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‘Obesity needs to be treated as a chronic disease’

Lee Han-soo  Published 2019.12.02  18:02  Updated 2019.12.02 18:02

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Countries have to face the fact that obesity is a chronic disease and that maintaining the lost weight is more important than just losing weight, an expert said.

Professor Arya Sharma at the University of Alberta explains why it is essential to designate obesity as a chronic disease, during the International Diabetes Federation conference 2019 satellite symposia sponsored by Novo Nordisk at BEXCO in Busan on Wednesday.

Professor Arya Sharma at the University of Alberta made this and other points in a symposium sponsored by Novo Nordisk during the International Diabetes Federation conference 2019 in Busan.

“A lot of communities have recognized obesity as a chronic disease,” Sharma said. “This is because even if patients lose weight, if you wait long enough, everyone puts their weight back on, with only a handful of exceptions.” Sharma stressed that everyone, including doctors and patients, believes that controlling obesity is very simple and is about energy balance on controlling calories.

“We can control calorie intake by eating less and outtake by doing more exercise,” Sharma said. “So we believe that it will be easy to achieve a certain balance for weight loss. Therefore, in theory, this is not so difficult.”

However, the problem is there is a black box between controlling the intake and outtake of calories that people neglect, Sharma added.

Sharma explained that the black box is a complicated, sophisticated, redundant, and effective physiological system that is designed for one purpose, to defend a person’s body from weight loss.

“Unfortunately, when we try to lose weight with any method, the body’s system is going to work against the person trying to lose weight,” Sharma said. “Adaptations to weight loss include hormonal changes, increase in appetite, decrease in metabolic rate, and thermogenesis activity.”

Therefore, Sharma explained, maintaining the weight loss is more complicated than losing weight.

“I am only interested in what the best way is to keep the weight loss and not how to lose weight,” Sharma said. “The first thing we have to acknowledge is that an obesity treatment that a patient can stay on forever or obesity management that only goes on for only a certain period is not a treatment for obesity.”

According to Sharma, behavioral modifications, such as diet and exercise, and surgical methods are some of the treatment methods that hospitals use.

“Behavior modification, such as controlling what a person eats or exercises, normally helps patients lose 3 to 5 percent of their weight,” Sharma said. “The problem is that the lost weight will come back if the person stops their behavioral modification,” Sharma said.

Surgery is the best way to lose weight as it can cut a person’s weight by 20 to 30 percent, he added.

However, Sharma stressed that surgery is not an ultimate solution.

“As an example, that there are about 1.5 million people who are qualified for surgery, and Canada conducts 100,000 surgeries a year,” he said. “To give all the patients the surgery, it would take 150 years,”

Therefore, the problem with surgery is not that it does not work or effective. The problem is that it is not scalable to the size of the obesity population, he added.

To resolve some of the underlying issues, Sharma stressed that the first step that needs to be taken is acknowledging that obesity is not something that can be cured but is a chronic disease that needs management.

“Designating obesity as a chronic disease can benefit people living with obesity in terms of reducing stigma and providing better access to obesity prevention and management,” Sharma said.

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