Obesity and Its Consequences

Obesity is defined as excessive collection of fat (adipose tissue) in the body. Fat tissues which are widely present in adipose tissue in our body are used to store excess energy. It releases stored energy as free fatty acids for the use of other sites. This energy can be used for humans to survive starvation for as long as months. Due to the adaptation of sedentary life style these fats get deposited in our various body parts and result in many adverse health consequences.

Measures of Obesity:

• BMI (Body Mass Index) = wt. kg/ Ht2 m.

                Normal = 19-25
                Overweight= 25-3
                Obesity >30
                Morbid Obesity >40

• Waist to Hip ratio= > 0.9 (W); > 1 (M)
• Anthropometry (skin fold thickness) = mostly used in children <5>

BMI is the most important indicator used widely.

Consequences of Obesity:

The definitive cause of obesity is unknown some says it may be due to genetical inheritance or due to the high intake of foods more than required. Obesity can result from increased energy intake, decreased energy expenditure, or a combination of the two. Thus, identifying the etiology of obesity should involve measurements of both parameters. This results in many adverse health conditions as

• Diabetes Mellitus
• Reproductive Disorders: Male- hypogonadism, Gynecomastia; female- Polycystic Ovarian Syndrome
• Heart Disease: Coronary Disease, Stroke, Heart Failure, Hypertension associated
• Pulmonary Disease: may cause increased work in breathing, Severe Obesity results in Obstructive Sleep Apnea ( snoring while sleeping)
• Gallstones: Obesity is associated with enhanced biliary secretion of cholesterol, super saturation of bile, and a higher incidence of gallstones, particularly cholesterol gallstones.
• Cancer: In males cancer of the esophagus, colon, rectum, pancreas, liver, and prostate; obesity in females is associated with higher mortality from cancer of the gallbladder, bile ducts, breasts, endometrium, cervix, and ovaries.
• Bone, joint and cutaneous disease: Osteoarthritis, Gout.

Treatment:

• Behavior modification: Eating Habits, Counseling regarding weight loss.
  
• Diet: Reduced Caloric Intake. A deficit of 1000 kcal/d should cause a loss of 1 kg per week. Advantages of very low calorie diets are the greater rate of weight loss compared to less restrictive diets. In patients on such diets, blood pressure, blood glucose, cholesterol, and triglyceride levels fall, and pulmonary function and exercise tolerance improve. Sleep apnea may improve within a few weeks. Complications of very low energy diets are: fatigue, constipation or diarrhea, dry skin, hair loss, menstrual irregularities, orthostatic dizziness, and difficulty concentrating.
  
• Exercise: It plays a major role in decreasing obesity and is valuable to sustain diet. Daily means of light exercise or jogging keeps oneself healthy and prevents from other health conditions as heat diseases.
  
• Drugs: Despite modest short-term benefits from several agents, medication-induced weight loss is not a cure and is often associated with rebound weight gain after the cessation of drug use. The use of these drugs has their own side effects too. This makes it hard to prescribe for long term use in cases of Obesity.
  
• Surgery: In response to typically ineffective treatment using diet, exercise, and available drugs, surgical approaches are increasingly being employed. The potential benefits of surgery include major weight loss and improvement in hypertension, diabetes, sleep apnea, CHF, angina, hyperlipidemia, and venous disease. Two procedures in common use today are the vertical-banded gastroplasty and the Roux-en-Y gastric bypass.