Understanding Obesity: A Broad Heart Doesn't Necessarily Mean a Large Body
Update Date：2025/05/05，
Views：236
Dr. Hsuan-Wei Chen / Dr. Kuo-Feng Hsu, Bariatric and Metabolic Surgery & Weight Management Center
In today's society, an increasing number of individuals are becoming overweight or obese due to poor dietary habits and irregular lifestyles. According to the "National Nutrition and Health Survey" conducted between 2013-2016, the prevalence of overweight and obesity in Taiwan's adult population has reached 45.4%. Compared to the 32.7% from 20 years ago and 43.4% from 8 years ago, this statistic reveals a dramatic increase, with the ratio of obese adults evolving from 1 in 3 to nearly 1 in 2 in just two decades.
Obesity is considered a chronic disease. Research shows that compared to those with a healthy weight, obese individuals face significantly higher risks of developing diabetes, hypertension, cardiovascular diseases, dyslipidemia, arthritis, and gout—often at multiple times the risk. The World Health Organization (WHO) recognizes obesity as a chronic disease. Beyond the physical health implications, obesity can also affect an individual's self-esteem and confidence. Studies indicate that the correlation between obesity and low self-esteem grows stronger from childhood to adolescence, with a notably higher impact on women, similar to depression. Therefore, the problems caused by obesity are often multifaceted, affecting physical, mental, and emotional well-being.
The causes of obesity go beyond diet and physical activity. They also involve genetic factors, mental health, and environmental influences, meaning it is often not just an individual issue. One of the major challenges in weight loss is not only the difficulty of adhering to lifestyle changes but also the inability to maintain long-term, stable results. Many individuals experience cycles of weight loss and regain. The literature does not have a unified definition of weight cycling, but most studies define it as the process of losing 4.5 kg or more, only to regain it later. Understanding why weight loss efforts fail is essential to avoid repeated setbacks.
When it comes to dietary control for weight loss, achieving a negative energy balance is necessary. The general principle is to aim for a weight loss of 0.5–1 kg per week, which requires reducing calorie intake by 3,500 to 7,000 calories each week. Exercise plays a crucial role in maintaining health, but relying solely on exercise for weight loss is challenging. For example, to lose 1 kg of body fat, one needs to burn approximately 7,700 calories, yet jogging for 1 hour only burns about 300-400 calories. However, exercise can prevent the loss of muscle mass caused by dietary restriction, while also improving muscle strength and insulin sensitivity, which can help counteract the decline in basal metabolic rate caused by dieting.
Pharmacological interventions are not considered the first-line treatment for obesity. They are typically used only for patients who are unable to achieve their target weight loss goals despite dietary, exercise, and behavioral interventions, and after a detailed evaluation by a physician.
On the psychological side, individuals who are overweight or obese are more likely to experience psychological distress and emotional problems, including depression, anxiety, and binge eating behaviors. Often, it is the lack of a broad outlook that leads to obesity, or conversely, obesity brings about further emotional and psychological challenges. Therefore, controlling one's weight is essential not only for physical health but also for mental well-being.
References
Beechy L, Galpern J, Petrone A, Das SK. Assessment tools in obesity - psychological measures, diet, activity, and body composition. Physiol behav2012; 107:154-71.