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
- Renal failure
- Type-II Diabetes mellitus
- Drowsiness (day time)
- Sleep Apnea
- Heart Burn
- Barrett's oesophagus
- Stress urinary incontinence
- Accelerated arthritis of spine
- Degenerative arthritis of the Hip, Knees
- Venous stasis in legs
- Pseudo tumor cerebri
- Polycystic ovarian syndrome
- GERD (Gastro esophageal reflux disease)
- Pregnancy complications