Obesity is a composite condition, with serious social and psychological dimensions, and one that can affect practically anyone, ranging across various age and socioeconomic strata. It poses an overwhelming threat to both developed and developing nations.
The Body Mass Index (BMI), or weight-to-height ratio, is currently the most common measure we use to determine if adults are within the healthy limits of weight for their respective heights. For most adults, an ideal BMI is in the 18.5-24.9 range. If a person’s BMI is higher than 25, his weight is more than what is ideal for his height. “Overweight” is defined by the WHO as having a BMI greater than or equal to 25 and lower than 30, while “obesity” is having a BMI equal to or greater than 30.
Located at the other end of the malnutrition spectrum, obesity is one of today’s most brazenly visible yet most neglected public health problems. Global obesity, or “Globesity,” is now taking over many parts of the world, becoming an issue warranting major concern, particularly in some Asian countries. Dr. Praveen Raj of Gem Hospitals Coimbatore, India, states that Obesity is a metabolic syndrome where it is a metabolic abnormality internally, that is responsible for obesity and diabetes which has evolved to be the biggest epidemic of today.
There is a common view that men are more prone to being overweight, while obesity favors women. This being said, obesity poses a major risk for contracting serious non-communicable diseases (NCDs), including diabetes mellitus, certain cancers, cardiovascular diseases, sleep apnoea, hypertension and stroke. Its health consequences range from increased risk of premature death to serious chronic conditions that reduce the overall quality of life.
What causes obesity?
- Obesity typically results from over-eating (especially an unhealthy diet) and lack of enough exercise. With the rise in fast food, together with the exponential growth of fast food joints providing cheap and quick meals, it is not surprising that this epidemic is spreading rapidly the world over. With the consumption of these foods, which are high in salt, sugars and fat, combined with our increasingly sedentary lifestyles, increasing urbanization and changing modes of transportation, it is no wonder that obesity has rapidly increased globally over the last few decades. Healthy eating is very often more expensive than less healthy options.
- Another common cause of obesity is attributed to genetics. A person is more likely to develop obesity if one or both parents are obese. Genetics also affect hormones involved in fat regulation.
- Medications can also cause the side effect of weight gain. Some of these belong to the class of antidepressants, anticonvulsants, diabetes medications, antihypertensive drugs and antihistamines, oral contraceptives, and most corticosteroids.
- For quite a few people, emotions influence their eating habits. Many individuals eat excessively in response to stress, sadness, or simply because they are bored. It has been found that about 30 percent of people who seek treatment for serious weight problems are dealing with the habit of binge eating.
- Certain diseases such as hypothyroidism, polycystic ovary syndrome (PCOS), and Cushing’s syndrome are also contributors to obesity.
- In general, women tend to gain weight surrounding events such as pregnancy, menopause and sometimes with the use of oral contraceptives.
- Levels of physical activity can also affect obesity.
- Socioeconomic inequality can lead to different groups being disadvantaged and having less access to needed resources and healthier foods.
Is there a solution to this epidemic?
Since obesity is a chronic illness, its solution needs to be an on-going and lifelong process. Very often, obese individuals take up strenuous diet plans to achieve their “ideal body weight.” It must be understood that these diets may aid in a certain amount of weight loss but are not a permanent fix. It should also be noted that once the individuals resume their regular diet, the lost weight returns. Most people who lose weight regain it within five years. The goal of treating obesity should not be to strive towards an ideal weight but should be to establish a healthier weight. Here are some factors to consider as a part of a healthier lifestyle to combat obesity.
Eat and work out right!
A safe and effective long-term weight reduction and maintenance diet has to contain balanced foods to avoid deficiencies and malnutrition. Eating right would signify consuming a protein rich diet with reduced intake of carbohydrates. Make sure to increase consumption of complex carbohydrates compared to simpler ones that are easier to digest. Perform 20-30 minutes of moderate cardio exercise five to seven days a week. Something as simple as a half hour of brisk walking every day could aid in leading a healthier life and keeping one’s weight in check.
Do medicines play a significant role in weight loss?
Several FDA-approved over the counter drugs claim to aid in weight loss. While studies have proven that certain medicines do help, they should be used only as an adjunct to diet modifications and an exercise programme. Medications, in general, should not be taken for cosmetic reasons and must be used only by individuals who are at risk of other obesity-related illnesses.
Can surgery help?
Surgery is one of the most effective solutions in the management of obesity. It is, however, indicated by the National Institutes of Health only in:
- Patients with a BMI of greater than 40
- Patients with a BMI of greater than 35 who have serious medical problems such as sleep apnoea that would improve with weight loss
Cosmetic surgery, like liposuction and resection of portions of fat and skin, or a combination of the two, are done mainly to alter a person’s physical appearance. In other words, you can see that the change is only on some specific parts of the body and only on the fatty tissue found right under the skin. It does not particularly deal with the problem of obesity. Cosmetic surgery only changes the physical appearance of those parts of the body that “bother” the patient and they want to modify.
Over the past three decades the treatment protocol that has grown in popularity is bariatric surgery. This procedure is a metabolic surgery that addresses the problem of obesity at the grass root levels, reducing the amount of overall body fat, i.e., visceral fat and under the skin, by reducing the percentage of it in the entire body. Currently, there are basically two types of bariatric surgery:
Restrictive surgeries: These surgeries restrict the size of the stomach and slow down digestion.
Malabsorptive/Restrictive surgeries: These surgeries restrict the size of the stomach but also bypass or remove part of your digestive system to decrease absorption of food/calories.
Bariatric surgery is a necessity for management of obesity in those who are unable to reduce their weight by regular and simpler means. The role of bariatric surgery is not just in the treatment of obesity, but in addressing all the components of metabolic syndrome including poly cystic ovarian syndrome , non-alcoholic fatty liver disease ; obstructive sleep apnea etc., says Dr. Praveen Raj. The best solution for weight management, however, is always to take the preventive route. Opting for healthier eating habits and adding activities to the day’s schedule to break up your sedentary lifestyle cycle are the best places to start.