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Managing Excess Weight in Men: How Obesity Harms Your Overall Health

Being obese, or overweight is not merely a cosmetic issue, but a complex medical condition that is associated with numerous health risks. According to a 2022 report from the World Health Organisation (WHO), 2.5 billion adults (18 years and older) were overweight, of which 890 million were classified as being obese. (1) Worldwide obesity in adults has more than doubled since 1990, underscoring the urgency of addressing this issue. While the impact of obesity has become widely recognized, its consequences on men’s health are still largely underestimated. In this blog post, we will delve into the specific health conditions linked to obesity, explore how body fat distribution affects your health, and uncover the secret to maintaining a healthy weight through lifestyle change.


Scale and Food

Excess body weight occurs due to an imbalance between your energy intake and output. It’s a complex interaction between lifestyle choices (i.e. food choices), environmental factors (i.e. food availability), and physiological predispositions (i.e. genetics). Despite facing heightened severity and elevated mortality rates associated with overweight and obesity, only a handful of obese male patients engage in successful treatment interventions.


TESTOSTERONE AND OBESITY

 

You might wonder why we are honing in on obesity in males instead of addressing obesity overall. While research on overweight and obesity has been extensive, there has been a relative lack of focus on understanding why obesity tends to be more prevalent and severe among men compared to women. Although there is no single, straightforward answer to this question, it is evident that testosterone levels play a significant role.

 

Testosterone, the primary male sex hormone, plays a role in regulating fat distribution, muscle mass, and metabolism. These factors collectively impact body weight and composition, and disruptions in testosterone levels can contribute to the development and exacerbation of obesity in men.

 

In addition to testosterone influencing obesity, obesity itself can also impact testosterone levels, causing an accumulation of visceral fat, which is illustrated by the hypo-gonadal obesity cycle.(3) This cycle reflects a complex interaction where obesity can lead to hormonal changes, including decreased testosterone production, which in turn can exacerbate weight gain and further contribute to the ongoing cycle. Understanding this relationship sheds light on the nature of obesity and its dynamic in men.

Testosterone levels have been linked to impaired glucose control, insulin sensitivity, dyslipidaemia and energy imbalance which can ultimately contribute to overweight or obese. However, it is important to note that the relationship between testosterone and obesity is bidirectional. Excess fat stores can lead to higher oestrogen levels, lower testosterone and lower levels of SHBG (sex hormone binding globulin).

 

 

BODY FAT DISTRIBUTION AND HEALTH:

 

Adipose tissue, commonly known as fat, is distributed throughout various areas of the body. Interestingly, where fat accumulates plays a pivotal role on our health outcomes, perhaps even more so than the total amount of fat present. When we envision “fat,” we are likely thinking of the type of fat known as subcutaneous fat, which is the fat that is stored just beneath the skin. This type of fat serves numerous vital functions, including insulation to regulate body temperature, energy storage, and protection of internal organs. Unlike other types of fat, subcutaneous fat is relatively inactive metabolically, which means it has less of an impact on overall health outcomes. However, an excess of subcutaneous fat can still elevate the risk of developing various health conditions.

 

On the other hand, visceral fat, often termed central obesity, presents a significant health concern. It predominantly accumulates around the abdomen and internal organs, giving rise to the distinctive 'apple' shape frequently seen in overweight individuals. Unlike subcutaneous fat, visceral fat is highly metabolically active, releasing inflammatory substances that play a pivotal role in the onset of insulin resistance, diabetes, heart disease, and cancer. Visceral fat tends to be more prevalent in men than in women, putting men at an even higher risk of developing the abovementioned conditions.


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HEALTH RISKS ASSOCIATED WITH OBESITY

 

Given the multitude of health risks tied to excessive body weight, obesity is now recognized as a medical condition that requires urgent attention. Its close association with chronic diseases such as Type 2 Diabetes, hypertension, cardiovascular disease, specific cancers, sleep apnoea, and even male fertility issues underscores the urgency in addressing this pressing health concern.

 

1. Diabetes mellitus

 

Obesity, particularly abdominal obesity, significantly heightens the risk of developing diabetes due to its impact on insulin resistance. In obesity, adipocytes (fat cells) become enlarged and dysfunctional, causing an increased release of free fatty acids into the bloodstream. These free fatty acids disrupt the insulin signaling pathway, causing the pancreas to secrete more insulin which can potentially result in hyperinsulinemia. Over time, this compensatory mechanism may falter, and the pancreas may be unable to overcome insulin resistance. Consequently, your blood glucose levels may remain elevated and uncontrolled, resulting in type 2 diabetes.  

 

2. Cardiovascular disease and hypertension

 

Having excess body fat increases the workload of your heart, as your body requires more blood to supply oxygen and nutrients to the adipose tissue. Over time this can lead to elevated blood pressure (or hypertension) which can further damage the blood vessels, increasing your risk of heart disease and stroke. Obesity is also often associated with dyslipidaemia (abnormal lipid levels). Dyslipidaemia contributes to the formation of arterial plaque, which gradually accumulates and narrows the arteries, affecting blood flow. In severe cases, this plaque buildup may trigger a heart attack or stroke by rupturing, underscoring the critical need to address obesity as a preventive measure against cardiovascular complications.

 

3. Cancer

 

Despite a lack of understanding surrounding the exact mechanism of action, obesity can influence cancer progression and outcomes. One contributing factor lies in the secretion of hormones and growth factors by adipose tissue, which have the potential to fuel tumour growth and progression. (4) Additionally, obesity can compromise immune system functioning. This impaired immune response can increase the risk of cancer development with poorer outcomes as our immune system has greater difficulty recognizing and eliminating cancer cells.

 

4. Inflammation and Metabolic Syndrome

 

Obesity is intricately tied to a state of low-grade chronic inflammation. Within adipose tissue, a diverse array of hormones and molecules, known as adipokines, are secreted. Adipokines can be proinflammatory (i.e. lectins) or anti-inflammatory (i.e. adiponectin). In the context of obesity, the adipose tissues become dysfunctional, stimulating the release of pro-inflammatory molecules, like lectin and cytokines. These pro-inflammatory markers fuel systemic inflammation, laying the groundwork for a host of health complications. Additionally, the inflammatory cascade orchestrated by these cytokines not only contributes to systemic inflammation but also interferes with insulin signalling pathways, exacerbating the effects of insulin resistance, and further increasing the risk of diabetes and metabolic syndrome.

 

5. Hypogonadism and infertility

 

Male obesity is linked to hormonal disturbances leading to impaired hormonal and reproductive function. Obesity has been associated with reduced testosterone levels and increased estrogen levels. Although obesity-related infertility has a multi-factorial approach, the hormonal imbalances ultimately cause impaired gonadal function. Studies have shown that almost 20% of subfertility and infertility cases in males can be attributed to overweight and obesity. (2)

 

6. Mental Health Disorders

 

Obesity frequently coincides with a heightened prevalence of depression and anxiety disorders, a correlation that can be attributed to several interconnected factors. These include struggles with low self-esteem and body image and feelings of social isolation and loneliness stemming from potential discrimination and social exclusion. Although the origins of these conditions are multifaceted, it is crucial to recognize obesity as a primary risk factor. (5)


Healthy Lifestyle Balance

MANAGEMENT OF OBESITY IN ADULT MALES:

 

1. Diet and lifestyle interventions.

 

Maintaining a healthy weight comes down to striking a balance between calorie intake and expenditure. While there is no one-size-fits-all solution, adopting a nutritious eating plan can set you on the path to success. Here are some practical tips to help you achieve and sustain a healthy weight:


  • Focus on Whole Foods: Base your diet around whole, nutrient-dense foods such as fruits, vegetables, whole grains, lean proteins, and healthy fats. These foods are rich in vitamins, minerals, and fibre, which promote satiety and overall health.

  • Watch Portion Sizes: Be mindful of portion sizes, especially when it comes to high-calorie foods like fats, oils, and processed snacks. Use smaller plates and bowls to help control portions and avoid mindless overeating. Some useful tools to consider when monitoring portion sizes include:

  • Limit Added Sugars and Processed Foods: Minimize your intake of added sugars, refined grains (white bread, cakes, and biscuits), and processed foods, which can contribute to weight gain and increase the risk of chronic diseases.

  •  Stay Hydrated: Drink plenty of water throughout the day, as thirst can sometimes be mistaken for hunger. A general rule of thumb is to drink one glass of water for every 10kg of body weight you have. Limit your intake of sugary beverages and alcohol, which can contribute to excess calorie intake.

 

2. Physical Activity

 

To maximize the benefits of physical activity for weight loss, aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week, combined with strength training exercises at least two days per week. Remember to choose activities that you enjoy and make them a regular part of your lifestyle for long-term success. Regular physical activity can help burn calories, boost metabolism, maintain lean muscle mass, improve cardiovascular health, and enhance mood and well-being.


3. Behavioural Changes

 

Achieving sustainable weight loss involves more than just diet and exercise—it requires a comprehensive approach that addresses various aspects of our lives. Here are some key factors that influence sustainable weight loss and tips for incorporating them into your lifestyle:


  • Adequate Sleep: Prioritize getting sufficient sleep each night, as inadequate sleep can disrupt hormone levels, leading to increased hunger and cravings. Aim for 7-9 hours of quality sleep per night to support overall health and weight management.

  • Stress Management: Implement stress-reducing techniques such as mindfulness, meditation, deep breathing exercises, or engaging in hobbies and activities you enjoy. Chronic stress can contribute to emotional eating and weight gain, so finding healthy ways to manage stress is essential for long-term success.

  • Mindful Eating Practices: Practice mindful eating by paying attention to hunger and fullness cues, eating slowly, and savouring each bite. Avoid distractions like screens or multitasking during meals and focus on the sensory experience of eating. Mindful eating can help prevent overeating and promote a healthier relationship with food. See our blog post about intuitive eating here: https://www.corenutrition.co.za/post/intuitive-eating 

 

4. Medical Intervention

 

In some cases, medical interventions such as prescription medications or bariatric surgery may be recommended for individuals with severe obesity or obesity-related health complications. It is important to consult with a healthcare professional, such as a registered dietitian or doctor to explore suitable treatment options.

 

5. Holistic Approach

 

Combating obesity demands a concerted effort spanning physical, psychological, and social domains. Surround yourself with a supportive network, prioritize self-care practices, and arm yourself with evidence-based strategies for lasting weight management success. Remember, with dedication, informed choices, and professional guidance from a registered dietitian, achieving and maintaining a healthy body weight is within reach!




References:

  1. World Health Organization. (n.d.). Obesity and overweight. WHO. Retrieved from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight#:~:text=Key%20facts,years%20and%20older)%20were%20overweight (Accessed 9 May 2024)

  2. Lenart-Lipińska, M., Łuniewski, M., Szydełko, J., & Matyjaszek-Matuszek, B. (2023). Clinical and Therapeutic Implications of Male Obesity. Journal of Clinical Medicine, 12(16), 5354. doi: 10.3390/jcm12165354.

  3.   Kelly, D. M., & Jones, T. H. (2015). Testosterone and obesity. Obesity Reviews, 16(7), 581-606. doi: 10.1111/obr.12282.

  4. Centers for Disease Control and Prevention. (n.d.). Obesity and Cancer. Retrieved from https://www.cdc.gov/cancer/obesity/index.htm (Accessed 9 May 2024)

  5. World Health Organization. 2024. Obesity and overweight. Retrieved from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (Accessed 9 May 2024)

  6. American Psychological Association. (n.d.). Mind/body health: Obesity. Retrieved from https://www.apa.org/topics/obesity/mind-body-health (Accessed 9 May 2024)

  7. De Lorenzo A, Noce A, Moriconi E, Rampello T, Marrone G, Di Daniele N, Rovella V. MOSH Syndrome (Male Obesity Secondary Hypogonadism): Clinical Assessment and Possible Therapeutic Approaches. Nutrients. 2018 Apr 12;10(4):474. doi: 10.3390/nu10040474. PMID: 29649106; PMCID: PMC5946259.

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