Prevention and control of obesity

          Prevention and control of obesity

<25 BMI is normal 

Obesity  

  Nowadays a simple formula for measuring by The National Institutes of Health  (NIH) defines simply if one's BMI is less than <25 then it is normal, similarly, if  BMI= is between 25 and 30 then it is called overweight.  A BMI above >30 is called obesity.

The BMI (body mass index) is calculated by dividing measured body weight in the kilograms by the height in meters squared.

Upper body obesity(excess fat around the waist and flank) is a greater health hazard than lower body obesity (fat in the thighs and buttocks).

Obese patients with increased abdominal circumference 102 cm in men and 88 cm in women) or with high waist-hip ratios (1.0 in men and>085 in women) have a greater risk of diabetes mellitus, stroke, coronary artery disease, and early death than equally obese patients with lower ratios.

Further differentiation of the location of excess fat suggests that visceral fat within the abdominal cavity is more hazardous to health than subcutaneous fat around the abdomen.

Causes of obesity  

Obesity was considered being the direct result of a sedentary lifestyle plus chronic ingestion of excess calories. Although these factors are undoubtedly the principal cause in many cases, as much as 40-70% of obesity may be explained by genetic influences.  

Studies demonstrate substantial genetic influences on BMI with little influence from the childhood environment. Most human obesity undoubtedly develops from the interactions of multiple legends, environmental factors, and behaviour. 

Less than 1% of obese patients have an identifiable secondary, nonpsychiatric, cause of obesity. Hypothyroidism and Cushing syndrome are important examples that can usually be diagnosed by a physical examination in patients with unexplained recent weight gain. 

Such patients require further endocrinologic evaluation, including serum thyroid-stimulating hormone (TSH) determination and dexamethasone suppression testing.

Some common  causes of obesity 

• Lack of sleep  

• Greasy and processed food  

• Lack of physical exercise  

• Overeating  

• Medication  

• Depression  

• During pregnancy  or after delivery 

Complications of obesity 

Myocardial infarction:  Obesity increases the chances of MI  (Myocardial infarction ) because obesity raises cholesterol level in the body, and blood clots due to rising cholesterol level because of this blood circulation suddenly stop flowing to the heart.

Stroke: Obesity can also cause a stroke because obesity raises blood pressure and the brain's blood vessels rupture due to high blood pressure.

Diabetes: The more obese a person gets, the more likely he or she is to develop diabetes type 2.

Polycystic ovarian disease ( PCOD):  Obesity can be caused by Polycystic ovarian disease (PCOD), due to which affects women's menstruation and that makes it difficult to conceive.

Fatty liver: Obesity can lead to fatty liver, which can lead to indigestion later in life, and because of this, the body also becomes anaemic.

Obesity cause joint pain. Arthritis is a common problem in people today, and arthritis is also caused by obesity.

Can obesity cause cancer?

Of course, some types of cancer can be caused by obesity like breast cancer, gallbladder cancer, Kidney cancer or uterus cancer.

Prevention and control of obesity

Using conventional dietary techniques, only 20% of patients will lose 20 lb and maintain the loss for over 2 years; 5% will maintain a 40-lb loss. Average weight loss is approximately 7% of baseline weight.

 For most patients incorporate the same principles that apply to healthy people who are not obese. Special attention is usually paid to limiting foods that provide large amounts of calories without other nutrients, ie, fat, Sucrose, and alcohol. 

There is no physiologic advantage to diets that restrict carbohydrates, advocate relatively larger amounts of protein or fats, or recommend ingestion of foods one at a time. 

Diets that are restricted in carbohydrates (such as the Atkins and South Beach diets), however, can be effective in achieving a lower total calorie intake. Several studies have demonstrated that low-carbohydrate diets can be used safely and effectively for weight loss without adverse effects on lipids or other metabolic parameters.

Exercise and physical activity 

Exercise offers a number of advantages to patients trying to lose weight and keep it off. Exercise will also preserve lean body mass and partially prevent the decrease in basal energy expenditure (BEE) seen with semistarvation. 

When compared with no treatment, exercise alone results in small amounts of weight loss. Exercise plus diet results in greater weight loss than diet alone. 

A greater intensity of exercise is associated with a greater amount of weight loss. Up to 1 hour of moderate exercise per day is associated with long-term weight maintenance in individuals who have successfully lost weight. Social support essential for a successful weight loss program. 

Medications

Medications for the treatment of obesity are available both over the counter and by prescription. Considerable controversy exists as to the appropriate use of medications for obesity. Several medications are approved by the US Foods and Drug Administration (FDA) for the treatment of obesity. 

Catecholaminergic medications (eg, phentermine, diethyl-bupropion, mazindol) are approved for short-term use only and have limited utility. 

Orlistat works in the gastrointestinal tract rather than the central nervous system. By inhibit intestinal lipase, orlistat reduces fat absorption.

Surgery for weight loss

Bariatric surgery is an increasingly prevalent treatment option for patients with severe obesity. In the United States, gastric operations are considered the procedures of choice. Most popular is the Roux-en-Y gastric bypass (RYGB).

In most centres, the operation can be done laparoscopically. RYGB typically results in substantial amounts of weight loss-Over 30% of initial body weight in some studies.

Complications occur in up to 40% of persons undergoing RYGB surgery and include peritonitis due to anastomotic leak.

Caution is very, very important in eating, to prevent obesity, it is important to eat more fruits and vegetables. Avoid rice, potatoes, chocolates,  junk foods and processed foods.

Avoid alcohol and smoking and increase uptake of protein in diet Follow the guidelines of the nutritionist.