Obesity and risk of kidney disease in Ghana

According to the World Health Organisation (WHO), about 13% of the world’s population are obese.
Obesity has dramatically doubled since 1980 and seem to be increasing due to lifestyle changes and growing modernization.
As at 2014 over 600 million were obese worldwide and even many more were overweight. Obesity is simply the accumulation of excess body fat with health implication. It can calculated by simply measuring your weight in kilograms and dividing by the square of your height in metres to attain the body mass index (BMI).
A BMI value greater than or equal to 30 defines obesity. Go ahead and calculate yours! You are considered overweight if your body mass index is equal to or greater than 25 but less than 30. Obesity can also be assessed by measuring the circumference of your waist with a tape measure.
A waist circumference of 102cm in men and 88cmin is associated with increased risk of diabetes, abnormal cholesterol levels, high blood pressure (hypertension) and heart problems like cardiac arrest.
In Ghana, obesity is increasing at an alarming rate. Some earlier studies in Ghana revealed that over 5.5 -14.1% of Ghanaian adults older than 25 years are obese 1,2 with females in the majority. Obesity is more common among the married and employed leaving in urban areas. Obesity was highest in Greater Accra and virtually absent in Upper East or Upper West regions. By ethnicity, obesity was highest among Ga Adangbe followed by Ewes and then Akans of 14.6%, 6.6% and 6.0% respectively.
3. Obesity is also more common among literates and sedentary workers in the Ghanaian population. Obesity occurs when there is imbalance between the consumption of calories as compared to energy expended. You will potentially gain weight if your intake of calories exceed the rate at which you use the energy accumulated. Currently in Ghana, people have become more sedentary, walk less, drive more, eat more fast foods, take soft drinks and less fruits and vegetables.
These activities all promote obesity with increasing health. Obesity also increases the risk of developing cancers of the breast, prostate, ovary, liver and gallbladder just to name a few. Obesity has also been identified as risk factor for developing kidney disease. This occurs either directly or indirectly. Obesity directly leads to kidney disease by causing the kidney to overwork to filter more blood due to the increased body weight. This eventually wears out the kidneys leading to kidney damage. When damage progresses, it leads to end stage renal disease.
At this stage the patient can only survives on dialysis or after he/she gets a kidney transplant. Obesity also leads to sieving of protein in the urine which has destructive consequences on the kidney leading to kidney failure. Indirectly, obesity increases the risk of developing the major causes of chronic kidney disease i.e. high blood pressure and high blood sugar.
Obesity also increases risk of renal cancers and formation of stones in the kidneys (uric acid and calcium stones) which has the potential of causing kidney damage by obstructing the flow of urine out of the body. With high cost of dialysis services and the unavailability of kidney transplant services currently in Ghana, it is necessary to decrease the occurrence of kidney disease by preventing and fighting obesity with all seriousness, without ignoring the other causes. This requires effort from all of us to maintain a healthy dietary habits, exercise more frequently and maintain an active daily routine. It has been estimated that even more people are going to be obese by the year 2025.
There is evidence that weight reduction can reverse the progression of kidney failure and therefore strongly suggested. For this reason the upcoming world kidney day this year will be celebrated on the 9th March, 2017 and has as its theme: ‘kidney disease and obesity; healthy lifestyle for healthy kidneys’.
We seek as doctors treating people with kidney diseases to highlight the effects of obesity on kidney diseases and how to manage and prevent obesity by healthy lifestyle modifications. This will go a long way to prevent kidney disease and prevent or even reverse progression of chronic kidney disease in those who have already been diagnosed with renal failure. Managing obesity.
1. I recommend regular physical activities to reduce weight and maintain a normal weight. You can plan regular keep fit sessions but it is also advisable to stay active at your workplace. For instance, use the stairs instead of the lift, walk over to a colleague’s office instead of calling on phone and pack your car away from your work place to walk each day. Enjoy physical activities so you don’t get bored easily and stop. It has been suggested that at least 30 minutes of physical activity at least three times a week is helpful in maintaining your weight.
2. Obesity is NOT a sign of good living, it rather has consequences. In Ghana, if you do not gain weight after marriage, then your spouse has failed. This is dangerous and should be condemned. Let’s not try to gain weight or cause our spouses to gain weight just to please society and our in-laws because it comes with serious health consequences.
3. A visit to your dietician is also necessary to learn dietary options with very low caloric content. Starvation is not suggested as a way to lose weight, you may end up binging after a period of starvation and this does not help you lose weight. On the contrary, you might rather end up gaining a few more kilos. Low fat and low caloric diet are highly recommended. Book an appointment with your dietician.
4. Maintain a healthy lifestyle such as weekly weight checks, reading food journal, reading labels of processed foods as you shop in the malls to know food content and focus on eating a balanced lifestyle. Have a healthy way to manage your stress as some people eat a lot when stressed or depressed. Depression has been associated with obesity especially in younger females.
5. Some gain weight because they have eating disorders. You may need to see your psychologist if you have an eating disorder. Some people cannot help it but eat and overeat. This will lead to obesity and such patients should go for help.
6. Ensure you are not on any medications that promote weight gain. You may need to discuss your prescription or over-the-counter medications with your physician to help identify possible obesity-causing medicines.
7. Weight reduction does not happen overnight. It takes time and a lot of effort. You need to be very disciplined if you are to become successful at it. Don’t give up too quickly, as nothing good comes easy. Doing nothing about your weight will lead to an increase in weight.
Sometimes, just maintaining your weight alone is a great achievement and better than gaining weight. If checking your weight too frequently depressed you, then check at longer intervals. Self-check and good record keeping is key to success.
8. Lastly, be cautious about any drug or herbal medication that promises ‘fast’ weight reduction. You may end up with liver or kidney problems as consequences.
Just stick to the basics; good dietary habits and exercise. All the best in your weight reduction drive. 
Author: Dr Elliot T. Tannor, Physician Specialist, KATH,