weight discrimination in the workplace has affected a great part of the population, many people are still experiencing it at different levels and it tends to worsen if they have a high BMI. 

Weight Discrimination in Healthcare

Weight discrimination also extends to healthcare and its consequences pose serious threats to a person’s well-being because they may not get the necessary care and attention due to weight bias. One of the most common beliefs is that heavier people are inherently unhealthy and that they “must” lose weight if they want to improve their health, ignoring any other factors or underlying medical conditions that may be causing the initial discomfort. 

Unfortunately, research[6] has shown that healthcare professionals “behave in discriminatory ways, such as blaming serious health issues on weight and, therefore, inadvertently ignoring other possible causes”. One of the main biases some healthcare professionals have is that they view and treat obesity as a personality trait and not as a health condition, thus labeling the patient as weak-willed, lazy, and uninterested in improving their health.

Another study found that people with overweight or obesity report lower quality care[7] and that medical professionals offer treatment recommendations based on stereotypes, not the person’s actual needs.

When it comes to statistics, weight bias has been increasing up to 60% within the medical field in the last decade and other data gathered by this 2016 paper suggest the following[8]:

• 53% of women with obesity report being on the receiving end of inappropriate comments concerning their weight from healthcare professionals.
• 79% of people with excess weight or obesity report eating more to cope with weight discrimination.
• 52% of women say that their weight has kept them from receiving appropriate healthcare. Concerns about weight are also associated with delaying or avoiding preventative care.
• 40% of healthcare professionals admit to having negative reactions to patients with obesity.

These percentages, as previously mentioned, have risen throughout the last decade and if things don’t change, they will only continue to increase. When it comes to healthcare, medical staff must be educated and trained on how to let go of any weight stigma that they might have developed throughout their life. Some examples of weight stigma within the medical community may include holding negative beliefs about people based on their weight, falsely attributing health problems to weight, misunderstanding the causes of obesity, using shame tactics to make a person lose weight, and believing that weight is the most important factor in health.

Consequences of weight discrimination and stigma

Now that we’ve discussed what weight discrimination entails, it’s important to highlight the negative impact it has on people’s health. First, the harm it has on a person’s mental health can bring forth other harmful consequences, such as increased anxiety and depression. When it comes to their physical health, it’s also common for many to develop disordered eating and to avoid preventive care due to fear of being judged or shamed because of their weight.

Other studies[9] have found that people also tend to gain more weight due to weight discrimination. The overwhelming stress can drive a person to overeat or binge; it can also increase their cortisol levels, which can also increase their weight at a quicker rate. People who face weight discrimination at work also tend to have lower incomes, thus preventing them from having access to better healthcare. 

What can be done?

To fight weight discrimination in healthcare and at the workplace, it’s important to speak up and to seek legal guidance in order to make a change. We’re still a long way from achieving just laws that protect everyone, but spreading awareness is one of many steps that must be taken. If you or anyone you know is facing weight discrimination, make sure to find or create a good support system where everyone feels safe. However, if the discrimination progresses into harassment or if it’s having a heavy toll on your mental health, please contact a health professional to get the help you need.

Contact Us to Learn More

If you want to learn more weight discrimination, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] “Weight discrimination in the workplace”. https://hpalivewell.com/weight-discrimination-in-the-workplace/. (Accessed February 9, 2023). 
• [2] Puhl R, Brownell KD. (2001). Bias, discrimination, and obesity. Obesity Research, 9:788-805. Puhl, R.M., Andreyeva, T., & Brownell, K.D (2008). Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. International Journal of Obesity. doi: 10.1038/ijo.2008.22
• [3] “Weight Discrimination: A Socially Acceptable Injustice”. https://www.obesityaction.org/resources/weight-discrimination-a-socially-acceptable-injustice/. (Accessed February 9, 2023). 
• [4] “Overweight and Underpaid: Weight Discrimination at Work”. https://safetymanagement.eku.edu/blog/overweight-and-underpaid-weight-discrimination-at-work/. (Accessed February 9, 2023). 
• [5] Lee H, Ahn R, Kim TH, Han E. Impact of Obesity on Employment and Wages among Young Adults: Observational Study with Panel Data. Int J Environ Res Public Health. 2019 Jan 7;16(1):139. doi: 10.3390/ijerph16010139. PMID: 30621065; PMCID: PMC6338917. 
• [6] Rubin R. Addressing Medicine’s Bias Against Patients Who Are Overweight. JAMA. 2019;321(10):925–927. doi:10.1001/jama.2019.0048
• [7] Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev. 2015 Apr;16(4):319-26. doi: 10.1111/obr.12266. Epub 2015 Mar 5. PMID: 25752756; PMCID: PMC4381543.
• [8] Fruh SM, Nadglowski J, Hall HR, Davis SL, Crook ED, Zlomke K. Obesity Stigma and Bias. J Nurse Pract. 2016 Jul-Aug;12(7):425-432. doi: 10.1016/j.nurpra.2016.05.013. PMID: 28408862; PMCID: PMC5386399.
• [9] Tomiyama, A., Carr, D., Granberg, E. et al. How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Med 16, 123 (2018). https://doi.org/10.1186/s12916-018-1116-5