Category: Wellness

It’s common knowledge that old age and certain health conditions such as diabetes and heart disease put people at increased risk of suffering severe symptoms of COVID-19. But did you know obese people who contract the virus are also more likely to become dangerously ill?

A slew of recent studies shows a profound relationship between obesity and the risk of admission to the intensive care unit, intubation and death due to the virus. This is alarming news for the more than 40% of American adults who are considered obese (defined as having a body mass index, or BMI—a measure of body fat based on height and weight—of 30 or more), including the 10 percent who are considered morbidly obese (having a BMI of 40 or more).

As BMI increases, so does the risk of death. A study of 150,000 patients with COVID-19 found hospitalizations were seven percent more likely and deaths were eight percent more likely among patients with a BMI of 30-34.9%. That increased dramatically among those with a BMI of 45 who were four times more likely to die from the virus than those of normal weight, according to a study of 7,000 COVID-19 patients published last in the Annals of Internal Medicine. 

Carrying excess weight is linked with impaired immune function and chronic inflammation, both of which can worsen COVID-19.

And people with obesity are also more likely than those of normal weight to have chronic health ailments that are risk factors for COVID-19, including hypertension, type 2 diabetes and lung disease. 

But you don’t need to be obese to be at risk of becoming seriously ill if you contract the virus. Even a few extra pounds can put you in the danger zone. The Centers for Disease Control recently issued a warning that even moderate excess weight (having a BMI of 25 or more) may increase the risk of severe illness from the virus. With 42% of Americans classified as obese and another 32% considered overweight, the U.S. has the highest prevalence of obesity of any country in thew world — this means 75% of the country’s adults are at increased risk of severe symptoms if they contract the virus.

Early on in the pandemic researchers were unsure whether excess weight in and of itself increased the chances of contracting COVID-19 or whether it was the health issues that accompany obesity that make people vulnerable. These new studies prove there’s no doubt about it: excess weight means extra risk. 

This underscores just how crucial it is to maintain a healthy weight. (People with the lowest risk of becoming severely ill from the virus have a BMI that’s typically under 25.) While wearing a mask is the first step to stay healthy in the age of COVID-19, the next best course of action is regular moderate exercise to reduce weight and thus minimize the effects of COVID-19 infection.

If you’re overweight and working on shedding the pounds, that’s a good thing. Not so good, however, is the fact that if you’re not careful you can lose muscle along with the fat. Studies show as much as 25 percent of weight lost by dieters is from muscle. 

That’s a problem because muscle not only keeps you feeling strong and fit, it protects against disease, boosts mortality and can even help prevent rebound weight gain since losing muscle can slow your metabolism, which means you’ll burn fewer calories. 

Preserving muscle mass is essential during weight loss. 

So how do you optimize fat loss while maintaining muscle? Here are four tips to keep in mind:

Pump it up

Regular physical activity helps get rid of fat. If you lose weight through diet alone, you’re more likely to lose muscle. That’s why exercise is essential in your weight loss plan. While both aerobic activity and resistance exercise are necessary for good health, numerous studies show that resistance exercise (using weights, weight machines, resistance bands and your own body weight with exercises such as push ups and squats) is more effective than aerobic activity when it comes to increasing muscle strength and muscle endurance. 

Boost your protein

A high-protein diet increases metabolism, reduces hunger and helps you retain more lean muscle mass. That’s because protein supplies amino acids, the building blocks to creating muscle tissue. The recommended daily allowance (RDA) of protein for adults is about 50-60 grams per day (to figure out your RDA multiply your weight in pounds by 0.36 or use this online calculator). Increasing this amount can help counteract muscle loss. Some easy ways to increase your protein intake include replacing your breakfast cereal with eggs (there are 6 grams of protein in a single egg), snacking on almonds (6 grams in a 1 ounce serving), opting for Greek yogurt instead of the regular variety (17-20 grams in an 8-ounce serving) and having canned fish for lunch (20–25 grams in a 3.5 ounce serving). 

Take it slow

A slow but steady approach to weight loss allows for a greater preservation of muscle mass. Reducing calorie intake by 500-1,000 calories a day will result in weight loss of a pound or two a week. Any further reduction in calories means you are likely to lose muscle as well.  

Vitamin D can help

It’s estimated that about 40% of adults are vitamin D deficient and people who are overweight or obese tend to have lower levels of this all-important vitamin. That’s cause for concern because not only does vitamin D keep bones healthy and protect against diseases such as diabetes, it also helps improve muscle strength. Vitamin D deficiency is linked with poor muscle health, especially in older adults. 

It’s totally possible to lose the pounds and keep the muscle if you have a targeted approach. The above nutrition and fitness strategies will help you achieve the best results. 

Childhood obesity is an emerging epidemic: one-third of children are overweight or obese. 

 Life as an overweight kid isn’t easy. For one thing, such kids are much more vulnerable to being picked on—a study in the journal Pediatrics found that children in Grades 3 to 6 who were obese were 65% more likely to be bullied than their peers of normal weight. They also suffer from low self-esteem, sadness and loneliness, according to Sylvia Rimm, author of Rescuing the Emotional Lives of Overweight Kids.

Children carrying excess pounds are more likely to grow into adults who tip the scales and are putting themselves at future risk of adverse conditions such as early onset heart disease, stroke and arthritis as well as type 2 diabetes. 

 Protecting these children, especially obese children—from both social ills and physical problems—requires taking action in order to help them reduce their rate of weight gain while allowing for normal growth and development. Dramatic weight reduction diets aren’t the answer. Neither, in most cases, is medication or surgery.

 So what does work? Early screening for one thing. The US Preventive Services Task Force recommends children six years and older be screened for obesity. For those who are diagnosed with obesity the most effective treatment is behavioural intervention—along with parental involvement—to change unhealthy habits. These interventions, provided by health care professionals such as family physicians, dietitians and counsellors, focus on four key areas: 

 It can be challenging for parents to instill new habits around eating, exercise, screen time and sleep. It’s important to remember you don’t need to go it alone—reach out to your health care professional for help. 

Right now, as you read this, you’re burning calories. From breathing to thinking to the subtle movements of your eyes across the screen — everything your body does takes energy. Of course, it’s not much. An hour of reading or watching something on a screen burns fewer than 50 calories. But it does add up. And at a time when most of us are more sedentary than ever, every little bit counts.

I’ve talked before about finding the right combination of approaches to lose weight or treat obesity, and I’d like to add something else to the mix: doing nothing. Or close to nothing. “Nonexercise activity thermogenesis,” or NEAT, refers to the body’s continuous expenditure of energy. Think of it like the gas used when your car is idling. Scientists are increasingly aware of the value of NEAT in weight loss, not as a standalone focus but rather as a way to extend your regimen into downtime.

The idea is simple: try to find opportunities to add movement to otherwise sedentary activities in order to increase NEAT. The differences can be surprising. Here are just a few very simple ways to put it to work.

Inconvenience yourself

We take countless shortcuts in our lives. Microwaves, elevators, dishwashers – making things easier is just part of human nature. But there are major benefits to doing things the old-fashioned way. Beyond the obvious advantages of taking the stairs whenever possible, something as simple as baking dinner instead of microwaving it can massively raise the relative caloric expenditure of the activity. Not to mention make for tastier meals. Scientists have shown that choosing to take the slightly more challenging approach to a task can add up to a higher level of NEAT over time.

Start by standing

If you’d like to help burn calories while binge-ing your show du jour, you can. Just stand up. Anything you normally do sitting down can become a tool in your weight loss regimen this way. It’s one of the reasons why standing desks have become so popular in offices. With a slight shift in verticality comes a major jump in NEAT, and seeing how long you can go without sitting down will also make your move to the couch that much more satisfying.

Take a moment to move

If you’ve ever been self-conscious about fidgeting, don’t be. Believe it or not, studies show that tapping fingers and feet can actually add calorie-burning movement to sedentary activities. But don’t stop there. Pacing and stretching take that NEAT even further. While your family may not appreciate you circling the room on movie night, walking around while performing otherwise stationary tasks is one of the most reliable ways to increase thermogenesis. Research indicates that something as simple as stepping in place during TV commercials not only made a significant contribution to daily steps, but also reduced overall TV time among participants of one recent study.

Find NEATer hobbies

You’ve probably picked up on the theme by now: If it involves movement, it burns calories. Playing an instrument, watering the garden, or singing in a choir – these are the kinds of downtime activities with good potential for NEAT. Every note played or flower planted is another micro-step toward your goals.

Nonexercise activity thermogenesis is never a replacement for true exercise. But it is a valuable reminder that every activity has potential to contribute to your fitness priorities. At the end of the day, being mindful and proactive about our bodies can have remarkable benefits over time. It’s about more than just pushing yourself hard for an hour each day, but rather sustained, gradual choices to be just a little more active. And as COVID keeps us indoors for at least a little while longer, there has never been a better time for this kind of mindfulness.

How the “maintainers” keep their progress

‘Tis the season for ambitious goals. With 2021 (thankfully) here, many of us are setting out on new fitness journeys. But how do we turn an ambitious beginning into sustained improvement?

Losing weight is hard enough — but maintaining that loss is always harder. Fatigue sets in, life gets in the way of carefully laid plans and before too long many people find themselves back at where they started on January 1st. But not everyone.

To identify what works best over the long term, doctors turned to the people most successful at sustaining weight loss: the “maintainers.” What’s working for those who can lose 30 pounds, then keep it off for more than a year? It turns out that it’s not about restriction, but addition.

Scientists recently confirmed an idea that doctors have had for quite a while: restrictive diets may help a great deal in the short-term, but for long-term results, the maintainers rely on Physical Activity Energy Expenditure (PAEE). This refers to active exercise, not just the Total Daily Energy Expenditure (TDEE) we experience in our day-to-day lives. In other words, the attribute shared by most maintainers is that they’re making a concerted effort to exercise every day. The study, which used isotopes in specially prepared water to track the energy expenditure of its participants, made exercise the clear star when it comes to sustaining change. Seems like a no-brainer, but there are a few nuances worth discussing.

As many of us discover every holiday season, restrictive diets don’t always line up with our real lives. Changing our eating habits may need that serious behavioral switch at first, but it’s important that we can eventually transition back toward enjoying the foods we love. We can — but only if we introduce exercise to match. The maintainers weren’t consuming less calories than the other groups of the study. They were just far more active: in some cases nearly twice as much as the others.

The research showed that not only do maintainers walk farther each day than the less-successful members of the study with obesity, they walked farther than people of a normal body weight. On average, the maintainer group walked the equivalent of 12,000 steps each day, as opposed to the normal body-weight participants’ 9,000 steps. To me, this shows a major commitment to physical activity.

So how do we apply this to our own lives? Well, let’s look at that resolution. If you’re utterly miserable by March, you probably won’t still be at it in December. So rather than trying to commit to a rigorous exercise regimen, try experimenting. Give a new activity a shot. If you don’t enjoy it, try something else. Once you find something you do enjoy, it will be far easier to keep it going through 2021 and beyond — even if it’s not the most calorie-burning activity possible. It’s about finding that path to those 3,000 “extra steps” each day. Talk with your doctor about the kinds of activities you love, then work with them to develop a dietary plan that fits. 

Soon lots of us will be entering the new year with new gadgets and new regimens to help support our health and fitness goals. Smart watches, trackers, apps — there’s a host of products designed to help people live healthier. But do they work?

Well, I’m not going to endorse any specific gizmo here. But the fundamental idea they’re based on is strong: when we’re more aware of our goals, our progress, and the effort we’ve made every day, we’re more likely to achieve our priorities. This doesn’t just come from my own experience – there’s solid science behind it. For example, recent research has shown that when we keep track of our diets in a structured, consistent way, weight loss is made easier.

In a study published last year, scientists tracked the weight loss journeys of 142 participants. Every week, they joined an online session led by a dietician (this was before COVID introduced many of us to the world of teleconferencing, of course), and in between sessions they were asked to log everything they ate. Some kept detailed notes. Others spent large chunks of time on the tracker. But those who lost the most weight (over 10% of their starting number) were the people who logged most frequently. Researchers noticed the major improvements coming at a twice-daily log. But those who updated it three or four times a day found even more success.

Repetition creates habits. And new habits create sustained change. Along the way, it becomes easier. The frequent loggers spent about 23 minutes each day tracking their diets at the beginning of the study. Six months later, it was down to just 14. They had made it a seamless part of their routine.

I think this research is impactful for another reason: it shows the benefits of telemedicine. The participants had regular access to expert support from the convenience of their homes. It removed a barrier to care that prevents many people from sustaining their progress. In my book, anything that makes forming positive habits easier is an invaluable tool. Combined with effective monitoring tools, whether they’re focused on diet or exercise, telemedicine can be a powerful tool in your weight loss journey.

So as we unwrap our new gadgets and sign up for new apps, remember that they aren’t going to be a solution on their own. It’s how actively and regularly we use them that will make the difference. Of course, some people feel they’re already too glued to their devices and may be reluctant to add another to the mix. But if we can check our social media feeds every few minutes, we can spare some time to record something as important to our health as our diets.

In medicine, there are few silver bullets. It’s rare for any illness to have just one cure or one treatment. Usually it’s a tailored blend of therapies, medication and behavioural changes that add up to a solution that works for the patient’s unique needs. For example, chemotherapy and surgery for cancer patients, or dietary adjustments and insulin for people living with diabetes. Obesity is no different.

In my last article, I talked about the impact that our circadian rhythm can have on weight loss and appetite. Of course, changing when you eat is not going to achieve your goals on its own. For that, we need to change our behaviour — sometimes intensely.

Intensive Behavioural Therapy (IBT) is how doctors refer to “high-intensity” lifestyle changes like diet, exercise, and psychological therapy. In other words, a concerted regimen supported by doctors with the goal of losing weight. Through in-person counselling, physical therapy, clear goals and a strategy to meet them, IBT has been proven to be one of the two most reliable ways to achieve a 5-10% reduction in body weight. And it seems to work best when combined with the other one.

There are several medications approved for treating chronic weight management that can be relied on to achieve a 5% reduction in body weight. Each has their own benefits and side effects that must be managed by the patient and their doctor. Recently, scientists have shown that some medications can be paired with IBT for an even more effective treatment. Patients who underwent the therapy while taking a liraglutide drug called Saxenda achieved nearly double the weight loss of those who only underwent IBT. The single-approach patients lost an average of 6.1% of their weight, while the combined-approach patients lost 11.5%. That’s a serious improvement.

This study serves as good reminder to anyone frustrated with their own progress: just because one approach doesn’t seem to be working doesn’t mean it isn’t working at all. It may just need the right complement. In fact, the study even added a third layer: some patients also went on a strictly controlled diet of nutrient shakes and salad. While the addition didn’t dramatically change the results for this group, in the end they did lose the most weight.

There will always be another tool, however minor, that can help you reach your goals. But it’s never going to be a silver bullet on its own. So start small and keep layering. Set achievable goals to find a regimen that balances ambition with sustainability.

What’s critical is that you don’t simply add medications or diets at random. Don’t take risks: talk with your doctor about moderate additions that can bring out the best effects of the others. It may take a while to discover the formula that works best for you, but it’s worth it in the end.

It’s no secret that COVID-19 is hitting our older neighbours hardest. We’ve seen how devastating the pandemic has been to long-term care homes and retirement communities. The reasons are relatively clear: elderly people have a wide range of increased risk factors that put them in danger of hospitalization or worse. From pre-existing conditions to compromised immune systems, those over 50 are most vulnerable.

But what about younger people who experience the worst cases of COVID? As scientists look for common threads connecting younger patients who end up at the hospital, a recent study may have found one. Weight.

The data shows that patients below the age of 50 hospitalized for COVID-19 have a mean (or average) Body Mass Index (BMI) of 43.1, while those above 50 have a BMI of 30.1. That’s a big difference. Not only is the gap considerable, but the mean BMI of hospitalized COVID patients actually goes down as they get older. This isn’t the case for other illnesses. So it does look like obesity is one of the key variables that can make the difference between a relatively smooth recovery and a potentially fatal hospitalization.

Earlier this year I wrote about how obesity — and specifically the inflammation it causes — can make COVID worse. Now it seems as though that insight has been reinforced. Of course, there’s much more research that needs to be done on the subject. This new study doesn’t necessarily show why a high BMI can make the disease more dangerous. They do speculate that sleep apnea may be related to certain respiratory complications. It’s a condition quite common in people struggling with obesity.

To me the study points to a simple but critical takeaway: obese patients may be as vulnerable as elderly ones. So if you or someone you love is living with obesity, it’s vital that they take precautions, no matter their age. In other words, treat yourself as though you are high risk, because you very well may be. Wear a mask. Wash your hands regularly. Limit physical interactions to a minimum outside your immediate family.  

But people living with obesity can do more to protect themselves and their families. The same fundamentals that can help them live healthier and happier can be considered part of their pandemic safety regimen. Eating fresh fruits and veggies, taking time to stay physically active — lifestyle changes made now may make a difference if you or your loved one ends up in the hospital.

The pandemic may be with us for some time to come, so it’s never too late to make positive changes. Every step towards better health is another safeguard against the worst effects of the virus.

Imagine if people were ashamed to have cancer. And that the stigma was so great it could actually affect the outcome of surgery to remove their tumor. It may seem shocking, but that’s exactly what a recent study has shown for patients struggling with obesity.

Bariatric surgeries can represent hope when all other options have failed. And like any operation, they have major impacts on the body that require diligent preparation and follow-up. A study published in the journal Obesity found that a significant number of people who undergo bariatric surgeries experience high levels of anxiety, depression, and internalized shame about their illness — and that these psychological issues can seriously affect their post-operation success.

The study revealed that poor mental health in bariatric surgery patients can lead to higher risk of post-operative issues like weight gain, substance abuse and even self-harm. In other words, external biases and societal stigma surrounding obesity not only affect patients’ mental health, they can prevent them from getting better.

But the study also provides hope: active self-compassion can help reduce the risk.

Self-compassion is exactly what it sounds like: making a focused effort to be kind to yourself. For obese patients, it needs to be a priority. That means giving yourself credit for your success and forgiving yourself for perceived failures. Self-compassion is an actionable skill that can be developed and reinforced. Patients — even those not struggling with low self-esteem, shame or anxiety — can easily add it to their regimen. Now it seems as though techniques designed for our mental health can make the difference in our physical healing process.

 Shame and internalized biases about weight are difficult enough without being reinforced by your doctor and other caregivers. That’s why it’s crucial for medical professionals to fight stigma and bias in their care. There have always been good reasons for this — providing patients with a safe, supportive space as one example — but this study shows it has real, clinical impacts on patient health.

This study makes clear something I believe quite passionately: the medical profession urgently needs to de-stigmatize obesity and begin treating it like we would any other medical condition. That begins with helping patients reduce their own feelings of shame or internal stigma, teaching them that the road to recovery begins with self-love.  

If you or someone you care about are considering bariatric surgeries, please take time for the mental health care you deserve, both in the lead up to the procedure and as you recover. In fact, why not make self-compassion part of your regular routine?

The roadmap of our lives is first laid out by our genes. Before environment, experiences and choices shape us, they define many of the parameters in which we’ll grow. Some can be unexpected: for instance, the tendency to sneeze in direct sunlight is an inherited trait, as is the ability to differentiate musical notes through “perfect pitch.” Long before we mapped the human genome in 2003, we looked to family history to understand the risks of inherited illnesses. In the nearly two decades since that remarkable accomplishment, our genes continue to reveal new insights. But can they influence the way we diet and control weight gain? A recent study indicates they might.

Nutrigenomics is the emerging science of tailoring our diets to best fit our genes. Still a young discipline, it’s grounded in the theory that by understanding our genetic makeup, we can make choices customized to our unique needs and proclivities. This can be as complex as adjusting vitamin intake to reflect the way your body processes them, or as simple as recognizing allergies and intolerances to avoid certain foods. Practitioners of nutrigenomics begin with a deep understanding of the patient’s genes, then create a uniquely tailored diet to reflect them. Until now, however, there has been little comprehensive research into its effects.

In an article reported in The Obesity Society’s research journal Obesity, a team from The University of Western Ontario has established for the first time that nutrigenomics can have a measurable impact on weight loss, especially in the short and medium-term.

By comparing the results from two groups: one who underwent the “gold-standard” of today’s weight-loss regimens — clinically supervised dieting, exercise and other lifestyle changes — versus one who underwent the same regimen plus a nutrigenomic intervention, it was revealed that the second group’s results were considerably better after three and six months. By twelve months, the two groups’ results were similar, but the study shows that in cases where relatively rapid weight loss is required, such as in the lead up to a medical procedure, nutrigenomics can be a valuable introduction.

What can this tell us about the future of obesity treatment? Although it’s still early days, the study does show that there are still many factors beyond diet and exercise that influence how we control our weight. A better understanding of genetic differences can empower doctors to prescribe more relevant treatments or identify the reasons why certain approaches may or may not work

In the end, it’s all about listening to our bodies in new ways and using what we hear to make better decisions. There has never been a one-size-fits-all approach to tackling obesity, but studies like this one show us that we can continue to be more precise, relevant and effective in the ways we customize treatment. And as in-depth genetic testing becomes more available to patients and doctors, I’m excited to see how it can benefit how we work to improve outcomes for those struggling with weight loss.