Dr. Mir Anayat
India stands third amongst a list of top 10 countries with highest number of obese people just behind US and China, according to a study published in a noted medical journal Lancet. It is important to understand the changing life style and callous attitude towards personal health care has brought this alarming rise in obesity.
We need food for our well-being and this food provides us calories for energy and nutrients for healthy body. If we take more calories than we burn, it is stored as fat in our bodies.
If we continue to overeat, we gain weight and become obese. Junk foods like pizzas, burgers, chips and fish fry, candies, coupled with increase in intake of alcohol, sedentary life style and poor health awareness are leading us to a state of silent health hazard which makes one in every five Indian men and women either obese or overweight. Obesity is treated as a chronic disease like high blood pressure or diabetes. It has many long term serious health consequences and is a leading cause of preventable deaths.
Obesity is defined as having body mass index (BMI) of greater than 30. BMI is a measure of your weight relative to your height. BMI = Weight in Kilograms / Square of height in meters. Overweight in adults is categorized as Body Mass Index of 25 kg/m2 to 30 kg/m2 and obesity as Body Mass Index of more than 30 kg/m2.
CAUSES:- when you eat more calories than our body uses up, weight gain occurs. These excess calories are converted to fat. In the beginning fat cells increase in size and than by numbers. Obesity has many causes and varies from individual to individual. Age, gender, genes, psychological makeup, socioeconomic, and environmental factors all may contribute.
Age: People tend to lose muscle and gain fat as they age, metabolismalso slows somewhat. Both of these lower their calorie requirements.
Sex: Men have more muscle than women, on average. Because muscle burns more calories than other types of tissue, men use more calories than women, even at rest. Thus, women are more likely than men to gain weight with the same calorie intake.
Genes: Your genes may play a role in efficiency of metabolismand storage and distribution of body fat.
Family lifestyle: Obesity tends to run in families. This is caused both by genes and by shared dietand lifestyle habits. If one of your parents is obese, you have a higher risk of being obese.
Emotions: Some people overeat because of depression, hopelessness, anger, boredom, and many other reasons that have nothing to do with hunger. This doesn’t mean that overweight and obese people have more emotional problems than other people. It just means that their feelings influence their eating habits, causing them to overeat.
Environmental factors: The most important environmental factor is lifestyle. Sedentary lifestyleis important factor as people tend to eat more when they are doing nothing and just sitting idly watching TV or video games. Cars dominate our life and we seldom walk or exercise. There is less time to cook healthy food and we often tend to eat fast foods. Overeating and sedentary habits (inactivity) are the most important risk factors for obesity.
Pregnancy: Women tend to weigh an average of 4-6 pounds more after a pregnancy than they did before the pregnancy. This can compound with each pregnancy.
Certain medical conditions and medications can cause or promote obesity, although these are much less common causes of obesity than overeating and inactivity. Some examples of these are as follows:
Cushing syndrome
Depression
Certain medications (examples are steroids, antidepressants, birth controlpills)
Polycystic ovarian syndrome
Obesity can be associated with other eating disorders, such as binge eating or bulimia.
Symptoms And Signs Associated With Obesity:-
Once you become obese, it becomes a life long struggle. Obesity increases your risk to many diseases and health problems, including following:-
High blood pressure
Heart disease
Stroke
Diabetes
Osteoarthritis ( knee joint and hip joint pain)
Gout
Gallstones
Lung diseases
Loss of normal sleep with sleep apnea (snoring)
Colon and endometrial cancer
Depression and dementia
Fungal infections in skin folds
Many social taboos are associated with obesity like people feel they are unattractive and cannot perform well as a result they are subjected to ridicule and discrimination, which make them to feel ashamed or rejected. It can also lead to emotional distress and later to depression. Obesity is a major risk for diabetes mellitus and it was found in clinical studies that patients at high risk were able to decrease their risk by 60% with less than 10% weight loss in three weeks.
MANAGING OBESITY:-
Treatment of obesity focuses on life style changes and proper evaluation of the condition to rule out any medical problem or medication induced.
For obesity golden rule is, lose weight is to eat less and exercise more. Any weight loss programme, including medical and surgical approaches will also include decreasing caloric intake and exercise. There are no magic pills but your efforts and strong will power is going to do the job.
Being overweight, you should have regular checkups with your doctor to monitor for the known complications of obesity like diabetes, hypertension and heart disease.
Decreasing daily calorie intake by 500 calories or expanding an extra 500 calories during exercise each day, you will lose about 1 pound per week. A good diet plan will include exercise also. You should exercise for at least 30 minutes, five times a week. Regular exercise also helps your heart and lungs and lowers triglyceride levels that can cause heart disease. Simple measures such as taking the stairs instead of the elevator and short walks eventually add up to a lot of calories burned.
Behavioral modification is changing your attitude towards food and exercise. It is easy to learn and practice. It involves recognizing and increasing awareness of situations in which you overeat so that you can stop overeating.
Women who have gained weight after having a baby is the fact that breastfeeding help you shed some extra pounds. Besides the positive effects for the baby, breastfeeding burns approximately 500 extra calories each day.
Many medications promote weight loss but they only work in conjunction with eating less and exercise more. Appetite medical suppressing medications are thought to be safe but they do have side effects and drug interactions. Some weight loss products including over- the-counter drugs are known to be dangerous and for others safety has not been established, so they should be used only under supervision of a doctor.
Many homeopathic medicines along with diet and exercise have been found safe and effective in losing weight. Liposuction is purely a cosmetic procedure that removes fat cells but has no beneficial effects on health, such as heart disease and diabetes. Surgery to correct obesity (known as bariatric surgery) is not a solution for some obese people who cannot lose weight on their own nor have severe obesity-related medical problems.
The author is a medical practitioner and assistant editor health with The Legitimate. He is also trained in dug de-addiction from NIMHANS Bangalore.
The article first appeared in print edition of July 20 to 26, 2016.
