Keeping obesity at bay

Dr Flo,

I am shocked by the revelation that half of educated women of reproductive age in Kenya are overweight or obese, according to the recently released Kenya Demographic Health Survey (KDHS) 2022. I fall under this category and I would like to know how I can go about losing at least 10kgs in the coming months.

Dear reader,

The findings in the 2022 Kenya Demographic and Health Survey found that the incidence of obesity increases as one grows older, and the rates are higher in women living in urban areas and those who are educated beyond secondary school. There are many factors that could be contributing to these findings including increased consumption of processed carbohydrates and sugary foods/drinks and reduced physical activity. Other contributory factors include diet, age, environment, genetics, sleep and medications.

Weight management is important as either extremes of weight have associated health risks. Overweight and obesity increase the risk of developing diabetes, cardiovascular illnesses, musculoskeletal problems, fertility concerns among others. Healthy living includes all components of a healthy lifestyle like regular physical exercise; healthy and balanced meals and feeding habits; taking adequate amounts of water; getting enough sleep; stress management; and healthy lifestyle choices, in addition to weight management. Overweight and obesity can be assessed using any of these:

i) Body mass index (BMI) derived by diving the weight in kilogrammes by the height in metres squared (kg/m2)

ii) Waist circumference

iii) Waist-to-hip ratio

iv) Skin fold thickness

v) Bioelectrical impedance

If you are overweight or obese, it is advisable to adopt a health plan that allows for gradual weight loss of about 0.5 to 1kg per week and that is sustainable over the long haul. It begins with setting a realistic goal and committing to it, and getting advice and support from reliable sources. Visit a nutritionist for healthy meal planning. For most individuals, weight loss requires having a calorie deficit, meaning that the calories consumed are less than the calories used up in the day’s activities and they can lose weight just by changing how much, how frequently and what they eat. The diet should have less refined starches and sugars and be rich in complex starches, proteins, vegetables, fruits, cereals, and fibre. In addition, it is beneficial to increase the amount of physical exercise to include at least 150 minutes of moderate to vigorous activity per week, and to take adequate water. Getting enough sleep also helps in the weight loss journey as poor sleep is a risk factor for adding weight. Quick weight loss diets, medications and cleanses are unhealthy and unsustainable, and skipping meals is also not advisable as it can lead to health problems and may even make the problem worse because of snacking or overeating due to the hunger.

Dr Flo,

I recently moved to another county and for the past one week, I have not passed stool despite eating a balanced diet. Is this normal?

Dear reader,

The inability to pass stools regularly or being unable to pass stools completely is called constipation. It may also cause the stools to be hard, unusually small or large or lumpy. It can happen due to a change in your eating habits and/or your routine. For some people, a new environment, new people and new toilets may psychologically make them uncomfortable enough that they are not able to open bowels regularly.

However, most of the time, constipation is due to lack of or inadequate fibre in diet, inadequate water intake and reduced or lack of physical activity. Other possible causes include some illnesses and medications.

To manage it, take a high fibre diet, plenty of water and increase the level of your physical activity. In addition, give yourself adequate time and privacy to pass stool. It may be beneficial to place your feet on a small stool as you sit on the toilet or use a squat toilet.

In case the problem persists beyond two weeks, or if there is abdominal pain, vomiting, weight loss or rectal bleeding, then you need to be reviewed by a doctor. Any necessary tests will be done, and may include stool tests, abdominal x-ray and/or ultrasound scans amongst others. There are medications to make it easier to pass stools and relieve any peri-anal discomfort. If there is any underlying illness, it will be treated.

Last month I got my periods twice. I have not had them so far this month. What could be wrong with me?

Monica

Dear Monica,

The menstrual cycle normally lasts between 21 and 42 days, and the average is 28 days. If your cycle is normally shorter than 30 days, then this means that it is possible to have periods twice in one month. However, the menstrual cycle can be affected by hormonal changes, for example due to use of hormonal contraceptives and other hormonal medications, or pregnancy. Other possible causes of menstrual cycle changes include illness, environmental changes, stress, fasting or severe diets or eating disorders. When the period is early or late by a few days, or has any mild changes, then there is no cause to worry. However, if the changes occur regularly, or if they are significant, then it is advisable for you to be reviewed by a gynaecologist to check for any underlying disorders and for treatment of the same.

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