Obesity is known to be a disease when your body fat percentage is more than normal. It is a complex multifactorial disease involving the environment, family history and genetics, metabolism, behaviour, habits and more. Even though genetic and hormonal factors are not under human control, obesity can be best prevented by a healthy lifestyle which includes consumption of optimum calories and increased activity to the maximum.
Reaching and staying at a healthy weight is a long-term challenge for people who are overweight or obese, but it is also the chance to lower your risk for serious health problems. Scientifically approved treatment and commitment will successfully lower and maintain weight and thereby reduce your long-term disease risk.
Factors contributing to obesity
Excess calorie intake: Even though it is thought that increased calories “in” and less calories “out” can treat obesity, it rarely happens. However, a reduction in calorie consumption is always beneficial.
Sedentary lifestyle: This not only leads to one becoming overweight but also raises your risk of coronary heart disease, increased BP, diabetes, colonic cancer and many other health problems.
Environmental factors: Consuming high-calorie food and westernisation of every kind, including use of the internet, comfort, etc., is the major contributor to the pandemic of obesity.
Genetic factors: A family history of diabetes and obesity does predispose the siblings to have the same disease. Genetics affect body fat composition and distribution. Indians are more prone to have more fat even at a lower BMI and are typically prone to central/truncal obesity. Truncal obesity is known to contribute to metabolic syndrome and cardiovascular disease than just obesity alone.
Endocrine factors: Various endocrine factors like Cushing’s need to be investigated in a patient with morbid obesity before initiating treatment. Even though hypothyroidism is known to increase weight, the effects are known to reverse once the thyroid function is reverted to normal. However, hypothyroidism, when treated, is rarely a cause for severe obesity.
Medications: Certain medications like corticosteroids, antidepressants, and seizure medicines can induce weight gain and hence the patient should be counselled to take necessary preventive measures while taking them.
Depression and emotional eating: Both these symptoms are known to provoke weight gain. However, reports that have been published suggest that surgical treatment of obesity can improve depression and such behaviour.
Ageing: Hormonal changes are known to decrease your lean body mass. Hence an increase in activity is recommended as age advances.
Lack of sleep: Research shows lack of sleep increases the risk of obesity. Sleep helps maintain a healthy balance of hormones that make you feel hungry (ghrelin) or full (leptin). Lack of sleep results in higher levels of blood sugars also and may increase your risk for diabetes.
Who are at maximum risk?
Overweight and obesity affect people of all ages, sexes and racial/ethnic groups. This serious health problem has been growing over the last 30 years to reach almost an epidemic. Among Asian adults, 76 per cent of women and 74 per cent of men are overweight. This problem has not spared children and nor teenagers. Obesity has tripled among school children and teenagers. One in six between ages two to 19 are either overweight or obese.
Self observatory symptoms
Clothes are fitting tight and need a larger size
Scale shows you have gained weight
Having extra fat around the waist
Higher than normal BMI & waist circumference
The onset of diabetes, hypertension, and dyslipidemia
Joint pains
Snoring
What is BMI?
BMI is body mass index. It is calculated as below:
BMI = weight in kgs / (height in meters)
Asian consensus of BMI (JAPI Feb 2009)
BMI:
18 to 22.9: Normal
23 to 24.9: Overweight
>25: Obese
Where to find a solution?
You should seek treatment at expert obesity clinics with a multidisciplinary team of the following:
Endocrinologist
Registered dietician
Exercise physiologist
Bariatric surgeon
Psychiatrist/psychologist
Clinical social worker
(The writer is a laparoscopic and bariatric surgeon, Practo)
