OBESITY

OBESITY

Obesity and overweight are terms commonly used to describe individuals with increased body fat. Obesity is a state in which there is a generalized accumulation of excess adipose tissue in the body leading to more than 20 percent of the desirable weight.

Obesity invites disability, disease and premature death. Excess body weight is hindrance, leading to diseases like arteriosclerosis, high blood pressure stroke, diabetes, gall bladder diseases and osteoarthritis of weight bearing joints and varicose veins.

Usually obesity is due to positive energy balance. That is, the intake of calories is more than the expenditure of calories. 

Genetic factors: Genetic inheritance probably influences 50-70 percent a person’s chance of becoming fat more that any other factor.

Age and sex: It can occur at any age in either sex as long as the person is under positive energy balance.

Eating habits: Lack of Mastery over Mind

Eating habits of certain people may lead to obesity.

Physical activity: Obesity is found in persons who lead sedentary lives and pay less importance to physical education.

Endocrine factor: Obesity is found in hypothyroidism, hypothyroidism, hypogonodism and Cushing’s syndrome. Obesity is common at puberty, pregnancy and menopause, suggesting endocrine may be a factor in obesity.

Trauma: Obesity may follow due to damage to hypothalamus after head injury because it is not able to regulate appetite or satiety.

Body weight: An adult weighting 10 percent more than standard weight is overweight and 20 percent more is obese.

% Body weight excess of normal	Degree of Obesity
25	Mild
50	Moderate
75	Severe
100	Very severe

Body Mass Index: Also called Quilted Index

BMI = Weight (Kg) / Height2 (m)

Grading of obesity can be done based on BMI:

Grade III	>40
Grade II	30-40
Grade I	25-29.9
opt obese	< 25

1.  Grade I obesity

2.  Grade II obesity

3.  Grade III obesity

1.5 SIGNS AND SYMPTOMS:

Grade I obesity:

These people have body mass index more than 25 but less than 29.9. Overweight does not affect their health, they lead normal health and life expectancy is above normal. They may reduce on their own.

Grade II obesity:

The body mass index is between 30-39.9. For mechanical and metabolic reasons these patients are at increased risk of diabetes, atherosclerosis, hypertension, fatty liver, gall bladder diseases, osteoarthritis, hernias and varicose veins. Mortality rate also increases.

Grade III obesity:

The body mass index is above 40 and these patients are in pathetic condition. Their day-to-day activities are restricted due to their enormous mass and more susceptible to diseases mentioned in Grade II. They are susceptible to atherosclerosis, prone to accidents and have serious psychological disturbances.

1.7 TESTS:

Urinalysis

Thyroid-stimulating hormone

Blood glucose random and fasting

1.8 MEDICAL MANAGEMENT:

BMI	Assessment	Advice
18.5 – 24.9	Weight steady in adult life Gained > 5 kg in adult life	Healthy eating plan Weight maintenance with Increased exercise
25-29.9	No other risk factors Risk factors present Waistline problem	Healthy eating plan Weight reduction plan Weight reduction plan
>30		Weight reduction plan