Posted by: 4pack | June 29, 2008

Add Gout To The List of Problems With Obesity


AS we become desensitised to the countless obesity awareness campaigns organised by health authorities, statistics of people dying of heart disease due to obesity have increasingly become a mere number to most of us.

And that trend could not be emphasised more when consultant endocrinologist Dr Faridah Ismail named her presentation “I’m fat, so what?” at a weight management campaign recently.

There are some among our population who think that children and babies that are fat are cute and cuddly, Dr Faridah said. “Usually we perceive obese or slightly chubby children as lovely, nice or well fed. But that is not the correct perception anymore.”

With around 30% Malaysians falling into the overweight and obese category, doctors have a good reason to be concerned.

Obesity brings with it a plethora of other complications that further burdens our healthcare system.

Among the well-documented complications are the increased risk of a heart attack, stroke, diabetes and hypertension – all chronic diseases that require long-term management and care.

“We as health professionals are faced with these problems (associated with obesity) every day. (Now), medical chits are given out because of problems associated with obesity,” Dr Faridah said.

But not many people realise that the medical chits given out are not just for those who have chronic diseases such as heart disease or hypertension. There are other complications of obesity that could make a person’s life painful and miserable, Dr Faridah said.

One of those problems is joint pain. If you are obese, your uric acid may get elevated. When your uric acid is elevated, you can get gout, Dr Faridah explained. In gout, uric acid crystals deposit in your joints, tendons and surrounding tissues, causing the affected area to swell and cause pain.

For an obese person, panting after walking up a flight of stairs is not just a matter of fitness. “When a person is obese, the fat in the abdomen restricts and blocks the lungs where it has no space to expand,” Dr Faridah said.

With breathing difficulties and joint pain, people who are obese often do not exercise and that, in turn, makes them put on more weight, setting off a vicious cycle, Dr Faridah said.

Besides, the risk of developing gallstones and acid (gastroesophageal) reflux are increased in people who are obese. “The pain of having gallstones is like (the pain of) a woman in labour,” says Dr Faridah, adding that it is difficult to operate on obese patients, which are also predisposed to infection and other problems.

Senior lecturer in clinical psychology Dr Alvin Ng said the prevalence of mental disorders is higher in people who are overweight and obese.

“A few studies have shown that the higher your BMI is, the higher risk of you getting some sort of mental disorder at any one time,” he added.

That is why prevention is still the best in dealing with the obesity epidemic, because it is a lot tougher to get out of obesity than preventing it.

“We must remember that losing weight is not an easy or quick fix? It is a very slow and gradual process. We can’t expect (people who are obese) to lose 10 kilograms in one month, if they take 10 years to gain that weight,” Dr Faridah said.

Losing weight for obese people may seem to be an uphill task, but studies show that losing even 5 -10% of your current weight yields many health benefits. According to Dr Faridah, even if you lose 5% of your current weight, you reduce your chance of dying from diabetes related deaths and obesity related cancers by 30% and 40% respectively.

She advised people who wish to deal with their weight problems to first self-evaluate. “It is important for these people to determine their readiness and commitment to lose weight.”

You have to lose weight for yourself and for your health, said Dr Faridah, adding that physicians often have to evaluate patients for their readiness to lose weight because if they are not ready, they are less likely to listen to their doctor’s advice.

If you have the resolve to lose weight, see your doctor to get recommendations based on the evaluation of your health and risk factors you have, she added.

“There are no shortcuts (in weight loss). You still need to diet and exercise to lose weight … because obesity is a chronic disease, and not just a cosmetic issue.”

At risk of …

WHEN you are obese, you may increase your risk of developing…

1. Cardiovascular diseases


  • Hyperlipidaemia (high cholesterol or high levels of triglycerides)  
  • Hypertension (high blood pressure)  
  • Coronary heart disease  
  • Stroke 2. Metabolic complications 
  • Type 2 diabetes 3. Gallbladder disease 
  • Gallstones 4. Bone and joint problems 
  • Osteoarthritis  
  • Gout 5. Obstructive sleep apnea and respiratory problems 
  • Breathing difficulties 6. Cancer 
  • Breast, uterus, colon, oesophageal cancer. 7. Gynaecologic abnormalities 
  • Abnormal menstruation  
  • Infertility (both in men and women) 8. Psychosocial problems 
  • Poor self esteem  
  • Depression
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    1. exercise is key

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