Article 31: Obesity, Osteoarthritis, Stroke, and Lifestyle Management

The aging of the musculoskeletal system manifests in changes in bones and muscles. As people enter middle age, bone density decreases, bone elasticity and toughness weaken, fragility increases, the regenerative capacity of articular cartilage declines, osteoporosis occurs, total muscle mass and its percentage of body weight decrease, joint dysfunction and limited range of motion lead to a genuine feeling of weakness and inadequacy in middle-aged and elderly people.

Osteophytes are very common in middle-aged and elderly people due to the thinning and reduced elasticity of the intervertebral discs, as well as the degeneration, wear and tear, and hardening of the articular cartilage. However, there are significant differences between obese and normal-weight individuals in terms of the location and incidence of osteophytes.

The excessive physical burden on obese individuals causes premature degeneration and aging of their joints, leading to joint wear and tear. The pressure and stimulation between bone surfaces are significantly greater in obese individuals compared to those of normal weight. Therefore, the incidence of bone hyperplasia is significantly higher in obese individuals of the same age than in those of normal weight.

Moreover, the lesions are most commonly found in weight-bearing joints, such as lumbar spondylosis and osteophytes in the knee and ankle joints. This is also why obese people often experience lower back and leg pain.

Obese individuals often experience abnormal calcium and phosphorus metabolism, leading to osteoporosis. Obesity can also impair motor function to varying degrees, exacerbating the condition, increasing the body's workload, and triggering osteoarthritis. Once obesity is eliminated, the symptoms of osteoarthritis can improve, and symptoms such as lower back pain and knee pain can be relieved.

The incidence of osteoarthritis is alarmingly high among obese individuals. Clinical observations show that over 50% of osteoarthritis patients are obese middle-aged people.

The knee joint is the largest and most complex joint in the human body, and the meniscus is a cushioning device that protects the knee joint. When a person weighing 65-70 kg walks, the pressure on the meniscus is 4.5 kg per square centimeter; if the weight increases to 100 kg, then the pressure on the meniscus reaches 6.9 kg per square centimeter.

When joints, tendons, ligaments, and cartilage are subjected to prolonged overload, they will develop diseases. Osteoarthritis commonly occurs in the knee joint, as well as the hip joint, lumbar spine, and cervical spine.

The onset is relatively slow. Early symptoms include joint pain and difficulty walking and moving. Symptoms worsen after prolonged sitting and improve after slight activity, but discomfort returns after more activity.

As bone spurs and osteophytes form around the joint, soft tissues are damaged, exacerbating the pain. In severe cases, the joint swells, leading to deformities and severely limiting walking and movement.

Obese individuals often experience a vicious cycle when developing osteoarthritis. When joints swell or become deformed, activity is forced to decrease; reduced activity leads to further weight gain, increasing the pressure on the joints and further worsening the condition.

Therefore, obese individuals suffering from osteoarthritis should begin by losing weight. As weight decreases, the pressure on the joints reduces, symptoms gradually lessen, and mobility increases.

Obese individuals are more prone to hypertension, diabetes, and coronary heart disease, all of which are important risk factors for stroke. Therefore, obesity is an indirect risk factor for stroke.

Clinical observations suggest that obese individuals have a 40% higher risk of stroke compared to the general population. Why are obese people more prone to stroke? Because obese individuals often have more disordered endocrine and metabolic processes, resulting in elevated cholesterol and triglycerides in the blood, and decreased high-density lipoprotein (HDL). Furthermore, obese individuals frequently suffer from diabetes, hypertension, coronary heart disease, and other conditions, all of which are risk factors for stroke.

Some obese people have noticeable abdominal fat, while others have fat primarily in their hips. Studies have shown that people who are obese in the abdomen are more prone to stroke than those who are obese in the hips. Generally speaking, women tend to gain weight in their hips and thighs, while men tend to gain weight in their abdomen, which is also why men are more prone to stroke. Therefore, preventing obesity is beneficial for preventing cerebrovascular diseases.

Obesity has emerged alongside economic development, and its high incidence and rapid increase in the number of obese individuals in my country are truly worrying. As the number of obese people grows, so does the number of people trying to lose weight; almost everyone who is obese has tried, but successful examples are few and far between.

The health effects of obesity are well known, yet many obese people still don't care. This is more common among men, and most of them frequently eat out, often using social engagements as an excuse to never control their diet.

Over time, not only will you gain weight, but various ailments will also follow. By then, when you finally think about losing weight, some of the changes in your body will already be irreversible.

Obese women are different. While they believe that obesity affects their health, they also place great importance on how obesity affects their physical appearance. Therefore, their desire to lose weight is much stronger than that of men, and they have taken a variety of weight loss measures.

However, a common mistake among women trying to lose weight is that they restrict their diet to an extreme degree, failing to meet the body's normal physiological needs. This is putting the cart before the horse; weight loss is supposed to be for better health, but this kind of approach actually harms health.

If you're planning to lose weight, be prepared for a long-term battle. Weight loss isn't something that can be achieved overnight; you need perseverance and willpower. Remember that fat doesn't accumulate in a day, and losing it also takes time.

Being overweight can easily lead to arteriosclerosis, hypertension, and other cardiovascular diseases, thus affecting quality of life and even shortening lifespan. Overweight has become an epidemic in modern life and a major factor affecting human health in the 21st century; this issue deserves sufficient attention.

Obese patients should undergo weight loss treatment under the guidance of a doctor. Using advertised medications for rapid weight loss is not advisable and can harm the body. Weight loss should be a gradual process, with a weekly weight loss of 250-500 grams, and the total weight loss within a year should not exceed 10% of the initial body weight.

According to years of research, losing 5% of one's body weight can significantly reduce the likelihood of developing cardiovascular disease.

Obesity is spreading and developing globally. In my country, the number of obese people and obesity-related chronic non-communicable diseases is also increasing year by year. In some large cities, the proportion of overweight middle-aged and elderly people has reached more than 20%.

This is mainly due to changes in dietary structure, excessive fat intake, and reduced physical activity. Before the 1980s, the Chinese diet was mainly based on grains. After the 1980s, the consumption of grains, tubers, and beans decreased significantly, while the intake of animal foods and vegetable oils increased continuously.

According to a sample survey, 75% of urban households have increased their meat consumption by more than 20%, and one-third of households have increased their meat consumption by more than 50%. Household cooking oil consumption has also increased significantly. 75% of households derive more than 30% of their total energy from fat, and some households derive more than 35%.

Obesity increases the incidence of related diseases such as hypertension, coronary heart disease, and diabetes. Studies have shown that overweight individuals have more than twice the incidence of hypertension and two and a half times the incidence of diabetes compared to those of normal weight.

To curb the rising trend of obesity, long-term and effective methods should be adopted, and a healthy and scientific lifestyle should be promoted, including adopting a low-calorie diet, increasing the intake of vegetables, fruits, wheat and whole grains, preventing the Westernization of diets, and increasing physical activity.

When formulating urban construction, transportation, and housing plans, the demand for spontaneous physical activity should be fully considered. Patients who are excessively obese, in addition to adhering to dietary control and increasing physical exercise, should also undergo medication under the guidance of a professional doctor to effectively control their weight.

Obesity can be classified into three types based on its cause: hereditary obesity, secondary obesity, and simple obesity. Simple obesity is the most common type of obesity, caused by excessive accumulation of body fat due to overnutrition.

Social factors, dietary factors, and behavioral and psychological factors can all directly lead to simple obesity. Common treatments for obesity include: controlling total calorie intake, exercise, medication, and traditional Chinese medicine.

In today's competitive and fast-paced lifestyle, controlling total calorie intake is the most convenient and effective method. Controlling total calorie intake does not mean controlling the amount of food consumed, but rather controlling the intake of high-calorie foods such as fats.

Patients with simple obesity can achieve weight loss by controlling their total calorie intake, without necessarily needing to use medication.

(1) Slow eating for weight loss: After food enters the body, blood sugar levels rise. When blood sugar reaches a certain level, the brain's relevant centers will send a signal to stop eating. If you eat too quickly, by the time you receive the signal to stop eating, you have often already eaten too much. Therefore, slowing down your eating speed can prevent overeating and excessive nutrition, thus achieving the effect of weight loss.

(2) Eating earlier to lose weight: Studies have shown that the timing of meals is more important for weight gain than the quantity and quality of food intake. Since the body's metabolism peaks between 8 and 12 AM, those trying to lose weight should have breakfast before 6 AM and lunch around 10 AM to achieve good results.

(3) Dietary restriction for weight loss: It requires dieters to eat certain foods at different times during each meal. For example, when eating high-fat, high-protein meat dishes, they can eat a vegetable, but they cannot drink beer or eat sugary foods such as bread and potatoes. This is because eating sugary foods while consuming high-protein foods will increase the body's fat and cause weight gain.

(4) Eat more vegetables and fruits: Scientific research has found that eating more vegetables and fruits helps with weight loss. This is because meat is easily stored as fat in the body, causing weight gain. The plant proteins and sugars in vegetables and fruits are not easily converted into fat, and green vegetables, which do not contain sugar, are especially effective for weight loss.

(5) One dish cooked with oil per meal: Limit yourself to one dish cooked with cooking oil per meal. During weight loss, it is still necessary to eat about a teaspoon of oil per meal. Oil can make you feel less hungry and reduce the chance of snacking, and it also has the effect of increasing the absorption rate of carotene.

(6) Change cooking methods: Excessive consumption of fried foods or foods stir-fried with oil is the main cause of obesity. Therefore, do not make fried foods frequently just because they are convenient and delicious. Instead, actively consider conditioning methods that can reduce calories.

Furthermore, even with the same fried food, if the ingredients are cut into very small pieces before frying, they absorb oil more easily and therefore have a higher calorie content. In other words, the calorie content can vary considerably depending on the frying method.

"Many adults often cook fried foods and other dishes to cater to growing children, which can easily lead to obesity. Therefore, even when using the same ingredients, it is more appropriate to use low-calorie cooking methods such as steaming, boiling, or baking for adults."

(7) Drink plain water: Alcoholic or sugary drinks are the biggest "enemies" of weight loss, while plain water and tea are the best partners. Even drinks that are 100% fruit juice contain a lot of sugar, so it is best to refrain from drinking them. It is generally believed that drinking alcohol will not accumulate calories, but in fact, alcoholic beverages contain a lot of calories.