CHAPTER 2: What is obesity?

“You’re fat. And don’t try and sugar-coat it, because you’ll eat that too” – Dr Phil

“Obesity is a chronic disease that leads to an over-production of fat. Nothing more, nothing less” (Rensburg 2005). Regardless of popular belief, obesity is not the same as over-mass. By determining the true definition of obesity, we can cure this disease as well as prevent it from occurring.

How to measure obesity

Your doctor or healthcare specialist usually asks your height, weight and sex, they pop these figures in a chart and then claim to show your ideal weight or BMI. If this method is so accurate, how do we then explain “thin” people with fat rolls or the “statistically overweight person” with no fat (think Arnold Schwarzenegger)? This is as accurate as sticking your head in an oven, your feet in a freezer and being, on average, comfortable.

Going back to the definition of obesity being an “overproduction of fat”, we can then see that skin fold testing is a much more accurate, albeit it not entirely conclusive, measure of obesity.  In addition to skin fold testing, bioelectrical impedance can give an even more accurate measure. It works on the principal that electricity flows much faster through water and muscle and much slower through fat, which is measured as a resistance. There are, as with all things in life, limitations to its accuracy and so a trifecta of fat measurement, namely skinfold measures, bioelectrical impedance as well as tape measuring will give as close to accurate fat composition profile as possible.

The key word, when defining obesity, is composition. This has to do with the amount of fat (as a %) in your body. Normal ranges are as follows:

The body is so well designed as to regulate all types of tissues, hormones, electrolytes etc to create a normal, safe balance known as homeostasis. When an imbalance occurs, it manifests as a disease. In this case, an over production of adipose tissue (fat) is manifested as the disease known as obesity. And left untreated will manifest into other clinical diseases such as heart disease, cancer, diabetes and so on.

There is no such thing as being a “little fat”. If a person is overweight due to an over production of fat (note, not muscle), they are obese.

Different types of fat

Structural fat: This is fat, in healthy percentages, that forms structures and protects organs. Examples include the buttocks (a cushioning as such, not a sofa worth!), fat around the heart and kidneys to insulate and protect against trauma (like a kick in the back or hypothermia); facial fat to give form and structure. It is very important that this type of fat is NOT lost during fat loss programs, for obvious reasons.

Normal fat reserves: This fat is typically stored in muscles and around the belly where it is continuously broken down and redeposited for energy usage. 

Abnormal excess fat: Both structural and normal fat reserves are essential. But in a small percentage. Any credible weight loss program should not allow the loss of the essential types of fat. Some exceptions may be made for athletic goals and a credible weight loss specialist will also know that these athletic goals are not, as we age, maintainable indefinitely and should be thus monitored closely. 

How successful is obesity treatment?

Research shows that of 100 people put on the best anti-obesity diet the following statistics are reached:

• Only 20 will reach their goal weight
• After one year only 5 will have maintained their goal weight
• After five years only 1 would have reached success

Once excess fat has been deposited it is extremely difficult to lose and maintain the loss. Dr H. Rensburg, medical obesity specialist, has established a method of assessing the success rate of the 1% through his 40 years of clinical trials. He explains the difference between the successful, partially successful and the unsuccessful groups are as follows:

The most successful (1%) maintain the following attributes:

1. These people understand their condition. “A better-informed patient is a better patient” (Rensburg 2005). They do not suffer from the ‘paralysis of analysis’ either. They acquire, and accept, sound medical understanding of their disease.
2. The 1% understand that they are ACTIVE participants in their weight loss. A healthcare practitioner cannot lose the weight for you. If you do not put in the hard yards, you will neither lose nor maintain the fat loss.

The partially successful and unsuccessful patients

To varying degrees, these 2 groups are either not informed on their condition (through ignorance or a lack of correct medical knowledge) or maintain “passive participation”. These groups are also the patients who will say that they have tried “every diet available and nothing worked for them”. These are not the winners in fat loss and tend to blame society and genetics solely for their condition. 

There is hope

All obese patients are giving an equal playing field in that fat loss is equally HARD for everyone. Anyone who loses even a bit of fat weight deserves a medal for their efforts. Just finding the correct sound medical advice is a battle in itself and it can seem like an endless struggle. But it IS possible to lose fat and maintain the goal weight. You didn’t get fat overnight so don’t expect to lose the weight in a week either. It will take time, and that is OK! As long as you don’t give up.