Simply stated, obesity is the state of being excessively fat or overweight. It is a medical condition in which excess body fat gets deposited in the body and impacts the health negatively.
Before the 21st Century, obesity prevailed as an epidemic only in developed countries like the United States and European countries. However, today, obesity is a curse to the developing countries as well. This is due to the rise in middle class incomes and with the advent of global food markets, the prevalence of obesity has increased in developing countries like India, affecting almost 5% of the country's population. Also, a major difference in work pattern in our country in recent times has added to the disease burden. Sedentary lifestyle, increased calorie intake, genetic tendencies and hormonal imbalances contribute to obesity.
What is Obesity?
When fat inside the body accumulates in excess proportion such that it leads to negative health effects, the condition is called obesity. This is calculated by a parameter called Body Mass Index {BMI}, a measurement that is obtained by dividing a person's weight by the square of person's height. When BMI is between 25- 30kg/sq.m , and over it, then the person is termed obese. It is more common in women than in men and children who tend to be obese, grow as obese adults. Obese individuals, in contrast to their non-obese counterparts have leptin resistance, a protein hormone expressed by adipocytes (fat cells) that have a great impact on weight maintenance.
Burden of Obesity :
Obesity is often underestimated because of lack of awareness and lack of public health care strategies to fight the issue. Obesity increases the likelihood of morbidities like cancers (such as breast, prostrate, colon), cardiovascular diseases, dyslipidemia, type 2 diabetes, hypertension, sleep apnoea, osteoarthritis, fatty liver disease, PCOS, infertility problems, gout and also mental depression and social stigmatization. Alcohol and smoking further increase the magnitude of these diseases if the person is obese.
Causes of Obesity :
Sedentary lifestyle, and lack of physical activity plays a significant role in Obesity. Globally, there has been a major change in work pattern due to increased mechanized conveyance methods and technology advancements. Today's schools giving less importance to physical education and restricting children only to books, leads to childhood obesity. Genes and environmental factors also play a major role in causing obesity. Mutations in genes like FTO (fat mass and obesity associated gene) that control appetite and metabolism predispose to obesity. Hormonal imbalances like hypothyroidism, cushing syndrome, Growth hormone deficiency and certain drugs that are used to treat specific diseases also cause this disease. Psychiatric disorders like binge eating syndrome, night eating syndrome increase the risk of obesity.
Prevention:
Obesity is considered the leading preventable disease worldwide. This can be achieved mainly by lifestyle modification that includes diet control and physical activity. Behavioral therapy, drug therapy and surgery also aid in reducing the illness.
Diet control and weight loss management:
- Avoid FAST FOODS, ALCOHOL, SMOKING.
- Cut down calorie intake especially sugars, carbohydrates, fatty foods, and all packaged and processed foods that contain excessive salt, transfat and preservatives. These contribute to the increased cholesterol levels in the body, which is not good for health.
- Eat properly at correct time intervals by having four to five servings in a day. Reduce the portion of each serving week by week.
- A balanced diet or proper nutrition is essential. Consume boiled vegetables and fresh fruits and nuts like almonds, walnuts and other dried fruits.
- Choose brown bread, brown rice, whole grains over refined flour. Increase consumption of dietary fibre as it gives a feeling of stomach fullness.
- Weight loss strategies include vigorous physical activity on daily basis. Indulging in physical activity for about 1-2 hours a day is the key to fight obesity. Walking, jogging, gym or yoga, swimming and other intense forms of exercise such as muscle strengthening helps in maintaining body weight.
- Loss of 1 kg a week should be the goal which implies an ideal loss of 4-5 kgs a month.
- Do not ignore or postpone everyday work outs. Find opportunities to walk for atleast 10-15 minutes in between every 2 hours of work.
- Make sure to monitor BMI regularly and keep a track of your goal.
- Behavioral therapy includes stress management, counselling people for psychological eating disorders, anti-depression therapies.
- Drug management consists of medication for specific hormonal imbalances and other co-morbidities.
- Bariatric surgery is indicated when BMI is over 40kg/sq.m or 35kg/sq.m with any co-morbidity such as type 2 diabetes, hypertension, severe sleep apnoea. Procedures like gastric sleeve, Roun-en-Y gastric bypass are some permanent solutions where some part of the stomach is removed that helps people to eat less food and eventually aids in weight loss.
Obesity is a cause for many subsequent ailments and diseases that prevent one from leading a healthy life. Thus, one needs to incorporate good habits or a better lifestyle to have a healthy life!
