Doc, why should people be concerned about BMI?

Dr Floh,
What is the significance of BMI (body mass index)? Obesity at the outset is a killer disease; what's more, it makes you look ugly. What foods should one take and what exercise regimen should one follow to reduce weight? Does being overweight lead to cardiovascular among other diseases?
Please shed light on this.
Ali

Dear Ali,
Body mass index is calculated by dividing the weight in kilogrammes by the height in metres squared. It is used to screen for weight that may lead to health issues. Healthy BMI is between 18.5 and 24.9. BMI below 18.5 is underweight and above 25 is overweight, above 30 is obese. Unwanted weight gain occurs when there is intake of more calories than the body requires. It is affected by unhealthy diet, inadequate exercise, genetics, hormonal changes, medication, poor sleep, and a slowing down of the bodies’ metabolism, which means the body needs less food and less energy to carry out its daily tasks.
Obesity is associated with many health issues including diabetes, hypertension, heart disease, stroke, gall bladder disease, liver disease, arthritis, breathing problems, reproductive health issues and cancer. It may also affect your activity level and lead to psychological issues like low self-esteem, guilt and depression.
The best way to manage obesity is to reduce calorie intake and increase physical exercise over a long period of time. Therefore, you should choose a diet and exercise plan you can work with, possibly, for the rest of your life. See a nutritionist and a physical trainer to help figure this out. While it is tempting to try rapid weight loss strategies, they are neither healthy nor sustainable, and the weight lost is easily regained if the diet and exercise are not managed as well.

Dr Floh,
I don’t know where to start. I have been masturbating for nine years now. The problem is, I’m unable to get my girlfriend pregnant and we need a child. Also, my penis can’t get an erection anymore. I'm worried. I'm 26 years old. Please help.
Jose

Dear Jose,
Medically speaking, concerns about fertility arise after one year of having regular unprotected sexual intercourse. About 15 per cent of couples are unable to conceive after one year of trying. Of these, a third of the time, the woman has a problem, a third of the time, the man has a problem, and in the other third, both partners have a problem, or no problem can be found at all.
In women, infertility can be caused by abnormal ovarian function, hormonal disorders, fallopian tube obstruction and abnormalities of the uterus. Alcoholism, smoking, obesity, severe weight loss, extreme physical or emotional stress, and being over 35 years of age can increase the risk of infertility.
In men, infertility can be caused by a disruption of the function of the testicles, ejaculatory dysfunction, hormonal disorders and genetic disorders. Alcoholism, smoking, use of steroids, injury to the testicles, being overweight or exposure to some drugs, toxins or radiation can increase the risk of infertility.
Having a problem with achieving an erection once in a while is not a cause of concern. You may have low libido, which means there is a decrease in desire for sexual activity, which can lead to a problem with achieving an erection. If it persists, it may be due to psychological issues caused by excessive masturbation, or relationship issues, performance anxiety, stress, anxiety, depression, among others. You may also have a physical problem that is affecting the quality of your erections, for instance, obesity, alcoholism, smoking or other drugs and reduced testosterone levels. Erectile dysfunction is also known as impotence, though it does not mean one is infertile.
It would be advisable to be reviewed by a psychologist and a urologist. Also, maintain a healthy weight, exercise regularly, adequate sleep (seven to eight hours a day), avoid alcohol and cigarettes, and find a way to manage the stress. You may also benefit from pelvic floor exercises: contract the pelvic muscles for about 10 seconds, 10 times in one set, six to 10 sets in a day. To identify the specific muscles, stop the urine mid flow when you are urinating.