Fat Nation

It's true: your belly is out to kill you, but first it's going to make you suffer. From the outside, it looks fairly innocent, if a little round and hairy. It's a normal indication of slowing down, a life lived to the full. But from the inside, it's a code-red health warning.

Fact is, obesity is the enemy-and a cunning one at that. As you read this, your fat stores are planting a time bomb in your heart and insidiously lining your arteries, narrowing them and increasing your high blood pressure. They're quietly infiltrating your organs, padding them so that you find it difficult to breathe, and hijacking the hormones that allow them to do their job. They're weighing you down, sabotaging any chance that you will have the energy to get rid of them, while patiently wearing down your joints with their sheer mass. Finally, they're getting ready to perform a surgical strike on the Pentagon of your manhood: yes, your ability to perform sexually is their ultimate strategic target. The question is: what are you going to do about it?

Chances are, you're in for a life-long struggle. Obesity isn't like acne. You can't outgrow it. Quite the opposite, in fact. What most people don't realize is that obesity is a chronic disease that could be life-threatening unless it is treated on a long-term basis. Indeed, the World Health Organization (WHO) reports that being overweight or obese is as dangerous as smoking, drinking alcohol and having high blood pressure - all accepted killers.

The sudden concern over global obesity is a fairly new one. Until recently, the question of weight was a purely aesthetic one. Thousands were treated for diabetes, heart disease and sexual dysfunction, but no one thought to make the link between these problems and their underlying cause: obesity. We simply didn't know that they were symptoms of a greater crisis.

Birth of the Bulge

Physiologically, our bodies have changed very little in the past 50 000 years. So why are we suddenly becoming fat? Some say it's exactly those prehistoric genes that are to blame. Before your great-granddaddy figured out how to bring down that protein-rich mammoth, he survived on foraged nuts, roots and fruit. This kind of food is seasonal and provides limited bursts of energy, so he basically had to eat all day just to keep going. It wasn't long, in evolutionary terms, before our bodies learnt to store every extra joule of energy it got. To make matters worse, granddaddy developed a serious sweet tooth to help feed his developing brain the glucose it demanded.

Not even after agriculture secured us a reliable food source about 10 000 years ago did obesity become a problem. Farming was physically demanding and it wasn't until the past century that machinery started doing the hard work for us. Suddenly, our daily lives started becoming less active.

These days, the average urbanite spends most of his waking life motionless except for his fingertips. Given our lifestyles, it's no wonder we're blimping out. But that doesn't mean we don't have a say in the matter.

Super-Sized Measures

Obesity is a medical problem. It may start as a result of an individual's genetic predisposition and poor eating habits, but it ends up a medical problem that needs to be treated holistically and according to the individual's physical make-up. This means you have to work on the person's bio-chemicals, diet, exercise and psyche together, not individually. But treating obesity is a little bit like sticking one's finger into a dam wall when there's a flood coming. Until we find a way to nip the problem at the root, to stop people from developing unhealthy eating patterns to begin with, bariatric treatments will keep going belly-up.

Prevention is where the International Association for the Study of Obesity is aiming its big guns. The fight against obesity is not only an individual's problem; it's also society's collective responsibility. Statistics show that if a child between the ages of 10 and 14 is obese, there's an 80 percent chance that they will grow into an obese adult.

A recent poll, conducted by Time and ABC News, found that lack of exercise was rated as the leading cause of obesity in the United States, trumping even bad eating habits in the fat stakes. Less than one quarter of the 1202 adults polled said that they exercised vigorously three times a week for at least 20 minutes, as many experts recommend. When last did you walk to work or the shops? How often do you circle the parking lot in search of a bay right at the entrance rather than walk from the end of the parking lot? Don't try and look all innocent. You know you do it.

Let's face it. We're not exactly active as a nation. In the US, companies are starting to make it a condition of employment that their employees belong to a gym and clock in and out for a certain period of time each week. These may sound like draconian measures, but they reap results: employees enjoy better health and companies enjoy the benefit of workers who take less sick leave and are more productive.

We also need to target the very stuff we eat: the food we buy in shops and at restaurants. Fast-food outlets in particular need to be encouraged to take responsibility for what they put in their food. The South African government is currently working on legislation to control how food is labeled, what fast-food outlets can put into their meals and how healthy eating should be introduced into the school curriculum.

It's a contentious move, bringing something as basic as food under the legislative control of the state, but the government has no choice: it's too expensive to treat obesity-related diseases. In the US, between six and eight percent of the yearly healthcare expenditure goes towards treating type-2 diabetes, hypertension, osteoarthritis and other

diseases linked to obesity - and there's every reason to believe that South Africa's statistics will soon look the same, if they don't already. In a country already burdened with a huge healthcare bill for the treatment of tuberculosis, malaria and HIV/ Aids, we must do everything we can to prevent another medical crisis.

Know Thy Enemy

In a perfect world, you'd know the exact nutritional value of everything you put in your mouth. At work, you'd get an hour gym break on top of your standard hour of lunch and it would be just as easy to nip out to the gym as it is to nip out to the corner cafe to buy yourself lunch. In a perfect world, your children school in safety, and even the poorest school would offer extra-mural sporting activities. School tuck shops would ban junk food and sell only healthy fare.

But we don't live in a perfect world. Ours is one where money calls the shots - and food is big money. However, there has been a shift. We're waking up to the fact that the kind of food we're eating is killing, rather than feeding us. We're finally realizing that the fight against obesity is also a societal problem. Not that this lets you off the hook. The war against fat remains a lonely one that each man has to fight on his own. Only you can take the first step and only you will be standing on the scales of success at the end.

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