Obesity is a complicated disease that is affecting more and more people everyday. It isn’t simply a body image concern, it is a medical condition that can lead to serious illnesses if not treated. The fact is, some people are genetically predisposed to this condition but for others it’s through years and years of poor eating habits and a sedentary lifestyle that can cause this excessive weight gain.

What is Obesity?

Obesity is not the same as simply being overweight. Those who are considered obese would have to have a body mass index of 30 or more. When someone is obese, it also means that they are at a greater risk of contracting serious disease such as type 2 diabetes, heart disease, and cancer. Obesity is difficult to treat as it requires lifestyle changes. Often people who are obese will lose weight only to unfortunately regain it back a few years later. However, with the right combination of treatments, weight loss is possible for individuals who are obese and some have been successful in losing weight and keeping it off.

Causes and Symptoms of Obesity?

Obesity can be considered to be a disease that is highly linked to food intake and exercise, although it also can be caused from certain medical conditions. Here are some top causes of obesity:

1. Diet

Eating high energy density foods such as breads, pastas, pastries and fast food items can lead to obesity if eaten frequently and over a long period. Not eating healthy foods such as fibre-rich fruits, whole grains, and green leafy vegetables can not only create havoc in the digestive system but can also lead to weight gain.

2. Medical conditions

Certain health conditions can lead to weight gain. These conditions include: Poly-cystic ovarian syndrome, Prader-Willi syndrome, Cushing syndrome, hypothyroidism and osteoarthritis.

3. Emotional Eating

Emotional eating is overeating in response to negative emotions such as stress, boredom, anger or frustration. Around 30% of overweight people report that they have issues with binge eating.

4. Genetics

Around 400 genes have been said to contribute to overweight or obesity. These genes can influence factors such as appetite, metabolism, food cravings, satiety, emotional eating and body fat distribution in the body. Genetic influence can vary from person to person and can range from as low as a 25% influence to as high as a 80% influence.

5. Frequency of Eating

How often you eat can actually play a role in weight gain. Overweight people tend to eat less often than people with normal weight. Studies show that those who eat smaller meals four or five times a day have lower cholesterol levels and more stable blood sugar levels than people who eat only two to three meals per day.

6. Sleep Habits

Lack of sleep can cause hormonal changes in the body and can affect hunger and appetite. Sleep deprivation over a long period can have serious effects on your metabolism and set you up for weight gain. How do you know if you are obese? Here are some top symptoms to look out for:

• Breathlessness
• Snoring or sleep apnea
• Unable to do physical activity
• Excessive sweating
• Exhaustion or tiredness on a day to day basis
• Back and joint pains
• Hormonal imbalance (irregular periods, mood swings,etc)
• Skin and hair issues
• Lack of confidence and low self-esteem
• Feeling alone/isolated

How is Obesity Diagnosed?

There are a number of ways your doctor can diagnose obesity. Here are some of the most common diagnostic tests and examinations that can help uncover this condition in an individual:

1. Physical Examination

By conducting a physical examination (checking heart rate, blood pressure and temperature as well as checking your heart, lungs and abdomen) your doctor can assess whether you are overweight or obese.

2. Calculating BMI

The biggest marker that can indicate obesity is the Body Mass Index. If your BMI is 30 or more, you can be sure that you are dealing with obesity. Even though BMI is one of the most common ways to measure obesity, it isn’t always accurate. BMI cannot distinguish between bone mass, muscle mass and body fat, so gauging whether excess fat is an issue is difficult to accurately detect.

3. Measuring Waist Circumference

Visceral fat stored around the waist can be measured in order to determine certain health risks affiliated with obesity and being overweight. A waist circumference of more than 35 inches for a woman and 40 inches for a man is above the normal measurement and should be considered a risk factor.

4. Blood Tests

Certain blood tests can be taken to test for cholesterol levels, liver function, fasting glucose levels and thyroid. The results of these tests can be useful in determining obesity.

Risks Associated With Obesity

Unfortunately, obesity can pose many health risks for the individual. Some of these risks include:

1. Type 2 Diabetes

Insulin is required to lower blood sugar levels. Type 2 diabetes occurs when your cells are unable to respond to insulin. For those with type 2 diabetes, too much glucose and sugar build up in the bloodstream. This can cause health complications and can even reduce the body’s ability to produce insulin.

2. Heart Disease

Heart disease is an umbrella term that refers to many different types of heart conditions. Some of other conditions include Arrhythmia (an irregular heart beat), Atherosclerosis (hardening of the arteries), Cardiomyopathy (heart muscles harden or grown weak), Congenital heart defects (irregularities of the heart from birth), Coronary artery disease (caused by build-up of plaque of heart’s arteries), Heart infection (infection caused by bacteria or parasites).

3. High Blood Pressure

Also known as hypertension. High blood pressure occurs when blood pressure rises too high. Extra weight can raise the heart rate and reduce the body’s ability to transport blood through the vessels and higher pressure on the artery walls increases the blood pressure. It can be a precursor to heart attack or stroke.

4. Certain Cancers

Obesity can put someone at risk for certain types of cancers. These types include Meningioma (cancer in the tissue covering brain and spinal cord), Thyroid, Liver, Gallbladder, Upper Stomach, Pancreas, Ovary, and Kidney. Breast cancer, colon cancer and endometrial cancer are especially affiliated with obesity and should be monitored if the individual is considered obese.

5. Fatty Liver Disease

Also known as hepatic steatosis. Fatty liver disease occurs when fat is built up in the liver over time. Too much fat in the liver can cause inflammation which can lead to scarring (liver fibrosis), which can then lead to liver failure.

6. Sleep Apnea

Sleep apnea is a condition when breathing pauses repeatedly through the night while sleeping. Those with sleep apnea may feel tired throughout the day and wonder why. When left untreated, sleep apnea can cause health complications such as diabetes, heart disease and other serious illnesses.

How can Obesity be Treated?

Obesity is a complicated condition, and treating it can be complicated too. Although not impossible to treat, often multiple treatment should be applied at once to ensure the most success. There are a number of ways to approach treating obesity. Here are the best ways according to health professionals:

1. Diet Modification

One of the first modes of treatment involves food intake. Eating less calories (500-1000 a day) may help in reducing weight. Eating foods that are low in fat and calories and are high in nutrients can potentially bring your body back into a healthy balance. It is rare, however, that an individual who is obese succeeds with this treatment alone. It is often the trend that after going on a low calorie diet, the weight is regained about 2 years later.

2. Exercise

Incorporating exercise into your daily routine can help you lose weight. Daily physical activity along with correct diet modifications can even improve your metabolism and help your body regulate weight more easily. Something as simple as taking the stairs at work, walking while talking on the phone – can make a big difference.

How to Prevent Obesity

At the end of the day, eating a healthy diet and getting enough exercise is the best way to prevent obesity. Here are some ways to prevent this condition:

1. Eat More “Good” Fat

Avoiding weight gain doesn’t mean completely avoiding fat. On the contrary, polyunsatured fats such as omega 3 fatty acids found in salmon and nuts can actually lower cholesterol and obesity risk.

2. Eat Low Glycemic Foods

Eating low-glycemic foods that do not cause blood sugar spikes such as fruits, vegetables, whole grains and lean proteins can keep your blood sugar levels regulated and help maintain a healthy body weight.

3. Exercise Regularly

Exercising 150 minutes of moderate aerobic exercise or 75 minutes of vigorous exercise each week is important to maintain a healthy body weight. In addition to aerobic exercise, engaging in a weight training regime will train your muscles and prime your metabolism for healthy weight loss.

4. Reduce Stress

Stress can cause you to develop unhealthy eating patterns such as emotional eating and eating at irregular times. When feeling stressed, instead of reaching for a hamburger, try stress reduction techniques such as deep breathing, yoga or socializing. 

Summary

Obesity differs from being simply overweight in that it has a higher risk factor for certain diseases such as diabetes, heart disease and fatty liver disease. Obesity can be caused by a variety of factors including genetics, diet, physical activity, medications, and pre-existing medical conditions. The symptoms of obesity can include breathlessness, excessive sweating and lack of confidence.
One can fight back obesity by improving lifestyle, following a healthy diet, regular exercises, having plenty of water, and enough sleep helps to achieve the set target. Obesity can be prevented with the right diet and exercise routine. Avoiding foods that are high in sugar, fat and excess calories and eating foods that are high in “good” fats, fibre and nutrients can lower cholesterol and decrease obesity risk.

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By Dr. Sat Bir S. Khalsa

Perceived stress and anxiety can be a normal and healthy response to life circumstances. But for some, the fast pace and uncertainty of modern society causes debilitating levels of stress and anxiety. Chronic, unmanaged stress hurts our quality of life and is responsible for an increase in health issues and disorders across the world. It is a psycho-social crisis that has been accelerated by the COVID-19 pandemic. Rates of anxiety in the U.S. have more than tripled in the second quarter, from 8.1% in 2019 to 25.5% in 2020. [1] The resulting negative emotions are not only traumatic, but also make our immune systems more vulnerable. Managing these draining emotions is difficult but doable. 

Exercise, breathing techniques, relaxation and meditation have all been shown to mitigate anxiety. It is no surprise that traditional yoga — a practice that combines all four techniques — is what more people are relying on to manage their anxiety. However, yoga has not received the same level of attention from medical research. That is beginning to change. Health care professionals and researchers, like myself, are finding consensus around why yoga is such a powerful tool for regulating emotions and reducing anxiety. 

Yoga as a Mind-Body Treatment

If anxiety increases, it may start to interfere with everyday activities and overall well-being and thereby meet the criteria for an anxiety disorder such as generalized anxiety disorder (GAD). Mentally, this includes pervasive day-long exaggerated worry and tension, inability to relax, difficulty concentrating, anticipation of disaster and excessive concern about life issues. Patients are unable to control this even though they realize that their anxiety is more intense than is warranted. However, many anxiety symptoms are actually physical, such as muscle tension, trembling, sweating and insomnia. Such symptoms are due to an activation of the fight or flight stress response, which prepares both the mind and body for real or imagined threats by causing significant changes in the body, mind and emotions.

Conventional medical treatments for anxiety include pharmaceuticals, which do not necessarily address the underlying causes of anxiety. Psychotherapeutic approaches, such as cognitive behavioral therapy (CBT; considered a gold standard behavioral GAD treatment), do address underlying mechanisms of anxiety in many patients, but they are not effective for all. Both approaches focus primarily on mental aspects of anxiety. Given the physical symptoms of anxiety, it follows that any successful anxiety treatment would be best if it addresses both the mind and body, which is what makes yoga such an effective option. Yoga can address both the symptoms and causes of anxiety, while strengthening the tools needed for emotional regulation.

Feelings of anxiety can quickly overwhelm us, leading to an automatic reactivity with no gap, filter or interval for response. Through practice, yoga breaks the patterns responsible for this automatic behavior. The meditation practice component of yoga works on improving self-regulation of the attention networks in your brain. As you gain more skill in the interface between your thought processes and emotion control, you simultaneously become more sensitive and less negatively reactive to your own thoughts and life situations. The physical components of yoga practice work effectively on anxiety symptoms in the body while also impacting mental functioning through the mind-body connection. Overall, these skills make it possible to have a degree of control over our emotional state and how we respond to stressful events. It’s what makes the mind-body practice of Yoga so powerful.

Evidence from the Scientific Community

Yoga’s positive impact on anxiety and anxiety disorders is supported by a growing body of research. Recent published meta-analyses (review papers summarizing statistical results from a number of previous clinical trials) of yoga for anxiety have concluded that yoga might be an effective and safe intervention for individuals with anxiety disorders or with elevated levels of anxiety. [2][3]  Other researchers have found evidence to suggest that yoga for children and adolescents may also reduce anxiety — welcome news given that anxiety disorders are prevalent in younger people.[4]

Much of my own research has focused on Kundalini Yoga as a treatment for emotional and physical health. Kundalini Yoga is a traditional yoga practice that incorporates movement, postures, dynamic breathing techniques, deep relaxation, meditation and mantras. It is a yoga style focused on improving physical functioning, self-regulation of mind and body, increased mind-body awareness and enhancement of positive psychological states. These states include feelings of calm, balance, well-being, gratitude, compassion, and ultimately depth of self, transcendence, life purpose and meaning, and spirituality.

I have focused on understanding Kundalini Yoga’s efficacy in improving emotional well-being. That work has contributed to a study that showed positive benefits of a Kundalini Yoga treatment for post-traumatic stress disorder (PTSD).[5] I have also researched the potential benefit of enriching CBT with Kundalini Yoga to treat GAD.[6] The results showed statistically significant improvements in state and trait anxiety, depression, panic, sleep and quality of life, demonstrating its potential as a promising treatment for those suffering from GAD.

Following positive results of a preliminary study of Kundalini Yoga alone as a therapy for GAD,[7] our most significant research trial of Kundalini Yoga for GAD was published last August in the prestigious Journal of the American Medical Association Psychiatry. This large, rigorously conducted randomized controlled trial assigned patients with GAD to participate in a 12-week intervention of either Kundalini Yoga, CBT or a stress education control condition. Participants attended weekly group sessions and engaged in daily 20-minute home practice sessions. The results showed that Kundalini Yoga was a credible treatment. It was more effective than stress education in treating GAD, though not as effective as the CBT gold standard. Given that conventional treatments of GAD are not fully effective or easily accessible for everyone, these results are encouraging for the use of yoga as an additional treatment for anxiety and anxiety disorders. [8]

These findings are important steps toward establishing that traditional yoga (incorporating not just physical exercises but also controlled breathing, relaxation and meditation) is particularly effective at managing stress and emotion.

Practice at Home

While researchers continue to make the case to the medical establishment for yoga as treatment strategy, nothing is stopping you from using yoga as self-care. One of the many beautiful aspects of yoga is that it requires no special equipment — though a yoga mat is helpful — so there’s nothing to stop you from practicing Kundalini Yoga in your living room. Try a Kundalini sequence or meditation at home whenever you feel worried or anxious. It is always best to learn with a qualified Kundalini instructor to ensure that you are practicing properly, but there are plenty of techniques you can easily perform on your own while socially distancing during the pandemic. For a list of practices that beginners can use, visit https://www.3ho.org/kundalini-yoga/kriya/featured-kriyas.

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Editor’s note: This is a guest post by Dr. Sat Bir Singh Khalsa, Ph.D. Dr. Khalsa is the Director of Research for the Kundalini Research Institute, Research Associate at the Benson Henry Institute for Mind Body Medicine, and an Assistant Professor of Medicine at Harvard Medical School at Brigham and Women’s Hospital. His research on yoga for mental health in public schools, insomnia, anxiety disorders, and chronic stress; his Harvard e-book Your Brain on Yoga; and the medical textbook The Principles and Practice of Yoga in Health Care which he co-edited, have established him as a world-renowned yoga researcher, collaborator, author, and speaker.

^[1] https://www.washingtonpost.com/business/an-epidemic-of-depression-and-anxiety-among-young-adults/2020/08/22/dcc06c34-e43c-11ea-82d8-5e55d47e90ca_story.html

^[2] Cramer H, Lauche R, Anheyer D, Pilkington K, de Manincor M, Dobos G, Ward L. Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials. Depress Anxiety. 2018 Sep;35(9):830-843. doi: 10.1002/da.22762. Epub 2018 Apr 26. PMID: 29697885.

^[3] Hofmann SG, Andreoli G, Carpenter JK, Curtiss J. Effect of Hatha Yoga on Anxiety: A Meta-Analysis. J Evid Based Med. 2016;9(3):116-124. doi:10.1111/jebm.12204

^[4] Weaver LL, Darragh AR. Systematic Review of Yoga Interventions for Anxiety Reduction Among Children and Adolescents. Am J Occup Ther. 2015 Nov-Dec;69(6):6906180070p1-9. doi: 10.5014/ajot.2015.020115. PMID: 26565100.

^[5] Farah Jindani, Nigel Turner, Sat Bir S. Khalsa, “A Yoga Intervention for Posttraumatic Stress: A Preliminary Randomized Control Trial”, Evidence-Based Complementary and Alternative Medicine, vol. 2015, Article ID 351746, 8 pages, 2015. https://doi.org/10.1155/2015/351746

^[6] Khalsa MK, Greiner-Ferris JM, Hofmann SG, Khalsa SB. Yoga-enhanced cognitive behavioural therapy (Y-CBT) for anxiety management: a pilot study. Clin Psychol Psychother. 2015 Jul-Aug;22(4):364-71. doi: 10.1002/cpp.1902. Epub 2014 May 7. PMID: 24804619; PMCID: PMC4224639.

^[7] Gabriel MG, Curtiss J, Hofmann SG, Khalsa SBS. Kundalini Yoga for Generalized Anxiety Disorder: An Exploration of Treatment Efficacy and Possible Mechanisms. Int J Yoga Therap. 2018 Nov;28(1):97-105. doi: 10.17761/2018-00003. Epub 2018 Apr 26. PMID: 29698081.

^[8] Simon NM, Hofmann SG, Rosenfield D, et al. Efficacy of Yoga vs Cognitive Behavioral Therapy vs Stress Education for the Treatment of Generalized Anxiety Disorder: A Randomized Clinical Trial. JAMA Psychiatry. Published online August 12, 2020. doi:10.1001/jamapsychiatry.2020.2496

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