What is obesity? How much is the prevalence? How do you know the severity of Obesity?
You will be know All About Obesity in this blog. Obesity as we all know its mothapaa or basically increased storage of fat. Overall prevalence of Obese person is nearly 30-40% and Overweight people are almost 60-70%.
Fat is a rich source of energy in between mealtime. But if we do not burn or use it by activity it goes on increasing leading to Obesity.
To diagnose it we calculate BMI and Waist circumference.
Body Mas Index i.e. BMI is Calculated as wt in Kg/Ht in meter square and waist circumference we measure at the level of superior border of the iliac crest or at midpoint between the lower border of the rib cage and the iliac crest.
Obesity has been divided into different grades; like
- If your BMI is 18.5 to 24.9, it falls within the Healthy Weight range.
- If your BMI is 25.0 to 29.9, it falls within the overweight range.
- If your BMI is 30.0 or higher, it falls within the obese range.
What are the reasons for Obesity?
Mainly Has 4 reasons: Commonest is High Calorie Intake and Lack of Physical Activity and Reare are some medical condition like Hypothyroidism, cushing syndrome, genetic Susceptibility, Drugs like steroid, antidepressant.
If you consume high amounts of energy, particularly found in high fat and high sugar foods, and do not use all of the energy through physical activity, much of the extra energy will be stored in the body as fat.
The energy value of food is measured in units called calories. The average physically active man needs about 2,500 calories a day to maintain a healthy weight, and the average physically active woman needs about 2,000 calories a day.
For example, eating a large takeaway burger, fries and a milkshake can total 1,500 calories – and that’s just 1 meal.
Eating large amounts of processed or fast food – cheaper and more convenient, and is heavily advertised and promoted.
Drinking too much alcohol – alcohol contains a lot of calories
Eating out a lot – food cooked in a restaurant may be higher in fat and sugar
Eating larger portions than you need
Drinking too many sugary drinks – including soft drinks and fruit juice
Comfort eating – some people may comfort eat due to many other factors affecting their life such as low self-esteem or low mood
Physically inactive Lifestyle:
For example work from home, sitting job,. Many rely on their cars, lifts rather than walking or cycling or use of staircase.
So If you are not active enough, you do not use the energy provided by the food you eat, and the extra energy you consume is stored by the body as fat.
Consequences of Obesity?
- It affects almost all part of like Physically, Mentally and Socially as well.
- Diabetes mellitus, hypertension, hyperlipidemia, Heart attack, heart failure
- fatty liver, Gall stone diseases
- Arthritis, Sleep apnea,
- Obesity-related cancers like GI cancer, Reproductive organ cancer
What is Ideal Body weight and caloric intake? How to calculate it?
Ideal body weight (IBW) refers to how much a person should weigh according to his or her age, gender, height and other factors.
Roughly For Men, IBW= Height in cm- 100
For Women, IBW= Height in cm -105
Ideal Caloric Intake- Men 2000-2500, Women- 1800-2000
How to manage weight?
Obesity carerequires comprehensive and multidisciplinary approach. Team should have Dietician, Psychologist, Physician/ Cardiologist, Exercise Trainer, Sometimes nurse and surgeon as well.
Management comprises stagewise approach :
- First step- Determine Degree of Overweight and Obesity
- Second Step- Personalised Assessment of comorbidities and reason for Obesity
- Third Step- Setting the Goal on the basis of BMI and other observed factors
- Fourth Step- Management- Core and Adjunctive
- Fifth Step- Maintenance and Continuous assessment
FAD Diets? What they can do?
Fad diets promote quick weight loss without taking into effect the nutrients your body needs.
These diet have severe caloric restriction can slow your metabolism and make it harder to get leaner.
That’s why most dieters are caught in a cycle of losing and gaining weight. Dehydration, malnutrition, and electrolyte imbalances are common side effects of crash diets. There is also a risk of metabolic damage and muscle loss.
Exercise?
Although only aerobic exercise has solid evidence supporting its efficacy in the literature. There is enough evidence which suggests that both aerobic and resistance exercises are beneficial for patients with obesity and related morbidities.
For this reason, all scientific guidelines recommend that at least 150 min/week of moderate aerobic exercise (such as brisk walking) should be combined with three weekly sessions of resistance exercise to increase muscle strength
Increasing physical activity reduces intra-abdominal fat and increases lean mass, reduces blood pressure, improves glucose tolerance, insulin sensitivity, lipid profile and physical fitness, improves feeling of well-being and self-esteem and reduces anxiety and depression
Further objectives should be to reduce sedentary behaviour (e.g. television viewing and computer use) and increase daily activities (e.g. walking or cycling instead of using a car, climbing stairs instead of using elevators).
Exercise advice must be tailored to the patient’s ability and health and focus on a gradual increase to levels that are safe.
Cognitive Behavioural Therapy and Psychological Support:
Cognitive Behavioural Therapy (CBT) is a blend of cognitive therapy and behavioural therapy and aims to help a patient modify his/her insight and understanding of thoughts and beliefs concerning weight regulation, obesity and its consequences;
it also directly addresses behaviours that require change for successful weight loss and weight loss maintenance.
CBT includes several components such as self-monitoring (e.g. dietary record), techniques controlling the process of eating, stimulus control and re-enforcement as well as cognitive and relaxation techniques.
Pharmacological Treatment:
Pharmacological treatment should be considered as part of a comprehensive strategy of disease management
Drugs used are according to their licensed indications and restrictions . The efficacy of pharmacotherapy should be evaluated after the first 3 months. If weight loss achieved is satisfactory (>5% weight loss in non-diabetic and >3% in diabetic patients), treatment should be continued. Treatment should be discontinued in non-responders .
Drugs Used are Orlistat which reduces intestinal digestion of fat, Lorcaserine reduces appetite, Phentermine/Topiramate, Bupropion/Naltrexone, Liraglutide.
They all are associated with minimal side effects which require continuos observation.
Bariatric Surgery:
Surgery is the most effective treatment for morbid obesity in terms of long-term weight loss, improvements of co-morbidities and quality of life and decreases of overall mortality
Surgery should be considered for patients aged 18–60 years with a BMI ≥40.0 kg/m2 or with BMI between 35.0 and 39.9 kg/m2 and co-morbidities, in whom surgically induced weight loss is expected to improve the disorder (such as type 2 diabetes and other metabolic disorders, cardiorespiratory disease, severe joint disease and obesity-related severe psychological problems).
A laparoscopic technique should be considered as the first treatment choice in bariatric surgery.
Myth and Facts about Obesity:
1. To reduce obesity, eat less and move more
Fact: A well-balanced diet is necessary to reduce weight. Reducing the amount of food may cause deficiency of micro nutrients.
2. Losing weight is a linear process
Fact: Losing weight can take a long time. The process is generally not linear, as your weight tends to fluctuate up and down by small amounts.
3. Supplements can help you lose weight
Fact: The weight loss supplement industry is massive.
People fall for the marketing tactics and want the supplements to help them lose weight.
4. Skipping breakfast is necessary to lose weight
Studies show that breakfast skippers tend to weigh more than breakfast eaters However, this is probably because people who eat breakfast are more likely to have other healthy lifestyle habits.
In fact, in a study there was no effect on weight whether the participants ate or skipped breakfast.
It’s also a myth that breakfast boosts metabolism and that eating multiple small meals makes you burn more calories throughout the day.
There are 5 important tips to manage obesity:
- Recognition and Acceptance– Self
- Assessment of the– root causes, complications. From experts
- Setting Goal– Long term- Weight target. Daily- calory intake, Exercise duration and Intensity.
- Implication and Compliance with treatment: Core-medical nutrition therapy and physical activity and adjunctive therapies that may be required, including psychological, pharmacologic and surgical interventions.
- Continued follow-up and reassessments, and encouragement to self.
There is no Shortcut to loose weight but definitively there are good results with gradual and sustained efforts with. The help of experts.