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Understanding
obesity
Its consequences and possible remedy :
Obesity is considered a disease & not only
the effect of simply over eating. Definitely
there is imbalance between energy intake and
output as it was a belief that weight can
not be gained from air. Causes of over
weight/ obesity are (i) The increased food
intake specially of high calorie food than
the person expends. (ii) Sedentary life
style i.e, sitting & eating infront of TV,
watching long cricket matches & not playing,
computer games, using automobiles instead of
walking etc. (iii) Some endocrine disorder
e.g. Hypothyroidism, cushing syndrome. (iv)
Genetic i.e. from parents or even from fore
fathers. (v) Viral infection e.g. 33% of
overweight or obese patients are infected
with adino virus Ad-36. (6) Metabolic
disorder i.e. if two monozygotic twins are
given same high calorie diet both will gain
weight but it has been observed a big
difference in gaining weight, from this
observation it can be suggested that similar
amount of food can cause obesity to one &
normal weight to another person.
How would you messure your obesity?
This is a very simple method take your
weight in kg & height in meter. You have to
calculate your BMI (Body mass index)
BMI
= BMI from 18.5 to 25 is normal, 25.1 is
over weight, 30.1-35 is obesity & above 35.1
is considered as morbid obesity. Waist and
hip circumference has also to be measured.
If waist circumference of man is more than
102cm & 88cm in a woman is also considered
as obese persons.
Why obesity should be considered a
disease?
It has been estimated that an obese person
looses at lest 15years of his life i.e. he
has a big chance of dying 15 years before
his contemporary fellows. Obesity has
definite increased risk of developing very
serious diseases e.g. Type-II diabetes,
hypertension, coronary artery disease (heart
disease), CVA (Cerebro vascular accident)
obstructive sleep apnea (Breathing stops at
night) lipid disorder joint and spine
disorder etc.
Does obesity need any treatment?
Like hypertension and diabetes, obesity
or overweight needs medical attention.
Doctor has to find out the possible medical
causes of overweight or obesity. If no cause
detected than the doctor advises weight
reduction program. In case, any cause for
obesity is detected that has to be treated,
doctor also has to detect any co-morbid
conditions like diabetes, hypertension.
Sleep apnea, joint problem, lipid disorder
etc.
How to lose weight?
This is one of the most difficult task
for the over weight / obese person and also
for the doctor. Nonetheless the following
recommendations can be made.
(1) Diet: If you are not doing any
physical work your minimum intake for
calorie requirement is 1500k cal/day. Now
one has to understand 1 gm carbohydrate
(rice, bread) gives you 4K cal, 1gm fat
gives you 9K cal, 1gm protein gives you 4K
cal. So fat diet has got maximum calories.
You can not omit fat at all from your diet
because there are essential fatty acids
required for your life. You can choose many
options and your nutritionist can formulate
your diet according to your need.
(2) Behavior & change of life style:
This is also not easy. But what you can do
is to stop using remote control for your TV
& go & manipulate manualy. You can avoid
automobiles for short distance, you can stop
computer game.
(3) Eating habit : you should eat in
time and slowly, do not eat quickly and do
not eat in between meals but if you are
hungry you can take non calorie vegetables
e.g. cucumber. Don't drink water or other
liquid just after your main food, drink at
lest one hour after food. Do not eat while
you are watching TV.
(4) Exercise : Importance of exercise
is very big in weight control. Regular
exercise is mandatory. Swimming is the best
but if that is not possible you can do
cycling or walking. Start with ½ hour daily
and 5 days/ week and increase it up to 1
hour daily and 5days/week.
(5) If all these fails only than you need
medical / surgical treatment.
When to start losing weight?
If your BMI exceeds 23kg /m2, You should
start with diet behavior change and
exercise. If your BMI exceeds 30kg/m2 you
should take medical/surgical treatment.
Unfortunatly at present there is no good
medical treatment available and some agents
e.g. sibutramine & orlistat are available in
the market but these agents need prolonged
use and only 1 to 2% weight loss observed
after 6 months of treatment. At present
various surgical treatment available.
Principals of surgical treatment are to (a)
decrease the size of stomach, so that the
person does not feel hungry even after
taking very small amount of food. (b)
Preventing absorption of eaten food. All
these
operation can be done laparoscopicaly like
laparoscopic gall stone operation.
Unfortunately at present the instruments &
machineries for operation is costly and need
life long follow up.
Obesity is a disease if you think you have
this problem you can measure your BMI, your
waist circumference and you can easily find
out your position. Try to prevent overweight
/ obesity and live longer.
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