What is obesity?
Obesity is defined as excessive fat accumulation in the body. But fat is an essential macronutrient. Essential fat is of paramount importance in maintenance of the integrity of cell membranes, production of sex hormones and the lining of the neural sheath, to name a few. Fat that is stored within adipose tissue is storage fat. Fat that is found beneath the skin is called subcutaneous fat and that which cushions the organs is called visceral fat. Fat is an excellent source of energy. When fat is burnt, ketone bodies are produced which can be used as fuel for the functioning of the organ systems.
Obesity is graded based on body mass index(BMI) which is a simple mathematical calculation based on the weight in kg divided by the height in metres squared. A BMI 18.5-24.9 is said to be normal, 25-29.9 is classified as overweight, 30-34.9, class 1 obesity, 35-39.9 class 11 obesity and above 40 is morbid obesity or class 111. BMI does not take into account the relative distribution of fat in various parts of the body. Hence it does not correlate with cardiovascular risks associated with abdominal obesity. Therefore other values like the waist hip ratio and the percentage of body fat have been used to help with assessment of cardiovascular risks and improvement in these past meters have been proven to have numerous health benefits. A waist hip ratio below .8 in women and .9 in men is considered normal. The body fat percentage is another scale to check whether a person is obese. In general women carry more body fat than men. Hence a value of less than 30% in women and less than 25% in men is considered normal. The preferred site of fat deposition varies between races and genders. While deposition in women is more on the hip, thighs and buttocks giving a pear shape that in men is more in the abdomen giving an apple shape. Among races the Asians are more prone to deposition in the abdomen when compared to the westerners. This makes the Asian population more vulnerable to cardiovascular events.
What causes obesity?
The causes of obesity is multifactorial- intake of large portions of food, lack of exercise, genetics, hormonal imbalance etc. Health risks due to Obesity are numerous -cardiovascular events like heart attacks, type 2 diabetes mellitus, formation of gallstones, cancers, infertility, polycystic ovarian syndrome, pulmonary embolism, psychiatric illnesses like depression and cancers.
The signs and symptoms of obesity are increased snoring, breathlessness, inability to perform sudden activities , tiredness, joint pains and depression due to low self esteem.The period of obesity is a period of great stress to the body and numerous genetic changes are triggered by obesity. Hence it has to be rectified as soon as possible
The management of obesity is cutting down of calories, increasing physical activity and treatment of hormonal problems if any. Help from a health care provider is sought to review the diet routine and make changes, so that there is a deficit in calorie intake which can result in weight loss. Too few will result in loss of lean muscle mass. Diet plans with an exercise routine can reap benefits. In addition any hormonal problems need rectification. Pharmacotherapy using drugs can also be tried. Morbid obesity may require bariatric surgery if all the other methods fail
Is obesity a disease?
Yes it is. It is a chronic lifestyle disease. Obesity trends in India are alarming and has reached epidemic proportions. The prevalence of morbid obesity is about 5%. Fast foods, accessibility to junk food in childhood and adolescence and a sedentary life style have led to the marked increase in the number of obese patients.
Obesity program is a program that analyses the present health condition and the fitness level of the individual, reviews the biometric values and then gives a nutrition prescription and an exercise prescription. It is run by the co ordinated effort of a physician, nutritionist and an exercise therapist and can give a cure for this problem if the client is determined to fight obesity.