By most accounts, obesity has become the No. 1 health problem in the United States. Approximately 25 percent of the population is significantly overweight. Obesity, linked to chronic health problems such as heart disease and type 2 diabetes, taxes an overburdened healthcare system. Linda Gigliotti, director of the UCI Weight Management Program, offers these insights.

Q: What is causing this epidemic of obesity in the United States?

A: Our lifestyle changes have caught up with us. Technology – machines, cars, TVs, computers and automatic doors, to name a few – enable us to expend less energy on the activities of daily living. No example is too silly because every change contributes to spending fewer calories. There’s been a 75 percent decrease in physical activity in the last 100 years. At the same time, technology has made more food available to us. Processed, easy-to-prepare and even easier-to-consume food is available at every turn. The average American consumes about 250 calories a day more than we did just 20 years ago. Couple the increase in food calories with the decrease in activity calories, and we have the perfect stage for an obesity epidemic.
Q: More children are obese. What impact will this have in the future?

A: We already see health problems diagnosed at an earlier age. Type 2 diabetes once was referred to as “adult onset diabetes.” We now see that diagnosis in children because of insulin resistance caused by obesity. Similar statements can be made for blood pressure and cholesterol levels.
Q: There is debate about which type of diet is better – low carb or low fat, but neither seems to provide long-term solutions. How can people lose and keep off weight?

A: Most any diet will facilitate weight loss by creating a calorie deficit. Keeping the weight off long term requires lifestyle change – eating fewer calories and increasing physical activity. The task for anyone to keep the weight off for the rest of their lives is a matter of accumulating enough calorie and activity differences between their old lifestyle and new lifestyle to maintain a lower weight.
Q: The Weight Management Program at UCI advocates a “rational” approach to weight management. What does that mean?

A: Moderation in all things. No easy answer will work for everyone. We can prescribe a diet plan that people will follow for a short time to lose the weight, but to keep the weight off, an individual must manage calories-in versus calories-out in a consistent manner that results in lower body weight.
Q: Besides diet, what can people do to be healthier?

A: Move more. Increase activity in any and every way possible. Even if a person does not lose weight, increasing activity has wonderful health benefits like lowering blood pressure, decreasing insulin resistance, increasing bone mass and improving mood.
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