Obesity is a pretty familiar and common term in today’s world. Everyone desires a perfect body and shape, or at least we are forced to desire such things through various notions, cultural or societal pressure. This develops inherently from a very young age from growing up hearing a lot of such stuff. But, before we get started upon knowing obesity we should understand obesity has a lot to it than just appearing fat and feeling insecure. It is a serious condition that gives rise to a lot of secondary health conditions or further aggravates or worsens the existing conditions.
During the prehistoric era,
Natural selection favored genotypes that could endure certain harsh conditions, by stocking most fat.
Hence, getting back by a few centuries we could find that obesity was not even considered an unhealthy condition. This became a matter of concern only during the late 18th century.
With chronic malnutrition being the norm for the most part of human history our genetics evolved to favor fat storage, giving rise to modern-day obesity. In recent times, access to a lot of processed food and nutrition this became a disease process. What was once an advantage for survival is now working against us. Apart from that calorie-dense processed food and growing portion sizes coupled with pervasive marketing lead to passive over-eating. On the other hand, scarce resources and lack of or limited access to healthy and affordable food creates an even greater risk in certain disadvantaged communities.
According to the World Health Organization and National heart, lung, and blood institute (NHLBI) obesity is classified as an epidemic. From a global perspective, the increase in the prevalence of obesity is also alarming.
Obesity according to the world health organization (WHO) is an abnormal or excessive fat accumulation that presents a risk to the health of a person.
Obesity is also responsible for more than 300,000 deaths a year.
Obesity in proper terms can be explained as,
Obesity can be defined as an abnormal growth of the adipose tissue due to an enlargement of fat cell size or an increase in fat cell number or a combination of both.
TYPES OF OBESITY:
- Hyper tropic obesity (obesity that occurs as a result of an increase in the size of the cell)
- Hyperplastic obesity (obesity that occurs as a result of an increase in the number of cells)
- Combined or mixed.
WHY OBESITY OCCURS?
Obesity is caused by an imbalance of energy in the body. In other words, it is an excess storage of fat in the body. Storage of fat is a normal physiological process and therefore our bodies are designed to store extra calories as fat. Obesity occurs when the energy input from calories exceeds the energy output from physical activity. A combination of circumstances and choices also play an important role in making a person obese.
Genetics plays an important role in causing obesity.
- Studies on families and separate twins have shown a clear causal hereditary relationship to weight gain
- Recent studies have shown a link between obesity and variation in bacterial species that live in our digestive system.
However, in most cases, genes and behavior along with a combination of behavioral, metabolic, environmental, cultural, and socio-economic influences are important for obesity
HOW DOES THE BODY NORMALLY REACT TO EXCESS FAT?
As we know, the body reacts to every single thing we throw at it. The same applies in the case of obesity, the body deals with the extra calories in three different ways.
- The body might burn away the extra calories during physical activities like exercise, household work, etc.
- Convert the excess fuel to fat and store them in the adipose tissues
- It might sometimes waste the calories by converting it into heat and driving it away from the body.
Hence, it is very important to understand that a lot of process takes place inside the body (both hormonal and neuronal) to maintain this delicate balance between calorie intake and expenditure as energy.
BODY MASS INDEX:
Whenever we come across obesity or read something about it we can never miss the word “BMI”. So what is BMI basically?
Almost every one of us can answer that question quickly. It is the abbreviated form of the word ‘Body Mass Index. All of us wouldn’t have crossed our schooling years without writing the basic definition of this term along with a formula and an example to illustrate BMI. It simply goes on like a simple way of assessing the body’s mass by means of dividing the weight in kilogram by the height in meter square. This helps us to evaluate weight relative to height. Helps us to correlate significantly with the body fat, mortality, and morbidity of the patient.
The formula goes like,
BODY MASS INDEX (BMI) = WEIGHT (In Kg)/ HEIGHT (In metre square)
For example, if a person weighs 65 kilograms and is 1.5 meters tall the approximate body mass index of the person would be somewhere around 29.
So, obesity in terms of body mass index could be defined as a condition of excess body fat that occurs when a person’s body mass index is above 30.
The classification of obesity according to BMI, (from recent FAO/WHO/UNU)
|CLASSIFICATION||BMI||RISK OF COMORBIDITY|
|Underweight||<18.50||Risk of clinical problems|
Is BMI the only way of assessing whether the person has a healthy weight?
The answer is ‘no’.
There are a lot of other scientifically proven methods to assess our health in terms of weight. In fact, BMI is not such an accurate means of assessing our body mass. For instance, athletes have a higher than normal body mass index and don’t fit under the perfect category of being ‘normal’ (19.0 to 25.0), rather they might come out as being overweight or obese. This does not necessarily mean they are overweight .such results tend to occur because under these circumstances the athletes or physically overactive people having a higher muscle mass’ than the general population. This muscle mass is a result of many years of constant physical activity given to particular regions of the body. For example, professional weight lifters focus on developing and maintaining their biceps, triceps, calf muscles to name a few.
Hence circumstances like these led us to search for alternative ways of assessing the body’s mass accurately. Some of them include
This is one common method of assessing obesity. It is very simple and quick. A standard measuring tape is used and the idea behind this test is, adverse consequences of obesity are most closely correlated with the accumulation of intra-abdominal fat.
The circumference of the waist around the level of the iliac crest is measured, making sure the tape lies flat and intact without any bends or twists. Further, the tape should neither be held too tight nor left very loose.
A waist circumference greater than 35 inches (88cm) in women and 40 inches (102 cm) in men is considered a health risk or an abnormality.
WAIST TO HIP RATIO:
- The circumference of the waist at the level of L3 (Lumbar part of the spinal column) divided by the circumference of the hip at the largest area of the gluteal region (helps to identify and differentiate between central and android obesity)
- The waist to hip ratio for men should be >1
- The waist to hip ratio for women should be >0.85
Other ways of measuring obesity:
- X-ray absorptiometry
- Bioelectric impedance analysis (BIA)
- Skinfold thickness measurement
HEALTH PROBLEMS ASSOCIATED WITH OBESITY:
As we already discussed a lot of health problems are associated with obesity. The degree to which obesity has influenced these issues might change. We can categorize them as follows
CONDITIONS WHERE OBESITY PLAYS A MAJOR ROLE:
Gall bladder disease
CONDITIONS WHERE OBESITY PLAYS A MODERATE ROLE IN THE DISEASE PROCESS:
Coronary artery disease
Osteoarthritis of the knee
CONDITIONS WHERE OBESITY PLAYS A MINIMAL ROLE IN CAUSING THE DISEASE PROCESS:
Polycystic ovarian syndrome (PCOS)
Cancers of the breast, colon, prostate, and endometrial layer
Reproductive hormonal abnormalities
Certain complications that arise after administering anesthesia
Apart from these an unhealthy weight might promote a lot of pathological fractures especially in women after menopause and puts a lot of pressure over the weight-bearing joints of the body like the knees and ankles.
AVOIDING OBESITY AND MAINTAINING A HEALTHY BMI:
It is said that adults need 2.5 hours of any form of physical activity like running, jogging, aerobics, swimming, etc. and children might need 1 hour of physical activity every day.
But the truth is almost 1 in every 4 adults and 8 out of every 10 adolescents aren’t physically active or don’t engage in any form of physical activity.
Once obesity sets in, the climb to recovery becomes progressively steeper. The hormonal and metabolic changes might reduce the body’s response to over-eating therefore after losing weight a formerly obese person burns fewer calories doing the same exercise as a person who is naturally the same weight making it much difficult to further shed the excess fat. As people gain more weight damage to the signaling pathways makes it increasingly difficult for the brain to measure our food intake and fat storage.
Some simple means of avoiding obesity are,
- Regular exercise in any form. It might be any form of physical activity. The important point to note is sticking to a routine and gradually increasing the intensity. It is always best to do your exercises under a trained professional if you choose to have your daily portion of physical activity based on gym types of equipment since overdoing any form of exercise or doing it in a wrong manner might cause a whole lot of problems by itself.
Now, forget the clichéd version of this word that is synonymous with fad diets. Diets are not simply eating fat-free food or taking fewer portions of your favorite food. Diet is a way of living or rather a whole lifestyle. Never plan a diet if you’re not ready to stick to one for your whole lifetime. It is not something we adhere to until we lose weight and leave it after we achieve our desired weight goal. No, it does not work that way.
To put things out straight,
- It is wise to plan a diet with a help of a nutritionist or dietician since they may know what your body needs and plan it according to your health condition.
- Always keep in mind to stick to native forms of diet. For example, if you are a south Indian stick on to the staple diet that is consumed here rather than the fancy western diets.
- Avoid processed and readymade food as far as possible
- Water plays an important role in weight loss. So most importantly, consuming the required amount of water at frequent intervals is a key to maintain the body’s weight
- At any cost never skip meals especially breakfast. As the name implies ‘break-fast’ we are breaking away the long periods of fasting (throughout the night). Hence we should never skip the first meal of the day.
- Stop the habit of ‘binging’. Practice taking meals at regular intervals. Further, one important tip given by dieticians is, planning a day’s meal beforehand, breaking down the components, and spacing it out to consume at very frequent intervals like every 2 hours.
- Add greens and grams to daily food. Proportionate the food by taking more vegetables and less rice (especially the white variety). On the other hand, if you are a non-vegetarian by habit, consume less red meat and switch on to more seafood.
- Alcoholism is a ‘must avoid’ while planning to lose weight.
PHARMACOLOGICAL MEANS OF INTERVENTION:
It is important to understand that intervention through drugs is needed only when the patient falls under the category of being obese. Self–medication does more harm than good.
- A body mass index of >30 kg/meter square or 27 kg/meter square along with existing co-morbidities and previous behavioral modifications that were unsuccessful
- These medications could be successful only in conjunction with dietary modifications and exercise and they might not lead to drastic weight loss rather they maintain and prevent any further weight gain.
- These patients should also be careful while taking medication for other conditions since those drugs might indirectly cause some weight gain. It is always advisable to explain to the doctor clearly of existing conditions and to constantly keep an eye on their levels.
One particular specialty that deals with weight loss and related problem are the ‘bariatric surgery’
These include a variety of procedures like sleeve gastrectomy, Roux en-Y gastric bypass, etc. However, they are mainly done to achieve altered gut hormone levels responsible for the feeling of hunger and satiety (feeling of having enough of something). Bariatric surgeries are usually done as a last resort of treatment if other lines of treatment fail or in cases where weight loss is inevitable for the patient. This is basically, planned by the bariatric surgeon after strictly assessing the patient’s body condition and after deciding the pros and cons of the surgery.
So, having read about obesity and the serious consequences it causes, it is always good to stay away from unwanted habits and behaviors that might promote obesity. Therefore, stop the excuses and dust up those favorite pair of jogging shoes, and march your way to a more healthy and attractive future.