An Overview Of The Chronic Disease Of Obesity!
Obesity is a complex, chronic disease involving accumulation of excessive amount of body fat.
It significantly increases the risk of various health problems and is a growing global health concern.
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Causes of Obesity:
The main direct cause of obesity in simple words is eating more calories than we burn in a day.
Our food provides us with the energy required to carry out our body functions and activities.
If we consume more calories than our body burns, the excess calories are stored in our body as fat and our weight increases.
Modern lifestyle and affluence means that we are consuming more high fat, high sugar, calorie rich food, including processed snacks and lead a sedentary life lacking in exercise and physical activity, directly causing obesity.
Genetic factors also influence huger, fat metabolism and fat storage.
Hormonal causes like hypothyroidism, PCOS, Cushing’s syndrome and leptin resistance also contribute to development of obesity.
Leptin is a hormone produced by the fat or adipose cells.
When our body stores adequate fat, leptin signals to the hypothalamus that the body has adequate levels of stored fat and brain reduces appetite and increases metabolism and calorie expenditure.
In Leptin resistance the brain fails to respond correctly to the Leptin signals and the appetite increases instead of decreasing and the metabolism and calorie expenditure are reduced instead of increasing and fat storage is increased.
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Diagnosis Of Obesity:
Checking weight against a standard height for weight chart
Measuring waist circumference
Calculating waist to hip circumference ratio
Calculating Body Mass Index or the B.M.I.
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Effects of Obesity:
Obesity affects nearly every system in the body.
Physical Health Effects
Hypertension
Type 2 diabetes
Sleep apnea
Fatty liver disease (NAFLD)
Joint problems (especially knees and hips)
Heart disease and strokes
Certain cancers (colon, breast, endometrial)
Mental and Emotional Impact
Depression and low self-esteem
Social stigma and discrimination
Anxiety and body image issues
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Prevention of Obesity:
Adapting a healthy food culture including whole grains cereals and pulses and legumes, fruits, vegetables, low fat milk, curds and buttermilk and if possible fatty sea fish
Limiting added sugars, refined carbohydrates and trans fats
Learning to enjoy eating light: Making sure you’re as light after a meal as before
A few weeks of practicing eating light, makes one very uncomfortable if he or she eats a heavy meal.
Regular Physical Activity
If beginning from a scratch, begin to walk at a comfortable pace, morning and evening and in between if free and gradually reaching a goal of 30 minutes, twice a day, increase pace and time as you get fitter
Gradually reaching a goal of 6 km and then more, in time.
Include strength training 2–3 times per week, preferably smaller weights and higher repetitions, on your own if you have been trained or under a good trainer
Get adequate rest and at least seven to eight hours of quality sleep at night, lack of adequate sleep increases appetite
Manage stress better, practice yoga, yoganidra, meditation, pranayama, deep breathing
Cardiovascular exercise like walking, cycling, running, swimming reduces stress.
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Treatment of Obesity:
Treatment depends on the severity and underlying causes.
Lifestyle Modifications is the first line of treatment
Adapting a personalised food and exercise plan
Writing a daily diary of food and exercise regularly and making it a regular habit
Medical treatment for obesity
Newer prescription medications like GLP-1 agonists like semaglutide (Ozempic) and liraglutide (Saxenda) have been approved in the Western countries principally for type 2 diabetes but are also being used widely to treat obesity.
They help control appetite and cravings and are used as supplementary treatment to lifestyle modifications.
Some of these medicines are gradually becoming available in India.
These medicines have gastrointestinal side effects like nausea, vomiting, diarrhoea or constipation which may settle down after a while. More serious complications like pancreatitis, gall stones, hypoglycaemia have also been reported.
They cannot on their own help much unless accompanied by lifestyle changes.
Do not confer cardiovascular fitness.
Treatment of co-existing conditions like hypertension and diabetes.
Surgical Interventions (for severe obesity)
Bariatric surgery (gastric bypass, sleeve gastrectomy)
Usually recommended for BMI ≥40 or ≥35 with co-morbidities
Patients are advised to eat protein dense low carbohydrate foods after the surgery
Most Indian people are primarily vegetarian and find it difficult to eat protein dense low carbohydrate foods as most of their protein sources are also carbohydrate dense
Also they can’t eat more than 300 – 400 calories a day for several months after the surgery as the stomach cavity is severely reduced and maximally just 500 – 700 calories a day several months later.
So gross nutritional deficiencies are as inevitable as in any very low calorie diet (VLCD)
Sustained nutritional supplements have to be taken after surgery as they can’t eat much food
Maximum weight loss achievable post bariatric surgery is 50 to 70 per cent of the total excess weight, many lose much less.
Do not confer cardiovascular fitness
Most people start regaining weight after two to three years
Gastric pouch stretching and other anatomical changes occur in five or six years and many regain all the weight they lost post surgery, unless they adapt a healthy lifestyle including healthy food and exercise habits
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The Final Verdict:
Lifestyle modification including healthy, balanced nutrition and regular exercise is the only sustainable treatment of obesity.
It confers cardiovascular fitness.
It is by far the healthiest treatment of obesity.
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For four decades now, we have successfully helped innumerable people get slim and healthy not only in our Obesity Clinic in Pune, but all over the world, on our ‘Distance Program’.
Absolutely balanced nutrition and exercise even as simple as walking have always been at the core of our Weight Loss Treatment in Pune and all over the world.
We stand apart from the much advertised Slimming Centres and Obesity clinics in Pune or anywhere else in the world, as we do not use any so called slimming medicines or slimming machines, or meal replacement herbal shakes or powders.
For more details look up the articles ‘Am I Fat?’, ‘Diseases Associated With Obesity’, ‘Simple Steps To Slimming’ and ‘Dangers Of Unscientific Treatments’ on this website.