Accumulation of excess fat in the body is referred to as obesity. A person who weighs 20% more than the ideal weight is said to be obese. When your calorie intake is more than the calories you burn, this energy is stored in the body as fats. Eating junk food and ‘drive through’ foods which are not home cooked, are loaded with calories and saturated fats, and may cause obesity. Decreased physical activity, inadequate exercise is also a major factor predisposing obesity.
Obesity is one of the most common public health problems in the world. Despite of its high risk of mortalities and morbidities, obesity is still one of the most neglected health issue. According to World Health Organization, one in six adults in the world is obese and about 2.8 million individuals die each year due to overweight or obesity. According to a recent study, around 135 million people in India have generalized obesity.
Signs and symptoms of obesity
Increase in body size, flabby arms and thighs, protruded abdomen all are associated with obesity and pose a major cosmetic issue. People who are obese also tend to be lethargic and have difficulty doing daily activities. The health issues linked with obesity are numerous. Health risks associated with obesity include:
- Breathing disorders (Obstructive sleep apnea)
- Heart diseases(Atherosclerosis)
- High blood pressure
- Joint issues(Osteoarthritis)
- Liver disease
- Gastroesophageal reflux disease(GERD)
- Certain cancers (Prostate cancer in men, breast and uterine cancer in women)
Tools for assessing obesity:
There are many tools to assess obesity. However, calculation of BMI is the most preferred method of assessing obesity worldwide
- Calculation of Body Mass Index(BMI): BMI is calculated by using the height and weight measures of the individual. BMI is calculated by using the following formula.
BMI = weight (kg)/ height (m2)
According to the World health organization, the standard values of body mass index are as follows
|BODY MASS INDEX||CLASSIFICATION|
|18.5 – 24.9||Normal|
|25.0 – 29.9||Over weight|
|30.0 – 34.9||Obesity (class – I)|
|35.0 – 39.9||Obesity (class – II)|
|>40||Obesity (class – III)|
- Measurement of the waist circumference: Visceral fat or abdominal fat is the fat stored around the waist. Increased waist circumference causes abdominal obesity which increases the risk of diseases like diabetes and heart diseases. Women with a waist circumference more than 35 inches and men with circumference 40 inches are at a greater risk of diseases. Measurement of waist circumference must be done at least once a year.
- Skin fold thickness: This test uses an instrument referred to as a caliper to measure the thickness of fat at one or more site of the body. This instrument can measure fat at around 3-8 sites in the body. This skinfold thickness gives a reasonable estimate of the amount of fat stored in the body.
Assessing for the comorbidities associated with obesity
- Blood test: Blood test is recommended to detect for the comorbid conditions like diabetes, high cholesterol, heart problems, liver problems and thyroid problems.
|Diabetes||Assessment of blood sugar levels|
|Cholesterol||Assessment of cholesterol levels (LDL, HDL, VLDL)|
|Thyroid problems||Assessment of T3, T4 and TSH|
|Liver diseases||Liver function tests|
- Other diagnostic tests: If your doctor suspects that you may have the complications associated with obesity, you may be referred for some other diagnostic tests.
|Heart diseases||ECG, Echocardiography, Cardiac ultrasound, Chest Xray|
|Lung disorders||Pulmonary function tests, Chest X ray|
|Fatty Liver||Abdominal ultrasound|
Lifestyle measures to overcome obesity:
- Dietary changes: One of the main aspects for weight loss is reducing the intake of calories. Standard calorie count required per day for women are 1200 – 1500 for women and 1500 – 1800 for men. Plan a healthy diet plan consisting of fruits, vegetables and whole grains. Avoid consuming high carbohydrate and fat foods.
- Exercise and activity: Obese people should workout for a minimum of 150 minutes per week. Gradually the work out time should be increased to achieve weight loss. Try to keep moving during the day, to burn those extra calories.
- Behavioral changes: Lifestyle modifications play an important role in achieving weight loss. Try to maintain proper food habits, exercise regularly and sleep for eight hours a night. Trained professionals can provide counseling for healthy eating habits and their importance.
Medical treatment for obesity:
Medicines for weight loss help only if you are committed to follow diet and exercise measures to control obesity. Medicines alone cannot reduce the weight. Drugs like orlistat, lorcaserin, topiramate, bupropion, and naltrexone are prescribed for weight loss.
Weight loss surgery:
Weight loss surgery is recommended to only those patients whose BMI is greater than 40, and have medical complications associated with it. Weight loss surgery helps in decreasing the amount of food intake. This surgery is beneficial only when the person is committed to maintain a healthy lifestyle which includes healthy food habits and exercise.
Preventive measures for obesity:
- Have your breakfast daily: Do not skip your breakfast. Many people skip their breakfast as to reduce their weight. According to studies, if you skip your breakfast, you may increase your weight.
- Consume high-fibre food: High fibre foods possess fewer calories, low fat and keep you full. This also reduces your craving for food.
- Have green leafy and raw vegetables: Green leafy and raw vegetables contain high water and are digested slowly. These foods will keep your stomach full for longer periods and you do not tend to eat too much.
- Exercise: Make sure you dedicate at least 30 minutes for moderate intensity exercises everyday.
- Stick to your diet plan: Maintain the same diet plan on all days including weekends, holidays, and festivals.
- Monitor your weight: Check your weight regularly once a week. This will help you to monitor even minute changes in your weight and would boost you to do more exercise and adopt a healthy lifestyle.
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Rajendra Pradeepa, Ranjit Mohan Anjana, Shashank R. Joshi et al. Prevalence of generalized & abdominal obesity in urban & rural India- the ICMR – INDIAB Study (Phase-I) [ICMR – INDIAB-3]. Indian J Med Res. 2015 Aug; 142(2): 139–150.
Obesity. http://www.medbroadcast.com/condition/getcondition/obesity#symptoms. Accessed on 3/ 10/2017
Obesity. http://www.mayoclinic.org/diseases-conditions/obesity/basics/prevention/con-20014834. Accessed on 26/9/2017