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Obesity: Tipping the Scales

Thirty-year-old Colorado Springs resident Christina Kingcade remembers always being big. She recalls being both heavier and taller than most of her 4th grade classmates. She made frequent visits to her doctor as a child, with a collection of physical woes that were a bit of a mystery until the doc diagnosed his young patient with gallstones.

By the time she was 11, Christina weighed 150 pounds. When she was 13, she became the youngest person in Clinton County, New York, to undergo gallbladder removal, due, she and her doctor strongly suspected, to her weight. She tried dieting, but as often happens, she’d lose some, gain some back, lose and gain back more. By the time she graduated high school, Christina tipped the scales at 300 pounds and was wearing a size 26 pant.

“I was at one of the lowest points in my life at that time,” she says, “but even though depression had set in, it didn’t stop me from gaining weight.”

Christina’s story is one shared by millions of people across our country and across the globe. How have we as a population become so heavy over the past decades?

“Obesity,” says Colorado Springs Health Partners Advanced Laparoscopic Bariatric and General Surgeon Khurram Khan, “has become an epidemic in almost all western civilizations and is also becoming a problem in developing countries. In my opinion the recent explosion in obesity is a multifactorial problem.”

Scott W. Fisher, M.D. and Director of Bariatric Surgery at Penrose Hospital, agrees. “Food has become increasingly inexpensive,” he says, and our reliance on eating at restaurants, where the average meal contains 1,000-1,500 calories, has increased. Add to that, says Fisher, the proliferation of fast food, our decrease in activity levels, our increase in sugar intake—from 40 pounds per person in 1900 to 100 pounds in 2000—and poor nutrition education, and well, we find ourselves dealing with some serious issues.

According to the CDC, one in three American adults is obese, as are 17% of our children and adolescents. Obesity ranges are determined primarily by a person’s body mass index (BMI). A person is considered overweight with a BMI of 25-29.9, and obese with a BMI of 30 or greater. Let’s say you’re 5 feet 6 inches tall. To be considered obese at that height, you would weigh at least 186 pounds. Christina’s 300 pounds at a height of 5’11” put her at a 41.8 BMI.

Both Dr. Fisher and Dr. Khan stress the negative impact oversized portions of food and the types of foods we’re eating have on our expanding waistlines.
“As our activity level dropped with modern technology,” says Dr. Khan, “our food intake went up secondary to easy availability and access to food. The media is full with food ads that mostly target the young. Most of the easy food is high in calories, fat, sugar and also comes in huge portions.”

“It’s all about the sugar,” says Dr. Fisher, “sugar from sweets and more importantly from bread, rice, pasta and potatoes… These types of foods contain carbohydrates. Carbohydrates come in the form of simple sugars and complex carbohydrates known as starch. This raises an individual’s glycemic index, impacts insulin and leads to increased hunger.”

With obesity comes a long list of health concerns. “It is amazing how many body systems obesity affects,” says Dr. Khan. “Almost every medical problem you see in an obese person is somewhat related to the extra weight. It causes a condition called metabolic syndrome, which includes an increased abdominal girth, high blood cholesterol, high blood pressure (hypertension) and high blood sugar (diabetes type 2). All of this combined then increases your risk for heart disease and stroke. Other medical conditions that we see commonly in obese patients are osteoarthritis, breathing problems like sleep apnea, reproductive issues, psychological diseases like depression and also increased risk of cancer.”

Drs. Fisher and Khan offer bariatric surgery at the Penrose and Memorial systems, respectively. Candidates for bariatric surgery must meet certain criteria and go through an education program to prepare for the life-changing experience. Surgical options, says Dr. Fisher, include “the Gastric Sleeve—turns the stomach into a small banana; Gastric Bypass—creates a pouch the size on an egg; and Lap Band—a restrictive band placed around the upper portion of the stomach.”

Christina Kingcade made her life-changing decision when she was 20. “I stepped on the scale and it read ‘error’,” she recalls. First thinking the scale was broken, she realized it couldn’t go as high as her weight had climbed. It had reached its limit, and so had she. Christina signed up at a gym that was open 24 hours a day so she could go late at night and work out without the fear of being made fun of.
“Even though I felt ashamed of myself, I continued to work out five to six days a week between 10 pm and 1 am,” she says. She made profound changes in both fitness and nutrition, and slowly but surely, her body was transformed.

Fast-forward 10 years. Christina now shops the small sizes at her favorite clothing stores. Maintaining an ultra-fit 165 pounds (from her all-time high of 325), she works out six times a week. She taught Zumba classes for two years, she runs, hikes, bikes and enjoys any activity she can take part in to keep herself active and healthy.

“My life has changed in every way,” she says. “I am active, healthy, happy, confident and stronger physically and mentally than I have ever been. Controlling my weight is and always will be a lifelong struggle, but it’s a feat I choose to take head on. You just have to be willing to make that change and stick to it.” 

Positive Steps We Can Take

Drink water: no sweetened drinks and no artificial sweeteners
Decrease sugar intake: not just sugars in sweets. Think rice, potatoes, pasta and bread
Increase protein intake: shoot for 60 grams a day
Exercise at least 30 minutes: five times a week. Consider starting with a brisk 10-minute walk threetimes a week
Decrease portion sizes: eat from a smaller plate, like a salad or child’s plate

(combined suggestions from Drs. Fisher and Khan)