Obesity is when a person carries so much excess weight that it begins to effect their health negatively. If a person’s body weight is 20% higher than it should be, they would be considered obese. Another indicator of obesity is if the person’s BMI is between 25 and 29.9. One in four adult Canadians and one in 10 children live with clinical obesity, meaning six million Canadians living with obesity may require immediate support in managing and controlling their weight.1 Support from health care professionals can help you achieve clinically significant and maintained weight loss.3
Loading the player...Obesity and Dieting - Lifestyle Change Verses Crash Diets Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist, discusses dieting & obesity.
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Loading the player...Muscle Mass & Weight Control in Regards to Diabetes and Obesity Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist, discusses muscle mass & weight.
The preservation of muscle mass is critical to control your weight. One pound of muscle consumes roughly 50 calories per day, and that’s without exerting yourself. That’s sitting on the couch watching the football game. So, six pounds of muscle would be 300 calories a day so that’s roughly a light breakfast. So, if you undergo and crash diet and you lose six pounds of muscle, you’ve just lost – you have to diet 300 calories a day to break even afterwards. So again, it’s critical not to jeopardize your muscle mass.
So it is important, therefore, that exercise, and thereby maintenance of your muscle mass, is an integral part of any weight reduction strategy for sustainability of that strategy.
It’s important to discuss this with your healthcare providers, your exercise specialist, and address the obesity issue over the long term.
Local Practitioners: Endocrinologist
Obesity is a long-term issue for most patients, and so it needs a long-term solution.
While crash diets are attractive in so far as they make the scale look better, they’re not the solution. Medically, you want to keep your weight down over many, many years, and thereby, hopefully, decrease your risk of heart disease, and cancer, and the other risks that are associated with obesity.
Losing weight for six months, 12 months, two years, again, is not undesirable, but medically we want you to keep the weight off over a longer period of time. People tend to gravitate back to their usual diets and lifestyle, and so the effect is lost and after three, four, five years, they’re back to their weight they were before.
Another medical concern about crash diets or fad diets where you rapidly lose weight is that while you’re losing fat you’re also losing muscle. That’s actually disastrous. It’s a general rule as we age as human beings never to do something that will jeopardize your body’s muscle.
The muscle determines your metabolic rate, so if you undergo a crash diet and you lose muscle, after you come off the diet and your muscle mass is lower, your metabolism is lower. If you then eat the same food that you had before, with a lower metabolic rate you’re gonna gain weight, and that is a simplistic explanation for yo-yo dieting where you lose the weight, you rebound, and you end up weighing more two years later than you did when you started.
So, it is important, therefore, that exercise and thereby maintenance of your muscle mass is an integral part of any weight reduction strategy for sustainability of that strategy. So, it’s important to discuss this with your healthcare providers, your exercise specialist, and address the obesity issue over the long term.
Obesity is a chronic disease. 2015 was the year where the Canadian Medical Association recognized obesity as a chronic disease. For decades, obesity was recognized as a risk factor to develop other complications such as diabetes and hypertension.
It is an entity on its own, and it’s a chronic disease, because we all know—and everybody that’s tried dieting or losing weight does know that the battle is lifelong. Once we suffer from obesity, we have dis-regulation of several hormones, or even the neurobiology is modified.
For a long time obesity was regarded as being a lack of motivation. We now know that there are genetic factors involved, there is neurobiology involved, and there are hormonal factors that are implicated in weight management. Let me explain. Our adipose tissue actually secretes a hormone called lectin. Lectin goes to our brain to tell our brain we have enough storage.
Well, when we suffer from obesity, and we live with obesity, that signaling is lost. There’s a hormone secreted by our gut called the GLP-1, secreted after we eat, to tell our brain we just ate, we just had a caloric intake, so you can stop eating. It’s called satiety, satiety signaling. Well when we suffer from obesity, that signaling is also dampened. So now imagine: you’re trying to lose weight. You’re trying to control your caloric intake. And the two main signaling are dampened in your brain.
This being said, there is a concept of setpoint that I wanted to bring up. The concept of setpoint is important because it finally explains the weight rebound. Everybody that loses weight on a diet re-gains their weight. Sometimes very quickly, sometimes over years. But the reason is the setpoint theory.
Let me explain. When we lose weight, we also lose muscle mass. And muscle mass is very important for our basal metabolic rate. If we lose muscle mass, we lose basal metabolic rate, which kind of limits our calorie burn at rest. So we tend to re-gain weight.
Not only that, there’s also hormonal adaptation. I told you about a hormone secreted by the gut that is used for signaling in our brain to tell us we just had a caloric intake. Well, when we lose our weight, we lose that signaling. Imagine that? Even less. We’re already resistant to that satiety signaling, okay, that fullness feeling. And now we have less signalization to our brain.
Not only that, there’s a hormone called ghrelin secreted at the level of the stomach, that actually increases appetite. Well, guess what? When we lose weight it increases. So we have our defense mechanism is to make sure that we don’t die from starvation. So if we lose weight, as soon as there’s going to be food around we’re going to be able to re-gain our weight.
If you’re looking for more information on obesity and how to help with weight management, ask your family doctor, ask a specialist. You need a multidisciplinary approach: dietitian, kinesiologist, personal trainer even, to make sure that there are agents, medication to help you also if you suffer and you live with obesity.
Local Practitioners: Family Doctor