Obesity

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. An increase of 20% or more above the “ideal body weight” is the point at which excess weight becomes a health risk. India is now facing an epidemic of obesity with about 5% of its population having morbid obesity. (NFHS 2007). Indians are genetically susceptible to obesity especially around the waist

What causes obesity?

Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity and genetic susceptibility although a few cases are caused primarily due to hereditary causes, endocrine disorders, medications or psychiatric disorders

Morbid obesity is a complex multi factorial, chronic disease, where weight and symptoms build up slowly over time. Obesity becomes “ Morbid” when it reaches the point where it has an adverse effect on health, particularly causing heart disease, type 2 diabetes, obstructive sleep apnoea, certain types of cancer and osteoarthritis. Class II and class III obesity is considered morbid obesity.

Body Mass Index (BMI) is a tool to measure the extent of obesity, where weight and height are used in a formula. 

BMI = Weight in kgs/(Height in meters2).

Classification of Obesity

  • Overweight (pre-obese) if BMI is between 25-  29.9
  • Class I Obesity if BMI is between 30- 34.9
  • Class II Obesity if BMI is between 35 – 39.9
  • Class III Obesity if BMI is =/>40

Overweight and class I obesity can usually be treated with diet modification, exercise and behavioural changes and do not require surgery. Class II and III require bariatric surgery

Consequences of Morbid Obesity

  • Cardiac disease
  • Arteriosclerosis
  • CVA
  • Renal failure
  • Hypertension
  • Hypercholesterolemia
  • Type-II Diabetes mellitus
  • Drowsiness (day time)
  • Sleep Apnea
  • Heart Burn
  • Barrett's oesophagus
  • Gallstones
  • Jaundice
  • Stress urinary incontinence
  • Accelerated arthritis of spine
  • Degenerative arthritis of the Hip, Knees
  • Venous stasis in legs
  • Anxiety
  • Depression
  • Pseudo tumor cerebri
  • Migraines
  • Polycystic ovarian syndrome
  • Asthma
  • GERD (Gastro esophageal reflux disease)
  • Infertility
  • Pregnancy complications

 

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