Obesity (Excessive Body Weight and Fat)

Definition

Obesity is a medical condition characterized by excessive body fat accumulation leading to a number of health problems and subsequent reduction in quality of life and life expectancy. The various health problems that can arise from obesity are respiratory difficulty like asthma, high blood pressure, high cholesterol, triglyceride, diabetes, arthritis and various other medical conditions.

An intake of excessive amounts of high calorie foods, physical inactivity and genetic makeup are the common contributing factors in obesity. Weight reduction can be achieved through exercise, dietary modification, drug intake and surgery. Obesity still remains the main health-related problem throughout the globe and its incidence is rising, even among children.

Symptoms

The main symptom of obesity is accumulation of body fat to such an extent that the person develops other diseases. Body mass index (BMI) is the parameter used to diagnose obesity. BMI is expressed as weigh in kg (kg) divided by height of the person in meters squared (m2). Alternatively pounds and feet can be used.

Depending upon the BMI, people are classified into a number of weight categories such as :

  • BMI less than 18.5 = underweight.
  • BMI between 18.5 and 24.9 = normal.
  • BMI between 25 and 29.9 = overweight.
  • BMI between 30 and 34.9 = class I obesity.
  • BMI between 35 and 39.9 = class II obesity.
  • BMI above 40 = class III obesity

As BMI does not directly measure the fat content of the body. Sometimes muscular athletes may be included in the obese category despite a lack of body fat. Obesity contributes to a number of health related problems like :

  • Respiratory diseases like asthma and obstructive sleep apnea which are characterized by repeated episodes of sudden awakening from sleep in the middle of the night due to complete cessation of breathing.
  • High blood pressure.
  • Diabetes mellitus type 2.
  • Increased chance of heart attack and angina.
  • High level of cholesterol, triglyceride and LDL.
  • Stroke.
  • Depression.
  • Gallstones.
  • Osteoarthritis typically affecting the weight bearing joints like the knee.
  • Gout.
  • Low back pain.
  • Erectile dysfunction.
  • Hypogonadism.
  • Infertility.
  • Irregular menstrual bleeding.
  • Polycystic ovarian syndrome (PCOS).
  • Complications during pregnancy such as birth defects and intrauterine death of fetus.
  • Migraine.
  • Multiple sclerosis.
  • Certain type of cancers like those in uterus, cervix, breast, colon , rectum an prostate.
  • Poor wound healing.
  • Stretch marks.
  • Cellulitis.
  • Gastroesophageal reflux disease.
  • Non-alcoholic fatty changes in the liver.
  • Urinary incontinence.
  • Renal failure.

Causes

Whenever there is imbalance between calorie intake in food and calorie output in physical activity, excessive fat may accumulate in the body thereby leading to obesity. Genetic and hormonal factors may also responsible for obesity. An interplay of the following factors usually leads to obesity :

  • Physical inactivity.
  • High calorie foods and beverages.
  • Poor eating habits including opting for high calorie foods, skipping meals and then having a larger meal and eating large portions.
  • Inadequate sleep leading to hormonal imbalance and increase craving for carbohydrate and fat-rich food.
  • Intake of certain drugs like antidepressants, antiepileptic drugs, steroids and oral contraceptive pills.
  • Certain diseases may also lead to obesity namely Cushing’s syndrome, polycystic ovarian syndrome (PCOS), hypothyroidism and Prader-Willi syndrome.

Risk factors

  • Genetic makeup.
  • Sedentary lifestyle.
  • Food habits.
  • After quitting smoking.
  • Lack of sleep.
  • Age.

Treatment

The aim is to attain a healthy body weight and maintain it. Ideally conservative measures should first be tried for a long period of time before drugs or surgery is considered. Treatment options include :

  • Change in eating habits and choice of foods, such as low-calorie diets and low glycemic index (low GI) eating plans.
  • Regular exercise with calorie output to burn calories consumed in food.
  • Drugs such as orlistat and phentermine. Diuretics (water pills) only increases water output in urine and drugs for an underactive thyroid gland should never be used for weight loss.
  • Surgery is required for patients suffering from serious health related problems due to obesity or morbidly obese (BMI>40).

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