A CRITICAL look at most of Uganda’s health parlours, today, leaves no doubt that people are getting so fat, they are seeking out remedies to salvage their health. While there is no definitive finding that overweight per se is a disease, people who are obese find it difficult for life, especially when they lack the fitness to match their body mass.

On my recent vacation to Uganda, I visited a few health centres, only to find lots of evidently overweight men and women, trying to burn off fats in saunas and steam-baths, to very little success. What got me pondering, however, is that in all the parlours, these men and women would gulp lots of cold water, after each of their sessions in the steam-wash or saunas.

But, I would bet that even if they spent most of their money and time in saunas and steam-wash, they would still remain fat. Indeed, people who usually get fat, fail to reduce weight, even when they want to dearly, because of the little-effect remedies they employ.

In the United States of America (USA), for example, a big number of grown-ups are overweight, or obese. One third of all adult Americans, it is argued, try to lose weight at any given time.

A nutritional scientist Dr Stephen D. Ball of the College of Human Environmental Sciences at the University of Missouri- Columbia, argued that Americans were spending close to US $30billion annually on weight loss products and promotions.

But, at the same time, the country is gaining “weight at an unprecedented rate.” Ball, basing on statistics found a few years ago, held that approximately half of all adults in the US could be considered overweight. “Nearly one third can be classified as obese. Childhood obesity has also doubled in the last 20 years. These epidemic proportions have forced the medical community, fitness and health professionals, dieticians, and government agencies to ‘wage a war on obesity’.”

In fact, in 1998, the World Health Organization (WHO) officially declared obesity to be a disease. This came on the heels of attempts by health advisors that wanted then President Bill Clinton to pronounce obesity as a national health crisis.

The Debate
But, while the WHO classifies such overweight as being a disease, health disciplines consider it as debatable. Ball acknowledges that health risks like high blood pressure; hyperinsulinemia (too much insulin in the bloodstream – a common condition in Type 2 diabetes, with underlying causes of insulin resistance); increased cholesterol levels; diabetes; and even certain cancers are associated with obesity. “However, it is still unclear if obesity is the cause of these risk factors.”

The doctor believes it premature to declare obesity a disease. “Perhaps obesity is only a marker for poor health, but is not the direct cause.

Research has not been able to definitively conclude obesity to be the causal factor of its associated
negative health outcomes,” he asserts. “Research has shown that diet and activity levels – contributors to obesity – are also related to cardiovascular disease, cancer and strokes despite body weight. In addition, there is strong evidence that overweight but active individuals, are at a lower risk for cardiovascular disease than thinner counterparts that are not active.”

Ball quotes some 1996 studies by the Cooper Institute epidemiologist Steven Blair, who found that the best judge of mortality was cardiovascular fitness. This, Blair stated, was independent of body weight, Body Mass Index (BMI), or percentage body fat.

“In other words,” Ball added, “an obese person by BMI or percentage body fat standards that has good cardiovascular fitness, is at a significantly reduced risk of all causes of mortality, compared to a normal weighted individual that has low cardiovascular fitness.”

To him, the trick is very good cardiovascular fitness, for people who are overweight. Whereas, even normal weighted persons require such form, very fat people may be affected more. But, like Ball said, being obese becomes less of a factor with activity and diet.

Sauna Or Drugs?
For fear of weight, many people run to pharmacies for drugs. Others go to quack fellows, who are just ripping them off. Whereas pharmaceutical firms have ‘quick-fix’ pills that could prop radical dieting for fast weight loss, it is usually for a time, as the weight will balloon up all again, after the drugs.

Rob Lamper, in an article, ‘What Is The Danger Of Weight Loss Drugs’, says the pills work by “telling the brain it’s no longer hungry.” The brain then tips the metabolism (internal body energy to maintain one’s life) to aid shedding off of excess fat. Besides their temporary measure, some drugs have been blamed for some side effects, which include increased risk of heart valve disease.

For those that attend saunas with the sole expectation of getting thin, their efforts are almost worthless. Lamper argues that the weight loss that one may experience when using a sauna is temporary. This is due to the fact that the loss is through sweating.

Primarily therefore, it is simply water weight [lost]. “This [weight] is easily regained after drinking a couple of glasses of water or juice. Some argue that the heart beats faster, which in turn results in the body burning more calories, while in a sauna.

“However, this effect may result in very tiny increments of weight loss. Using a sauna is certainly not as effective as spending the same amount of time pursuing an aerobic activity like walking, swimming or taking an aerobics class.” He points out that athletes in some sports disciplines may occasionally employ saunas, or sweat suits made of rubber, to lose that small amount of weight.

“This is particularly the case with sports where competition is based on weight class, as in wrestling. A pound difference can mean competing or not competing! Usually, once a wrestler is given his weight class, he has time to produce more energy by drinking a protein drink or juice.”

It Is Fitness
According to Dr Ball, people should not spend their energies on fighting fatness per se. The war should be waged “against inactivity and poor lifestyle choices.” To him, the WHO should instead declare ‘inactivity’ a disease. “Maybe this would finally divert attention away from the bathroom scale and help us to start focusing more of our efforts on increasing activity and fitness levels.”

In the same spirit Lamper adds that the common treatments people go for or subject their children to, such as weight loss pills, fasting and/ or sauna and steambaths, are only for temporary results. “They do not address long term behaviour change such as lifetime physical activity and improved dietary habits.

“Even if health loss is achieved with drugs and maintained, there is no guarantee that it will be accompanied with health benefits. While the effectiveness of these weight loss drugs is not in question, they are more effective if they are used alongside a controlled diet and exercise regime.”

Lamper recommends the type of diet as requiring a balance of food groups to ensure a proper intake of vitamins, minerals and fiber. He suggests no harm in using a sauna for most people, but discourages it for people with low blood pressure and pregnant women.

He says; “For most, using a sauna after a workout can be a nice way to sooth aching muscles. Many feel quite refreshed using either saunas or steam rooms. But, for the dieter, you might want to skip the sauna as a weight loss tool and instead invest a few more minutes in aerobic activity. This is likely to result in the actual accumulation of muscle and burning of fat.”

Lamper recommends jogging every morning or working out in a gym. Just as one ought to consult a physician before taking weight loss drugs, he warns, a person should consult their doctor before undertaking any form of exercises.

The writer is a student of nutrition in Sweden