Eli Goodman, MD

Medical Insights

The cornerstone of all medical science and practice is internal medicine. Its principles should be readily available to all adults, especially in today's chaotic medical environment, which is full of complexities, inefficiencies, and difficult access issues. Take advantage of Dr. Goodman's expertise based on his 33 years' experience in virtually every medical situation and setting. [Editor's note: Dr. Goodman no longer contributes to Silver Planet, but we have made his archived blog entries available as a service to our readers.]



Is Obesity Really That Bad?

Yes! In every way and at any age

By Eli Goodman, MD

Overweight and obesity are both terms for ranges of weight that are
greater than what is generally considered healthy for a given height. These terms identify ranges of weight that have been shown to increase the
likelihood of certain diseases and other health problems. Without going into great detail in terms of weight ranges, there are some "rules of thumb."

If your waist is too big, and/or you are out of shape and a woman who weighs more than 170 pounds or a man who weighs more than 250 pounds, you most likely are overweight or obese. Your physician can help you determine by how much, since individual variables should be considered.

Medical science has clearly demonstrated that obesity contributes significantly to poor health. Conversely, it has also demonstrated that weight loss, even slow and small, will almost always at least attenuate illness. Frequently, weight loss and conditioning will reverse or cure illness. This really is so!

Here are some of the deleterious medical entities that derive from obesity:

  • Adult-onset diabetes (almost guaranteed)
  • High blood pressure (also almost guaranteed)
  • Depression
  • Gallstone disease
  • Obstructive sleep disorder ("sleep apnea")
  • Accelerated degenerative arthritis (especially of the low back, knees, and hips)
  • Cancers (especially of the breast, but many others as well)
  • Gastroesophageal reflux
  • Bladder incontinence
  • Polycystic ovary disease (a common cause of infertility)
  • Abnormal cholesterol profile
  • Chronic swelling of legs and feet

Many of the above cause other complications, which may include some of the following:

  • Heart failure
  • Kidney failure
  • Stroke
  • Peripheral vascular disease
  • Skin changes of the legs (venostasis)
  • Pulmonary hypertension
  • Sexual dysfunction

Then there are also the losses of self-esteem and dignity that obesity causes. Remember, each of us, to the most reasonable extent possible, has the obligation to maximize his or her own good health and to enjoy life.

Obesity can and should be treated. Proper diet and exercise—BOTH!—are necessary.

All currently approved medications for obesity, both prescription and over the counter, are NOT very good. All are expensive, all have significant side effects, and none by themselves tend to produce on average more than a 5- to 10-pound weight loss per year.

Proper diet is a big subject that I will not discuss in detail here. There are no magic diets. Good foods, in variety, and in modest portions are always in order. Nothing else is really necessary. The resources listed below can advise you further about specific foods, calorie counts, and nutritional values.

Surgical procedures to promote weight loss are expensive and dangerous; however, for select patients, these are perhaps the best interventions. Proper diet and exercise will still be necessary after these procedures, as the procedures themselves do not guarantee ideal weight and fitness.

Exercise should be regular (five or six days per week) and, ideally, combine three components in the regimen: aerobic (e.g., running, walking, hiking, bicycling, gardening), resistance (e.g., weight training), and stretching (e.g., yoga). High-intensity workouts are not necessary, and they might even be counterproductive for senior citizens. For exercise, regularity and completeness are the most important elements.

Your best resources to lose weight and get in shape include your physician, health clubs, nutritionists, physical therapists, skilled personal trainers, and support groups such as Weight Watchers.

Eli Goodman, MD
Medical Insights Blog

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