خريطة WOD

My name is Rita Simorra and I am a dietitian. I work for a Primary Care Centre in Barcelona, Spain. Recently we have gained a grant to set up an Obesity Department within the primary care (probably the first one in Spain...). The main objective is to offer a tailored treatment to people who suffer from obesity by a multidisciplinary team (doctor, nurse, dietitian, psicologist). Also, we are working hard with the paediatric team to enhance obesity prevention in childhood. We are planning a campaign in order to raise awareness about this chronic condition and the importance of its prevention. 

I am a Pediatrician in private practice for 40 years. I've seen the rise in obesity in children over the years and know that we cannot make gains without getting the buy in of the entire family, including the parents. I developed a 5 week family obesity workshop in my office and conducted this only after the families signed contracts to attend together. The results were amazing and the support of each family to one another was the most surprising finding. I put my program points in my first book: "The Happy Healthy Revolution : A Working Parent's Guide to Achieving Wellness as a Family" . I did several cohorts (about 5 families in each group ) at no charge to the families.

Additionally, I started a Walk with a Doc Oahu free weekly walking group 8 years ago so that my families could talk to me outside the office and continue to launch their journey with encouragement. When the Covid-19 pandemic arrived, everything came to a sudden halt.

I have restarted my weekly walking group, "Walk with a Doc Oahu" and people of all ages join me, especially the Seniors, who enjoy not only the exercise and education, but also the encouragement and fellowship. I have expanded this past year with social events like "Cook with a doc", "Craft with a doc" and an upcoming "Dance with a doc".

I am one person, but I am trying to reach out to my community in a small, but hopefully impactful way. I hope the ripples of hope and information I plant in our young families as well as the grandparents, begin to spread into the coming generations.

Facebook Page: Walk with a Doc Oahu

Instagram: wwadoahu

Website: weewellnesscenter.com

Walkwithadoc.org

I am Dr. Ketan Pakhale, Bariatric & Metabolic Physician, I experienced many of the patients from different professions & each one is having a common issues of weight gain due to sedentary lifestyle, food habits and stressful work patterns. This all requires customized way of treatment & needs to address on a larger scale.

I changed my lifestyle, for example, starting the day with a walk for 30 to 40 minutes, being more mobile all day long. I implemented a healthy diet like adding quinoa, more vegetables, healthy snacks including seeds and fruits on at least two occasions daily. I also aimed for healthy sleep patterns. By changing my lifestyle I could reduce my BMI from 28 to 25.

https://www.instagram.com/p/CawIuqfjRp-/?utm_source=ig_web_copy_link

With the growing continuum of health risks associated with being overweight and obese, international guidelines were advocated to determine health, weight loss interventions, pharmacologic treatment, and bariatric surgery. We mainly reply on a body mass index (BMI) cut-off point to define overweight and obesity. However, the appropriate BMI cut-off points to define overweight and obesity that are associated with increased mortality risk is controversial. WHO defines BMI between 25.00 and 29.9 kg/m2 as overweight and ≥ 30.00 kg/m2 as obese. However, these cut-off points have been derived mainly from Western populations and there is considerable concern that this cut-off for BMI is not applicable across ethnic groups, especially among diverse Asian populations. Evidently, there is an increased cardiometabolic/vascular disease risk at even lower BMI cut-off points for South Asian populations. Accordingly, the BMI cut-off point of 23.0– 24.9 and ≥ 25.0 kg/m2 have been recommended for Asian populations for defining overweight and obese, respectively.

The concept of duality of cut-off points for defining overweight and obesity for universal use and individual country use could be looked at in terms of one cut-off for morbidity and mortality statistics and the other to define the cardio-metabolic/vascular disease risk. Studies in South Asians have shown higher mortality risk at BMI ≥25 kg/m2 but fail to show inordinately high mortality at BMI cut-points ≥ 23 kg/m2. Thus, the validity of cut-off points ≥ 23 kg/m2 has been questioned because of the lack of robust data, particularly in the context of mortality. Further, the WHO Expert Consultation report in 2004, recommended maintaining the original cut-off values (WHO, 1995) as universal definitions since available data do not necessarily indicate a clear BMI cut-off point for all Asians for overweight or obesity and no attempt was made to redefine the cut-off points for each population separately. In addition, the WHO Consultation proposed that countries could make decisions about the definitions of increased risk for their populations.

Though BMI has been accepted as a satisfactory index of underweight and obesity, it cannot alone be used to identify the distribution of adipose (Body Fat Mass (BFM)) and lean mass (fat-free mass (FFM)) components of body composition making it difficult to disentangle the role of adipose and lean mass in associations of BMI with health outcomes. Also, BMI does not truly reflect the health risk in the population. Some individuals can have a normal BMI but a high body fat percentage known as normal weight obesity. A person who has normal weight obesity could be just as unhealthy as someone with a high BMI. Also, based on BMI cut-off we have equated lower weight with better health and often labelled weight loss goals to the standardized BMI ranges, which do not take into account the adipose (BFM) and lean mass (FFM) components of body composition nor how they are achieved. Also, the body positivity movement has gained tremendous pop-culture attention at present which echoed the shift in perception where we are moving out of the era of looking at a person and determining if they are healthy leading to an expanded definition of beauty based on BMI cut-off (Pak, 2020). Regardless of the fallacies of BMI, obesity and its association with a continuum of health risks cannot be ignored. Due to the health risk associated with obesity, efforts have been made to properly quantify body fat in individuals and in different populations. This call for an alternative measure of body composition as an indicator of health or obesity.

I changed my life 33 years ago when we moved to another city with 3 children and my mother. I worked all days long even sundays. I ate some candies, peanuts, fast food and had an increase of 20kg. I stayed like this till 3 years ago when I had a breast cancer. The doctor said I had to lose weight because my cancer type is attracted by fatty tissue. I lost weight, 15kg, but I have to lose more 10kg to be ok.

It's so difficult for me. The weight ruined my knees. I can't exercise often, I need to stop and go to physical therapy

OPINION: World Obesity Day imagines acceptance and equity in care

Obesity Matters began with a dream: to create an organization that could help bring awareness to obesity and its effects. We wanted to challenge the status quo by showing how obesity can affect all of us, regardless of age or background.

To accomplish that dream, a lot of things needed to change. One of those changes is ongoing as we work toward shifting the public perspective on obesity. Other changes, though, needed to happen for me on a smaller and more personal scale.

The COVID-19 pandemic flipped the world on its head. But while it came charged with uncertainty and loss for many, it also provided an opportunity for some to reassess, and change their outlook on work and life. This was me.

Like many companies in many industries, my event-planning business was impacted by the pandemic, and the growing uncertainty left me feeling like I had two options. I could wallow in fear and doubt or take action and carve out a new path.

I chose the latter.

The first stop on my new path was the Okinawa Islands off the southern coast of Japan. I didn’t manage to get there in person (pandemic and all), but I did discover the people of Okinawa through The Happiness Equation, a book and podcast by Neil Pasricha.

The people of Okinawa are remarkable for a few reasons. They age extremely well, their hearts are in great shape, they develop cancer, diabetes and other chronic diseases at a low rate, and they are happy. Plus, their region has the highest percentage of centenarians in the world — there are about 68 people 100 years or older for every 100,000 residents of Okinawa. In Canada, there are about 26 centenarians for every 100,000 people.

Okinawans have a diet high in carbs with plenty of fruit, vegetables, and healthy fats, all while consuming about 11 per cent fewer calories than the recommended consumption for an adult. It is a common cultural practice for Okinawans to stop eating when they are 80 per cent full, and they tend to eat off smaller plates.

This very specific diet may partly explain why the people on this small group of islands live so long, but it’s certainly not the whole picture.

Aside from seemingly hitting the genetic jackpot, Okinawans help their cause by living active lifestyles working mostly in agriculture and fishing. They also smoke and drink less than most other populations and they get plenty of Vitamin D.

Maybe most importantly, Okinawans maintain lifelong friendships through tight-knit communities. It is common for Okinawan children to be placed into social groups as babies, eventually growing old with the same peer group. Okinawan people are happy, and they cultivate a connection with the world around them by developing a deep sense of spirituality and purpose.

They also don’t have a word to describe the concept of “retirement.” Instead, they have another word: Ikigai . In Japanese, “ Iki ” means “life,” and “ gai ” describes value or worth. Ikigai is essentially the concept of a “reason for being,” or purpose in life. It was my discovery of this concept that brought me to the next step in my journey. I needed to find my Ikigai.

In thinking about what my own Ikigai could be, I knew that I wanted to make a difference in some way. I had been in the obesity space for a while, and I saw how stigmatized the community was and how many people needed a platform and group of like-minded individuals who understood the struggle and the pain obesity can cause.

Obesity Matters has a vision of weight acceptance

I saw the lack of care that people were dealing with, and I dreamt of a world where obesity would be perceived and treated like any other chronic condition without the stigma. It would be a long road ahead, and we would need to change a lot of people’s perspectives, but I felt ready for this challenge.

This was something I was passionate about, something the world needs and something I already had some skills and experience with. It had the makings of my own Ikigai .

After speaking with my eventual co-founders, it became clear that we not only shared a lived experience, but also a passion to make real change. And so Obesity Matters was born.

We decided to start a non-profit with a vision of weight acceptance while building on the wonderful work done by Obesity Canada. Health and happiness would be a main priority, but the mission would be to educate and empower this warm, wonderful community while reinforcing our core beliefs.

We believe that no matter your size, shape or means, everyone deserves to be cared for with respect, understanding and dignity. That also means that everyone has equal access to medical treatments and therapies, too.

Fast forward to today, and Obesity Matters has grown from just a dream into a successful non-profit. We’ve been able to unite individuals, families, communities, and organizations together in support of one common cause — creating awareness around obesity as a chronic condition and the importance of equitable access to care.

Our work has now reached thousands of people across Canada and beyond, and we see progress being made every day as more and more people become aware of obesity issues.

We are proud of our growing list of accomplishments after just two years:

A growing community. The growth and adaptability of the community of people with obesity to support each other and change the treatment and policy paradigm to focus on evidence-based solutions instead of stigma.

Influence. We are challenging the status quo and moving decision-makers to consider changes. More must be done to increase equity of access to treatments and supports.

International recognition. Our recognition internationally has been a boon to our growth as an organization.

Alliances. We have established partnerships in diverse sectors.

Solid community. Our community engagement has been equally rewarding and educational.

But these accomplishments are not enough.

Looking ahead, my dream is to work with kids while educating and empowering them to improve the health of future generations. I hope at a third anniversary we can report on the progress of that goal. In the meantime, there are a number of initiatives and goals we are working toward, including changing policy so that evidence-based treatments are available to all who need it; investigating the future partnerships with innovators, be it in virtual medicine, or with influencers and celebrities who can further disseminate the message of self-love; working with stakeholders who can help debunk the myth that obesity is a lifestyle issue and help us achieve our vision to create a future of weight acceptance; and helping people advocate for themselves so they can take action to help transform societal attitudes.

We still have a long way to go in our mission, but the progress we have made in such a short time keeps us optimistic that we can accomplish our big dreams.

On World Obesity Day, and every other day, Obesity Matters is committed to helping create a world where obesity is no longer an issue, and everyone can live in health and happiness. This is our collective Ikigai .

With our continued hard work and dedication, we know that this dream will become a reality someday soon. Together, let’s keep dreaming of a healthier future.

Priti Chawla is the executive director of Obesity Matters and can be reached at priti@obesity-matters.ca.

This article was first published in Healthing on March 2, 2023.

How Food Saved My Sanity From Being Raised In An Insane Home

From the time I was just five years old, I learned to use food to soothe my anxiety, handle my grief, lift my mood, and numb the chronic emotional pain I was experiencing from living in a chaotic, alcoholic home.

I’ve gained and lost hundreds of pounds throughout my first forty years. The most common weight-loss approaches I took were various diets, exercise routines, Twelve-Step groups, self-help books, and medically supervised weight-loss programs.

The problem with each of these methods was they never addressed the root cause of why I needed to turn to food to cope with my life in the first place. Therefore, every time I lost weight, I ended up gaining all of it back, and the cycle repeated itself.

When I turned forty and reached my top weight of 310 pounds, I knew I needed to do something different since it was obvious what I’d been doing wasn’t working. Since I was heading toward midlife, I began to worry that my excess weight could cause me to suddenly drop dead of a heart attack, become diabetic, develop chronic pain, or a whole host of other serious health issues that are common due to being severely obese.

Since I hadn’t been able to get my weight under control with diets, exercise, therapy, or Overeaters Anonymous, I decided to look to medical science for answers. I was encouraged to discover several peer-reviewed studies proving for people who were 100 pounds or more overweight that gastric bypass surgery provided a much better chance of reaching and maintaining a healthy weight for the long term versus traditional diet, exercise, and self-help approaches.

That was when I decided weight-loss surgery would be the smartest choice for handling my problem with food and weight. My gastric bypass weight-loss surgery took place in August 2002. The good news is I lost 160 pounds within two years. The even better news is I’ve been able to maintain my weight loss for the past twenty years.

The saga of my four-decade struggle with food and weight took a dramatic turn in 2017 when I learned that I had undiagnosed and untreated childhood trauma. It was then that I understood what had been driving me to turn to food to cope in the first place.

It was while reading: The Body Keeps the Score: Brain, Mind & Body In Healing Trauma" by Dr. Bessel van der Kolk that I came across the ACE-adverse childhood experiences study for the first time.

It was astounding to learn that children exposed to various types of adversity had much higher rates of addiction, obesity, anxiety, depression, and several chronic health issues in adulthood.

As I dove deeper into the science behind the ACE Study, I discovered some revealing information about how high ACE scores (4 or higher) can account for struggles with food and weight.

It was so validating when I found the data and graph from the ACE Study show that the chances of struggling with severe obesity increase by 240% when you have an ACE score of 4 or more compared to an ACE score of zero.

Just understanding what could be behind my forty-year struggle with food and weight was a huge relief for me. It helped me let go of the painful burden of shame I'd carried about believing I was weak and a failure for struggling with them. Learning about the link between childhood adversity and obesity sparked a desire to dig deeper into what had made me turn to food.

Learning about how my brain, body, and mind had been changed by trauma and that I needed special trauma-based therapies to heal lit a fire under me to write a book about my healing and recovery journey.