How Long Before We Get Personalized Obesity Therapy?

Wouldn't it be great if you could flick a switch or press a button and undo obesity? Those years of over-indulgence could be slowly rewound and life could go on. Well, although personalized obesity therapy does not claim to be a magic button, it could be the only chance for some people to lose weight which has stubbornly hung around for years.

What is Obesity?

The last thing any of us ever wants to hear are those painful words: Your BMI is over 30, you have become obese. But what is BMI? The Body Mass Index – BMI formula is very well known to dieters and doctors and everyone else.

It is calculated by using the following equation:  Mass (kg) : (Height (m))²

For a normal, sedentary person – i.e. someone who is not very active BMI scores mean:

• Less than 18.5   Underweight
• 18.5 – 25            Ideal weight
• Over 25              Over weight
• Over 30              Obese
• Over 40              Morbidly Obese

But it has recently been found that the BMI can be deceptive. This is because BMI was never intended to be used as a diagnostic tool. It was only supposed to be a way to classify body profile so that some researchers could tell if they were studying similarly shaped people.

Where Does BMI Go Wrong?

BMI measurements are not perfect. An unusually tall person will have a completely inaccurate BMI because tall people are not just ‘scaled up’ versions of short people. Also, athletic people are often classified obese in BMI tests because their extra muscle mass pushes them into the category, even though they are healthy.

But I think we all know when we are nudging into the wrong category, right? It is quite easy to spot the difference between a fit rugby player and a couch potato.

Are you TOFI? Thin Outside, Fat Inside?

The key lies in what is happening inside the body. In recent times, with improved ways of assessing the body, it is possible to look inside using MRI and CT scanners. Now we know that what is more important than just the physical measurement, is the amount of fat in the body cavities and even more important than that, is the way that the fat is distributed around the organs.

Someone can be what is known as a TOFI – Thin Outside, Fat Inside.

They may be predisposed to accumulating fat deposits around their vital organs – the heart, lungs, liver – and this will, in effect, shorten their life beyond expectations. 

In the normal scheme of things, someone with a TOFI body shape will not put themselves on alert and neither will they trigger any alarm bells with their doctor because, on the outside, they look healthy and happy. But purely because of the distribution of fat deposits, they may have a high risk of atherosclerosis, transient ischaemic attacks and even heart attacks.

Personalized Obesity Therapy

Personalized obesity therapy will work on a case-by-case basis. Instead of using a single measure for everyone and putting individuals onto a sliding scale of healthy and obese, personalized therapy will encourage a holistic approach which uses a wide range of data about an individual to arrive at a diagnosis and start treatment.

We all know someone who can eat like a horse but never put on any weight. We also know people who seem to be on a permanent diet, but struggle to keep off the pounds or constantly yo-yo between being fat and thin.

We now know that genetic factors and environmental factors both play a role in determining what kind of body shape we will have. Look at your parents. Whatever you see in them, the chances are high that this will be how you look when you are their age. That is the genetic influence. But there is a high proportion of environmental interaction at play. What your mother ate when she was pregnant with you, how your family treats mealtimes, what your attitude is to snacking and how your daily calorie needs are met by the foods you eat, are all just as important as the genes you were born with.

No Magic Bullet Yet…

Personalized therapy provides a way for medics to examine your present state of health and combine this with information about a vast number of different genes which regulate fat storage, energy metabolism and many different aspects of digestion. Along with a look at lifestyle and health prognosis, they can then tailor a prescription therapy which is based purely on how your body works and how that fits in to your daily routine.

• Have a thyroid function test to see if your metabolism is slower than normal.
• Have full blood lipids checked and fasting glucose. If there is diabetes present, then this will affect your metabolism and needs treating urgently.
• Look at the nutritional level of the food you eat. Does it contain all the vitamins and minerals that it should? Low levels of vitamins can affect the way that the body stores fats and some vitamins, such as vitamin D may become unavailable to the body because it becomes stored.

There is no need to struggle on with trying to lose weight. There are many alternative therapies and approaches which are now available to help.