OBESITY! A SERIOUS RISK TO HEALTH

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What is Obesity?


Obesity is abnormal deposition of  fat cells (adipocytes) in different areas of the body that are a risk to health. BMI over 30 is considered obese and over 25 is considered overweight.


Is it common in Higher income countries! NOT ANYMORE


Once obesity was only prevalent in high income countries but now it is much more prevalent in low to middle income countries but particularly in urban settings.


​​


Rates of overweight and obesity continue to grow in adults and children. From 1975 to 2016, the prevalence of overweight or obese children and adolescents aged 5–19 years increased more than four-fold from 4% to 18% globally.

https://www.who.int/health-topics/obesity#tab=tab_1



WHY YOU BECOME OBESE?


The basic reason is the mismatch between intake and expenditure of energy.




WHAT CAUSES OBESITY? 


There are many reasons this could happen https://www.ncbi.nlm.nih.gov/books/NBK459357/


1. Availability and access to refined sugar products.

2. Sedentary lifestyle

3. Eating behaviors

4. Genetic causes

5. Environmental causes

6. Certain medications


COMPLICATIONS OF OBESITY


Obesity is associated with some serious complications.

1. Diabetes Mellitus type 2 ( high blood sugar levels ) 

2. High blood pressure

3. Heart 💗 disease ( deposition of fat in arteries of heart and walls of heart can lead to heart attack and weakening of heart muscles respectively. ) 

4. Cancer ( assocation with cancer of pancreas, liver, gall bladder, uterus, kidney and list continues to go on ) 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500037/#S2title


5. Arthritis ( inflammation and destruction of joints ) especially leading to knee pain as overweight individuals have excess weight on their skeleton. 





Evaluation of obesity 



  • BMI= kg/m2 ( Normal =18.5 to 24.9 kg/m2)


  • Overweight: 25 kg/m2 to 29.9 kg/m2

  • Obese, Class I: 30 kg/m2 to 34.9 kg/m2

  • Obese, Class II: 35 kg/m2 to 39.9 kg/m2

  • Obese, Class III: more than 40 kg/m2


  • WAIST TO HIP RATIO

It is calculated as per the following formula

Circumference of waist / circumference of hip 

Following picture describes the significance of waist to hip ratio and health risk associated with it.







BODY TYPES IN OBESITY AND RISK ASSOCIATED WITH THEM:

The body types used to describe obesity are termed as pear, avocado or apple depending on the distribution of fat in the body. 

  • PEAR : More fat is deposited on thigh, hips and buttocks

  • AVOCADO: This is intermediate to the body type of pear and apple.

  • APPLE: More fat is deposited around the waist and upper body ( serious health risk especially associated with heart diseases.


Health risks include all the complications that can occur due to obesity. 

Other methods include skin fold thickness, bioelectric impedance analysis, and various others. They must be performed by professionals who are accurate in interpreting the significance of results. 




HOW CAN YOU DEAL OBESITY?

Obesity treatment must be individualized after proper evaluation of a person and targeting all the modifiable factors. 


Treatment can be summarized in following 

Dietary modification

  • Low carb diet : intake of carbohydrates must be restricted to only maintenance levels and even to deficit levels where total carbohydrates given daily are low in amount as calculated for body weight maintenance where body then tries to use the reserves to curb the energy deficit and mobilizing body fat stores to provide energy thus leading to weight loss

  • Low fat diet: fat is the final product that get deposited at different sites ( stored in fat cells ) leading to obesity. Hence lowering it in the first instance will lead to use of excess fat stored in the body. 

  • Limiting unhealthy foods (refined grains and sweets, potatoes, red meat, processed meat) and beverages (sugary drinks)

Active and healthy lifestyle: 

Get out of your comfort zone ! Your body has rights over you 🗣️

  • Jogging 

  • Brisk walking ( aerobic activity of 30 mins per day is associated with less health risks and increases your endurance and boosts your immunity ) 

  • Cycling

  • Increasing physical activity

  • Limiting television time, screen time, and other “sit time”

  • Improving sleep

  • Reducing stress

Consult doctor:

This is the last thing you should be worrying about as most people who are motivated and set their goals and stick to them are more successful in losing weight. Doctors can help you out with your dietary routine and can be a check over your compliance to your commitments. They can prescribe some weight lowering medications as a last resort. 

Surgery is one of the most significant interventions and is gaining popularity since last decade. It includes procedures that decrease your appetite or bypass some part of your digestive system so excess nutrients are not absorbed thus leading to weight loss. But this comes with significant risks and must not be considered unless indicated ( As in morbid obesity). The whole spectrum of surgical procedures associated with this comes under umbrella term “ Bariatric Surgery” 

Bariatric surgery - Mayo ClinicMayo Clinichttps://www.mayoclinic.org › about › pac-20394258

WORD OF CAUTION!

When weight loss is rapid, it is also associated with complications that include:

  • Cardiac issues ( irregular heart rhythm ) 

  • Increase uric acid in your blood

  • Stones in gallbladder

  • Mood and behavior alterations




CONCLUSION:

  • Obesity is associated with serious health risks.

  • It can be assessed by an individual himself.

  • Setting goals and sticking to them is the best way to progress. 

  • Motivation and changing to a healthy lifestyle is key to success.

  • Consult your healthcare provider for any concerns.










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