Obesity a weighing issue

In our modern world with increasingly cheap, high calorie food, prepared foods that are high in things like salt, sugars or fat, combined with our increasingly sedentary lifestyles, increasing urbanisation and changing modes of transportation, it is no wonder that obesity has rapidly increased in the last few decades, around the world

Changing lifestyle, diet, stress are some of the factors leading to people gaining weight and experiencing morbid obesity complications such as diabetes, hypertension, risk of heart diseases, cancer and breathing disorders. Today, as per Indian government statistics Telangana and Andhra Pradesh ranks fifth in terms of population suffering from obesity related problems. As per the official estimates around 18 per cent of the male population and 23 per cent of female population in these two states are obese.

Causes

While there are genetic and hormonal influences on body weight, obesity in a person occurs when one takes in more calories than burned through exercise and normal daily activities. An individual’s body stores these excess calories as fat. Obesity usually results from a combination of causes and contributing factors, such as:

• Lack of activities

• Unhealthy diet and eating habits

• Pregnancy

• Lack of sleep

• Certain medications

• Medical problems

Effects

Obesity has many and serious negative effects on health. Some of the health effects associated with obesity includes the following:

High blood pressure- Additional fat tissue in the body needs oxygen and nutrients in order to live, which requires the blood vessels to circulate more blood to the fat tissue. This increases the workload of the heart because it must pump more blood through additional blood vessels. More circulating blood also means more pressure on the artery walls. Higher pressure on the artery walls increases the blood pressure. In addition, extra weight can raise the heart rate and reduce the body's ability to transport blood through the vessels.

Diabetes- Obesity is the major cause of Type 2 diabetes. This type of diabetes usually begins in adulthood but, is now actually occurring in children. Obesity can cause resistance to insulin, the hormone that regulates blood sugar. When obesity causes insulin resistance, the blood sugar becomes elevated. Even moderate obesity dramatically increases the risk of diabetes.

Heart diseases- Atherosclerosis, called the hardening of the arteries, is present 10 times more often in obese people compared to those who are not obese. Coronary artery disease is also more prevalent because fatty deposits build up in arteries that supply the heart. Narrowed arteries and reduced blood flow to the heart can cause chest pain (angina) or a heart attack. Blood clots can also form in narrowed arteries and cause a stroke.

Sleep Apnea and Respiratory problems- Sleep apnea, which causes people to stop breathing for brief periods, interrupts sleep throughout the night and causes sleepiness during the day. It also causes heavy snoring. Respiratory problems associated with obesity occur when added weight of the chest wall squeezes the lungs and causes restricted breathing. Sleep apnea is also associated with high blood pressure.

Cancer- In women, being overweight contributes to an increased risk for a variety of cancers including breast, colon, gallbladder, and uterus. Men who are overweight have a higher risk of colon, pancreatic and prostate cancers.

Metabolic syndrome- Metabolic syndrome is a complex risk factor for cardiovascular disease. Metabolic syndrome consists of six major components: abdominal obesity, elevated blood cholesterol, elevated blood pressure, insulin resistance with or without glucose intolerance, elevation of certain blood components that indicate inflammation, and elevation of certain clotting factors in the blood.

Psychosocial effects- In a culture where often the ideal of physical attractiveness is to be slim or even overly thin, people who are overweight or obese frequently suffer disadvantages. Overweight and obese persons are often blamed for their condition and may be considered to be lazy or weak-willed. It is not uncommon for overweight or obese conditions to result in persons having lower incomes or having fewer or no romantic relationships. Disapproval of overweight persons expressed by some individuals may progress to bias, discrimination, and even torment.

Medical Management

Even after lifestyle if the condition does not improve then one may require treatment by a Doctor if your own efforts to lose weight have failed and/or if co-existing medical conditions make it crucial for you to lose weight.

That treatment may include:

• Medication to treat obesity-related health problems

• Behavioral changes to improve dietary habits and increase activity levels

• Therapy to address any eating disorders (may also require medication)

Surgical Management

Bariatric (weight-loss) surgery is the best option today that effectively treats morbid obesity in people for whom more conservative measures such as diet, exercise and medication have failed. Bariatric Surgery also contributes significantly to resolving co-morbidities and regaining quality - and quantity - of life. (The author is a senior consultant, Bariatric & Metabolic Surgery at Global Hospitals)

Diet alone isn’t enough

• Eat vegetables to help you feel full.

• Drink plenty of water.

• Get tempting foods out of your home.

• Stay busy -- you don't want to eat just because you're bored.

• Eat only from a plate, while seated at a table. No grazing in front of the 'fridge.

• Don't skip meals.

By Dr K S Lakshmi