In our current age Obesity may be the most prevalent form of
malnutrition. As time flies by it is replacing traditional health concerns
and is on its way to secure the position of one of the most significant
contributors to ill health.
According to statistics worldwide the case of obesity has
doubled from the year 1980. In 2016, there were more than 1.9 billion adults of
18 years and older who were overweight. And among them 650 million men and
women were obese. Even more concerning is that in the same year 41 million children
of 5 years or under were overweight or obese.
Commonly Obesity is defined as an abnormal growth of adipose
tissue due to an increase in the size of the fat cells or due to an increase in the number of
fat cells or due to a combination of both. Most of the time overweight is due to
obesity but some other causes like abnormal muscle growth or fluid retention
can also contribute to weight gain.
Why Obesity Occurs-
· Age-
There is no age limit for obesity and individual of all ages can
suffer equally. But it is found from studies that men between the age of 29 to
35 years and women between the age of 45 to 49 years tend to gain the most weight.
Another factor is having excessive weight during childhood.
About 1/3rd of the obese persons were overweight individuals during
their childhood. Having more fat cells from an early age leads to more rapid accumulation
as one ages and for that reason, there is more incidence of obesity in such
persons.
· Sex-
Generally speaking, women are more prone to obesity compared
to men even though there are more cases of overweight in men than women.
Women also gain an increase in BMI with each pregnancy. Recent studies
show that the increase on average is 1 kg per pregnancy. Whereas, in some developing
countries it was found that consecutive pregnancies at short intervals leading
to weight loss rather than gain.
· Genetic Influence-
A study conducted on Twins living in different environments
and diet showed a close relationship between their weights. Another study concluded
that 50-60% of abdominal fat is due to the influence of genes.
These genes are heredity and pass down from parents to
children. It is found that obese parents frequently have obese children but this
is solely not due to genes but also eating habits.
Then again when people of different ethnicity are exposed to
industrialized lifestyle, they tend to gain more weight and are more
susceptible to the development of obesity and other complications. This is due to
their genetic make-up which reacts in such fashion when the individual comes in
contact with a more affluent lifestyle.
· Physical Activity-
Lack of physical activity can lead to the accumulation of fat as
the excess calories are stored in the body. Also, reduced physical activity causes
muscle degeneration and the muscles are replaced with more adipose tissue.
In this age where physical workload is reduced due to
advanced technology and more time is passed watching TV and in sedentary form, people
are becoming more prone to life-threatening morbidities.
So, it is a must for all individuals to do some sort of physical
workout to maintain a level of fitness. But it should be kept in mind that
suddenly stopping heavy physical work can lead to a greater chance of obesity.
It’s a vicious cycle where due to sudden halt leads to
weight gain which reduces the bodies energy output leading to more severe
obesity.
· Diet-
Eating healthy is must not just to maintain a good health and
weight but also to stay safe from disease and other problems.
One should keep a tab on how much calories they are taking every day along with other essential nutrients. Foods containing artificial sweeteners,
processed food, and fast foods should not be a source of nutrients. These foods create
more problems than good. A combination of light exercise and a proper healthy diet
is the best for a good life.
It is found that diet containing more calorie than needed
can lead to Prolonged Post-Prandial Hyperlipidemia and increased deposition of
triglyceride in adipose cell leading to obesity.
It has been calculated that a child who needs 2000 K/Cal per
day if they consume 100 K/Cal extra each day will gain about 5 Kg weight each
year.
So, it is always good to maintain a very close equilibrium
between energy output and input of the body.
· Psychological Condition-
Psychological conditions are deeply related to weight
gain. People suffering from loneliness,
depression, anxiety, and frustration tend to eat more and drown themselves in a sedentary lifestyle. Excessively obese persons are often laid-back, emotionally
withdrawn, and self-conscious individuals.
They do this is to fuel the brain with the necessary energy to
cope with the stress. So, before arranging a plan for such a person an insight into
the circumstances of the individual is essential.
· Hormonal Factor-
There are some diseases out there that are mainly genetic
but causes a hormonal imbalance in the patients. Diseases like Cushing’s Syndrome
are such. Again, growth hormone deficiency can also lead to weight gain in
individuals.
For them, a simple diet plan and exercise may result in nothing
as they need to take medicines having steroids. So, for them, a complex pattern
of lifestyle formed with incorporating medical and fitness aspects is needed to
maintain good health.
· Alcohol and Smoking-
A recent study concluded that the relationship between alcohol
consumption and adiposity are generally positive for men and negative for women.
The exact relationship between smoking and weight gain is
not known. But studies show that smokers gain less weight than ex-smokers and
normal persons lie in between them.
· Drugs-
Use of certain drugs like corticosteroids, insulin, Beta-adrenergic
blockers etc. promotes weight gain. As they are steroidal drugs and promote
storing of energy as fat.
So, for people using such drugs, the Doctor needs to be consulted
for an alternative and if not possible than the management plan for such gains
needs to requested.
Assessment of Obesity
· Body Weight –
Using bodyweight to measure obesity is not an accurate
procedure but still it is easy and can be performed by anyone. That’s why it is
taken as a primary measurement technique.
For adults, some people follow other indicators. Like-
1.
Body Mass Index (BMI) – It is calculated by
dividing the weight (kg) by the square of height (meter).
2.
Ponderal Index – It is calculated by dividing
the height (cm) with the cube root of body weight (kg).
3.
Broca Index – It is calculated by subtracting
100 from the height (cm).
4.
Lorentz’s Formula – It is calculated by
subtracting 150 from height (cm) and dividing the result with 2 for women and 4
for men. And then again subtracting it from the result of the Broca Index.
5.
Corpulence Index – It is calculated by dividing
actual weight (kg) by desirable weight (kg).
Among this BMI and Broca’s Index is widely used.
· Skinfold Thickness –
Most fat accumulates underneath the skin. So, for this skin
is often used to measure the presence of total fat in the body.
This place is readily accessible and requires no invasive
procedure. Simply by using a caliper like Harpenden Skin caliper the thickness
of the skin fold can be measured. Measurements are generally taken from four
locations- Mid-triceps, Biceps, Subscapular, and Suprailiac region.
The sum of measurement should be less than 40 mm in boys and
50 mm in girls. But there is no internationally accepted standard for this
measurement.
· Waist Circumference and Waist: Hip Ratio –
Waist circumference is measured from the mid-point between
the lower end of the ribcage and the upper border of the iliac crest.
It is a simple measurement that requires no other factor for
assessment. And it correlates closely with BMI and provides an approximate
index of intra-abdominal fat mass and total body fat.
As for Waist: Hip ratio, is a simple extension of the previous
one for more accurate results. Individuals having a waist circumference of
>102 cm (Men) and > 88 cm (Women) or Waist: Hip ratio of >1.0 (Men)
and >0.85 (Women) are at greater risk of suffering from CVD and other
chronic disease.
Complications of Obesity-
There are myriad of possible complications in the case of
obesity. Some of these can make one suffer greatly while others can directly
take lives.
· Increased Morbidity –
Obesity can actively enhance the possibility of many diseases
and also create more difficult complications for treatment for the existing ones.
The diseases and complications influenced by it are
o
Hypertension
o
Diabetes
o
Coronary Heart Disease (CVD)
o
Certain cancer. Like- Bowel cancer
o
Hormonal Imbalance
o
Renal Disease
o
Gall Bladder Disease
o
Varicose Vein
o
Abdominal Hernia
o
Osteoarthritis of Knee, Spine, Hips
o
Flat Feet
o
Psychological Stress especially in adolescents
o
Increased Risk from Surgery
o
Lowered Fertility.
o
Lowered Life Expectancy
· Increased Mortality –
According to a study of Framingham Heart Study of USA people
with obesity suffered 20% more from sudden death compared to others.
The reason behind it is the increased blood pressure,
Coronary Heart Disease and also Renal failure. But the exact mechanism behind
it is still not clear and more study is needed.
|
Greatly Increased Weight |
Moderately Increased Weight |
Slightly Increased Weight |
|
Type-2 Diabetes Gall Bladder Disease Dyslipidemia Insulin Resistance Breathlessness Sleep Apnea |
Coronary Heart Disease Hypertension Osteoarthritis Hyperuricemia Gout |
Cancer (Breast cancer in Postmenopausal women, Endometrial
Cancer, Colon Cancer) Reproductive Hormone Abnormalities Polycystic Ovary Syndrome Impaired Fertility Low Back Pain Increased Risk of Anesthesia Complications Fetal Defects |
Control and Prevention of Obesity –
Control of weight should not begin after becoming
overweight. Rather it should start from an early age. Because obesity is harder
to treat in the case of adults. So, starting from an early age prevents undue
complications and a hassle-free management plan can be followed.
Steps to Prevent and Control Obesity –
· Dietary Modifications –
As mentioned before, such a diet has to be followed so that
the energy input and output is almost equal.
Also, foods
containing simple carbohydrates and lots of saturated fat should be avoided as
they are more likely to deposit and cause hypertensive problems.
· Increased Physical Activity –
Physical activity is required for people of all ages and sex.
It helps to keep muscles active and body energized.
Exercise not only consumes a lot of energy but also helps to
break down fats and remove harmful components from the body. That’s why regular
exercise is a must.
· Others –
There are some other factors regarding which care should be
taken. They are-
o
Not eating artificially sweetened foods
o
Not eating Processed food
o
Avoiding Fast Food
o
Avoiding Smoking and Alcohol.
o
And last but not the least having an open mind
so that depression can’t get the best of you.
Obesity cannot be treated within days. It requires time and
dedication. So, one should not hope for quick recovery or a miracle medicine
that can show rapid tangible results.
There are some treatment procedures like –
o
Taking Appetite Suppressing Drugs.
o
Jaw Wiring
o
Gastric By-pass
o
Gastroplasty
But the result of these procedures is limited and often best
to avoid.
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