What is obesity?
Obesity is a health issue in which someone has so much extra fat that it negatively impacts the health
It is fast becoming a public health problem in developing countries like India, Brazil, Russia
Obesity is most often measured by body mass index, which looks at bodyweight compared to height
A person is of healthy weight if his BMI is between 18.5 and 24.9
A normal body weight and fat content is healthy
Someone who has BMI between 25-29.9 is called overweight
Someone with BMI 30 or higher is called as Obese
Being obese has many harmful effects on the body because of the way the fat cells act. Substances produced by too many fat cells cause a low level of inflammation (swelling) in the body. This harms other organs like heart, liver and pancreas. Risk for cancer is increased in the obese people
By being obese they suffer extra strain on their joints and tissues which produces pain and Arthritis ( swelling of joints)
Obesity – Causes & Risk Factors
Children who are overweight have greater chance to develop obesity when they become adults
- Diet –
The modern western diet with high calorie content, larger portion size, more of refined carbohydrates, hydrogenated fats and poor in fibres is so ubiquitous in our society. Many extra calories are consumed in drinks like colas, sweetened tea and coffee, juices. Junk food and fast food come cheap and lack in nutrients required for bodily needs. - Social Causes –
With busier lives and tight schedules many people don’t find the time to cook at home, hence dependence on outside food Many modern advances ( cars, working from home, screen watching ) have made people less active and lacking in regular exercising
Conditions Linked To Obesity
Health experts have shown link between high BMI and many health issues such as
- Heart Disease
- Stroke
- Type II Diabetes
- Hypertension
- Dyslipidaemia
- Osteoarthritis
- Obstructive sleep apnoea
- Gastroesophageal reflux disease
- Many types of Cancers ( Breast, Endometrial, colon)
- Infertility
- Gall bladder disease
- Liver disease
Treatment
Losing weight and keeping it off requires sustained changes in how you live your lives and your connections with food and exercise, this is also called as Life style modification
A nutrition expert or a registered dietician can help you easing out into a healthy dietary plan which can be tailored to your needs and personal preferences
You can try keeping a food dairy for a week to see what you are eating and drinking and how often you are eating
Ultimately the goal should be to loose weight slowly at 1 to 2.5 pounds per week
Your main goals when planning your meals should be
- Add more complex starches and fibres (whole grains, nuts)
- Stay away from refined carbohydrates ( white bread and white rice)
- Eat more fruits and vegetables
- Stay away from high calorie drinks like colas, sodas and juices
Increase Physical Activity
Start slowly from 20-30 min of physical activity like walking or cycling three times a week and increase to 45 mins 4-5 times per week
Drug Therapy
Taking a healthy diet and exercise are the cornerstone of weight loss . however if you still don’t lose weight your doctor may add some drugs to control your weight. The FDA approved drugs are :
- Orlistat
- Phentermine
- Phentermine/topiramate
- Lorcascerin
- Liraglutide
Weight loss drugs should not be used alone but rather with practice of cutting calories and with increase in physical activity each day
Weight Loss Procedures & Surgeries
If your BMI is above 40 or between 35 and 40 and you have comorbid conditions like diabetes , heart disease, obstructive sleep apnoea, dyslipidaemia than you are candidate for bariatric surgery
They are generally of two types –
Endoscopic procedures:
They are currently becoming quite popular as they are incisionless and require shorter hospital stay Intragastric balloons (Spartz 3 and Orbera ) – the balloons fill the space in the stomach and produce early satiety and weight loss Endoscopic sleeve gastroplasty – newer technique which is performed endoscopically and reduces the capacity of the stomach
Surgical procedures:
Laparoscopic Sleeve gastrectomy and laparoscopic Roux -en- Y Gastric Bypass In both these procedures the capacity of stomach is reduced and a part of small intestine is bypassed from receiving food thereby producing weight loss