According to the World Health Organization (Who), obesity has nearly tripled since 1975 on a global scale, Moreover, in 2016 more than 1.9 billion adults 18 years and older were overweight. Notably, of these 1.9 billion adults, 650 million were obese. So how do we tackle this obesity epidemic?

In this episode of ExpertsConnect, pediatrician, weight loss, and health coach, Dr Orlena Kerek, initially discusses the common causes of obesity. Later, describes the role of sugar in obesity and shares her thoughts on the implications of obesity on our health. Dr Orlena also shares her perspective on the link between mental health and obesity and further shares how she helps her clients to reconnect with their sense of purpose in their own lives.  She also dives deeper into the components of the Mediterranean diet and shares her views on snacking. Finally, Dr Orlena shares her viewpoint on the role of technology in tackling the obesity crisis. 

SHOW NOTES:

What are the most common causes of overweight or obesity? [2:47] | Dr Orlena mentions the following. Well, there are simple answers to that question. And there are more complicated answers to that question. The simplest answer that unifies everybody, essentially, is overeating. So if you think about it, the definition of overeating is eating more than our body needs. So on a really, really simple level, it's just what happens people take in more energy than their bodies need. Now, obviously, that's a really, really simplistic version and there are so many contributing factors. So you know, one of the big culprits that I see is the habits that we have as a society. So we're so used to eating lots of sugar, lots of carbohydrates, we're so used to being able to get food at huge convenience, you know, if we want something to eat, we can walk into a shop, and pick up a really calorie-dense food and eat it immediately. Whereas, if you look back to how food used to be, we used to have to go and, you know, farm the food and pick the food and forage for the food. And there was a much bigger delay in this idea of you know, I want food, how do I get food? So there are all sorts of contributing factors. But essentially, well, the good news, I guess, is that we can fix it. And the solutions are relatively easy. And it's all about habits. I'm all about habits. And I think a lot of it is habits in the way that we think as well as habits in the way that we do things.

Does sugar play a role in obesity? [4:28] | Dr Orlena shares the following. I have to say, again, it goes back to this idea that we've grown up in this world with carbohydrates. When I grew up as a child, it was normal to eat carbohydrate. So sugar is a carbohydrate, but when I say carbohydrates, I mean pasta and bread and all of those other carbohydrates as well. And I remember a few years ago, listening to somebody saying, oh, I've given up sugar for an entire year and my family never eat sugar. And I thought, Oh, my goodness, that's totally unnecessary. You don't need to do that. And now I have changed my view. Now, you don't need to do that, you don't need to give up all sugar but there is actually no reason why we need added sugar in our diet. Yes, of course, it is delicious and we all love it and our brains are programmed to go and look for sugar, both adult brains and children brains, I call children glucose seeking missiles. Because, if you say candy and then suddenly children's, their ears pick up and they know exactly what it is and that's just normal behaviour. But again, if you think about what it was like, in the past, we would get our sugar, which is our main energy source from some blackberries, or some figs, or some other fruits, that was our main source of sugar, whether it was fructose, or glucose, whereas now, we just have it all the time, it's so easy to get hold of. So yeah, the bottom line is we don't need sugar in our diets. We don't need refined sugar in our diet. And it is very easy to get into this habit, both in our minds, but also in our bodies of I need some quick release glucose. So our bodies get into this habit of going, oh, I feel a little bit hungry, I need to get some sugar. But the reality is that actually what happens when you're hungry, and you don't eat? And the answer is your body goes off and goes, Oh, I'm going to go and get some internal sugar to that because we've got lots of stores of sugar in our body. We're designed so that we can go for days without eating. I'm not suggesting that that's what you do. But we can do that. So when we're hungry and we don't eat, our body just goes right, well, I'm gonna break down some sugar. I'm going to get some sugar. 

What are the implications of obesity on our bodies and overall health? [10:23] | Dr Orlena states the following. There are so many implications, essentially, from a health point of view, I mean, it does depend on how obese you are, but it affects all parts of your body, it essentially shortens your life. So what I like to do is look at the other side, which is, okay, how do I lead a long and healthy life? And how do I lead that life with as much energy as possible and in as much health as I possibly can? And the answer is to eat healthily. But, and when you eat healthfully, you avoid things like heart disease, you reduce your risk of cancer, immobility as well. So being overweight can have a knock-on effect on mobility. And then obviously, once that happens, you spiral down into what I call a negative club, or when things get worse and worse and worse. But what you want to do is, turn it outputs and keep yourself healthy, or, you know, start to make yourself more healthy, and then spiral upwards. And think about how you can lead a life full of energy, and lead a long and healthy life and avoid all of those horrible illnesses.

Is there a correlation between obesity and mental health? [11:47] | Dr Orlena explains the following. Yeah, it's really interesting, actually. So when I teach people how to lead a long and healthy life, I teach four pillars. So I teach healthy eating, and exercise and movement, sleep, which is really important, and then emotions and mindset. And I think all four of them go together. And that emotional piece is the foundation, and that without that emotional piece, you can't make consistent changes, because your brain is busy telling you things like I'm a failure, I can't do anything. We're so mean to ourselves all the time, we always have these mean thoughts, and until you can sort out those thoughts of frustration and overwhelm, then you can't make those changes sustainable. So yes, there is a link between the two of them because people feel frustrated, they think, why can't I do this? What's wrong with me? I feel stuck in this way of being. And that just has a knock-on effect.

How can obese/overweight people reconnect with their sense of purpose? [13:32] | Dr Orlena explicates - Yeah. And I think the first step is really self-awareness. Well, the first step to changing anything is self-awareness because, again, it's all about habits. But the problem with habits is that they are things that we do without thinking about them. So it may be a habit in the way that you eat. It may be a habit in the way you exercise. It may be a habit in the way you think and the way you talk to yourself. But because you're doing it without thinking about it, you're not aware of it. So the first step is really to think, okay, I can see myself being mean to myself. So when, when I work with people, we may, for example, we'll decide what we're going to do. So let's, for example, say I'm going to not eat chocolate for two weeks, and then they go off and they eat chocolate. And then we said okay, well that's a golden learning opportunity because I want you to start having a look and start thinking with curiosity, what has gone on there. And then you can begin to understand, for example, it might be that I'm feeling tired and stressed work, it might be that. Yeah, I can hear this judgmental voice in my head, which is going, you're a failure, you haven't done anything, right? So the first step is to really get aware of what is going on. And then you can take steps to change it and thinking about that. The way I teach things is the way we think about things affects how we feel about things. So there's a circle, and it goes thoughts, emotions, actions, and then it goes around again. So you've got your thoughts, you think something, oh, my goodness, I'm a failure that leads you to an emotion of upset, overwhelming stress, the action is you go to the fridge and you start eating, whatever you find in the fridge. And then you have another thought, which is your judgmental thoughts about yourself, which goes, Yeah, I showed you, I knew I was right all along, and you start to go down this negative spiral. And it just goes down and down and down. And gradually, what you want to do is turn it around and spiral it upwards. And you can actually make changes in any of those, you can make changes to the way you think and you have to do it in a way that works for you. You can't just magic yourself, oh, yes, this is what I believe. But you can do incremental changes in how you think about things. You can change your emotions, and sometimes you want to change your emotions and sometimes you don't want to change your emotions. But what we don't want is to be swept away by our emotions and allow our emotions to rule us. And for us to sort of dive down this plug hole of negative emotions. We all have negative emotions, but it's how we deal with those negative emotions that's the important thing. Yeah, and obviously, and our actions as well, we can obviously change our actions, we just do things, and that is changing our actions. So yeah, we can address it in any of those three areas.

What are the components of the Mediterranean diet? [20:46] | Dr Orlena mentions the following. Yeah, so if we look at the research of what is a healthy diet, essentially, coming out on top is what's called a plant-based diet. And that doesn't mean you can't ever eat meat. But it means that really, you're getting most of your food in the form of vegetables. I'm all about vegetables. And there are different types of plant-based diets. But they're all very similar, and the research behind the Mediterranean style diet. And as a side note, it's quite difficult to do research on nutrition, like good research so we can be slightly controversial, but there is reasonably good research that shows that the Mediterranean style diet helps towards leading a long and healthy life. So it's lots of fruit and vegetables, and less refined carbohydrates. It's not pizza, and pasta and risotto. It's a little bit of those white refined carbohydrates in moderation, a little bit of protein, good quality protein, which could be from meat and fish, eggs, nuts and seeds. Another interesting part is legumes. So thinking about things like cannellini, beans, chickpeas or garbanzo beans, that's another integral part. And specific to the Mediterranean diet, we have to think about fats. And in the Mediterranean style diet is extra virgin olive oil. Now, I love extra virgin olive oil myself. But if other people want different forms of healthy fats, you can have different forms. But there is a reasonable amount of research that extra virgin olive oil is good for you. And that I read that in the Mediterranean style diet, you can have quite a lot of it. So four tablespoons a day, which is actually a reasonable amount. And the other thing about fat healthy fat is it helps you to feel full up. So one of the problems that we've looked at, you know when we look at the history of dieting is that people started having low-fat diets and high carbohydrate diets. But part of the problem with that is that people never felt full up. 

What's your take on snacking? [30:05] | Dr Orlena mentions the following. So emotional intelligence is really about insight.  I see governments say you must eat five or six meals a day. And I'm like, What? There's no research that shows that and in fact, it's really interesting. According to Tim Spector, who wrote the diet myth, in the olden days, we used to have one meal a day and that was fine. That's what worked for us, it's all about habits, it's all about our body, knowing when the next meal is coming from. So it's all about habits our bodies get used to when we eat. And if you look at people who do intermittent fasting, they just get used to how often they eat, they eat at this particular time. And now, obviously, there's a transition, which is if your body is used to eating all the time, then it's going to be difficult for you to stop. Now, one of the problems of snacking all the time is, you know, I talked about this idea that we constantly want, we're constantly getting sugar from outside, well, what should happen in normal life is we get hungry, we eat, and then we get this energy, and we use the energy. And then we go and use some of that stored energy. And then we repeat the whole process. But the problem that happens if you're snacking all the time is you don't allow your body to use that stored energy. So it just goes, eat, store, eat, store, eat store. And that's a really good way of putting on weight. And it's a really good way of re increasing your insulin levels, which are not helpful if you want to lose weight. So at some stage, you need to allow your body to use the energy. Now I recommend with my clients that they have at least 14 hours of not eating overnight because that's a really easy way to give your body a little bit of a rest. But going back to the question, you know, should you be snacking during the day? Well, to play devil's advocate, it's a bit like, well, what works for you. And if you are eating healthy snacks, that's much better than eating unhealthy snacks during the day. So you know, if I was working with someone individually, we would work out a plan together, but it which would be healthy snacks, and ideally you don't need to be eating all the time. You know, if it's within two hours, that's a real indication that your body has hardly finished digesting what you've lost, eaten. And it's not because you're hungry. It's because you've just got into a habit or because of some emotional reason.

What's the role of technology in tackling the weight and obesity crisis?? [36:38] | Dr Orlena highlights the following. I think it's amazing. So I love the step counters, or the sports watches, I think everybody should have a sports watch. And I think they have so many features. So one of the good things is they allow you to monitor for when you're really sedentary, they poke you every hour to get up and do some movement. And I find that they really spurred me on to challenge myself to do extra things because they set these little badges. And, you know, it's just me competing against myself, but it does push me to the next level. And then you've got things like meditation apps, which really can teach you to meditate. And you know, be aware of your emotions. So I think there's so much technology that we have that is really, really helpful, actually.

Notable Quotes from Dr. Orlena

"So you know, one of the big culprits that I see is the habits that we have as a society. So we're so used to eating lots of sugar, lots of carbohydrates, we're so used to being able to get food at huge convenience, you know, we just if we want something to eat, we can walk into a shop, and pick up a really calorie-dense food and eat it immediately. Whereas if you look back to how food used to be, we used to have to go and, you know, farm the food and pick the food and forage for the food." [3:34]

“Most vegetables are carbohydrates. Some of them contain proteins, but they basically all have carbohydrates in them, except they are wrapped up in nice, you know, good nutrients, nutrients that are good for us, they wrapped up in fibre. And when we eat vegetables, it doesn't spike our glucose or blood glucose levels so quickly. So when we eat white, refined carbohydrates, suddenly it hits our stomach, it goes into our blood sugar, and our blood sugar levels go zoom up. And that's actually really dangerous for many reasons, partly because it's just dangerous by itself.” [8:31]

“[…] when you eat healthfully, you avoid things like heart disease, you reduce your risk of cancer, mobility as well. So being overweight can have a knock-on effect on mobility.” [11:11]

“[…]   I encourage people not to look at the scales too much. What you can control is how you think how you eat, how you exercise, all of those things. And it's far more important to control what you are in charge of than what you aren't in charge of.” [20:31]

“[…]  And if you are eating healthy snacks, that's much better than eating unhealthy snacks during the day.” [32:01]

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