Obesity is defined as an excessively high amount of body fat (adipose tissue) in relation to lean body mass. There is evidence that obese children and adults are at greater risk of short-term and long-term health consequences.
An obese person has accumulated so much body fat that it might have a negative effect on their health. If a person’s bodyweight is at least 20% higher than it should be, he or she is considered obese. If your Body Mass Index (BMI) is between 25 and 29.9 you are considered overweight. If your BMI is 30 or over you are considered obese.
Obesity causes or exacerbates many health problems, both independently and in association with other diseases. In particular, it is associated with the development of type 2 diabetes mellitus, coronary heart disease (CHD), an increased incidence of certain forms of cancer, respiratory complications (obstructive sleep apnoea) and osteoarthritis of large and small joints.
Obesity has reached epidemic proportions in the United States. Over two-thirds of adults are overweight or obese, and one in three Americans is obese. The prevalence of obesity in children has increased markedly. Obesity has also been increasing rapidly throughout the world, and the incidence of obesity nearly doubled from 1991 to 1998.
Who is at Risk?
- In women, overweight and obesity are highest among non-Hispanic Black women (about 82 percent), compared with about 76 percent for Hispanic women and 64 percent for non-Hispanic White women.
- In men, overweight and obesity are highest among Hispanic men (about 82 percent), compared with about 74 percent for non-Hispanic White men and about 70 percent for non-Hispanic Black men.
- Children also have become heavier. In the past 30 years, obesity has tripled among school-aged children and teens. About 1 in 6 American children ages 2–19 are obese. The survey also suggests that overweight and obesity are having a greater effect on minority groups, including Blacks and Hispanics.
Causes
Lifestyle and Behavior Factor – Healthy behaviors include a healthy diet pattern and regular physical activity. Energy balance of the number of calories consumed from foods and beverages with the number of calories the body uses for activity plays a role in preventing excess weight gain.
Other reasons for not being active include: relying on cars instead of walking, fewer physical demands at work or at home because of modern technology and conveniences, and lack of physical education classes in schools.
People who are inactive are more likely to gain weight because they don’t burn the calories that they take in from food and drinks. An inactive lifestyle also raises your risk for coronary heart disease, high blood pressure, diabetes, colon cancer, and other health problems.
Environmental Factor – People and families may make decisions based on their environment or community. For example, a person may choose not to walk or bike to the store or to work because of a lack of sidewalks or safe bike trails. Community, home, child care, school, health care, and workplace settings can all influence people’s daily behaviors. Therefore, it is important to create environments in these locations that make it easier to engage in physical activity and eat a healthy diet.
Lack of Sleep – People who do not sleep enough are at a higher risk of becoming obese, according to a research. The ‘epidemic’ of obesity is paralleled by a ‘silent epidemic’ of reduced sleep duration with short sleep duration linked to increased risk of obesity both in adults and in children. These trends are detectable in adults as well as in children as young as 5 years
Genetic Factor – Genetic changes in human populations occur too slowly to be responsible for the obesity epidemic. Nevertheless, the variation in how people respond to the environment that promotes physical inactivity and intake of high-calorie foods suggests that genes do play a role in the development of obesity.
Other Factors – Some illnesses may lead to obesity or weight gain. These may include Cushing’s disease, and polycystic ovary syndrome. Drugs such as steroids and some antidepressants may also cause weight gain. The science continues to emerge on the role of other factors in energy balance and weight gain such as chemical exposures and the role of the microbiome.
A health care provider can help you learn more about your health habits and history in order to tell you whether behaviors, illnesses, medications, and/or psychological factors are contributing to weight gain or making weight loss hard.
Endocrine disruptors, such as some foods that interfere with lipid metabolism. The molecular mechanism through which fructose (a type of sugar) in beverages may alter lipid energy metabolism and cause fatty liver and metabolic syndrome.
Symptoms
Weight gain usually happens over time. Most people know when they’ve gained weight. Some of the signs of overweight or obesity include –
- Clothes feeling tight and needing a larger size.
- The scale showing that you’ve gained weight.
- Having extra fat around the waist.
- A higher than normal body mass index and waist circumference
The BMI is a statistical measurement derived from your height and weight. Although it is considered to be a useful way to estimate healthy body weight, it does not measure the percentage of body fat. The BMI measurement can sometimes be misleading – a muscleman may have a high BMI but have much less fat than an unfit person whose BMI is lower. However, in general, the BMI measurement can be a useful indicator for the ‘average person’.
Complications
- Diabetes
- Heart Disease
- Hypertension
Other risks
In addition to diabetes, heart disease and hypertension, obesity is related to dozens of serious health problems. For instance –
- A growing body of evidence shows links between maternal health conditions -— including obesity, chronic diseases — and increased risks before, during and after childbirth.
- Approximately 20 percent of cancer in women and 15 percent of cancer in men is attributable to obesity.
- An estimated 24.2 percent of kidney disease cases among men and 33.9 percent of cases among women are related to overweight and obesity.
- Almost 70 percent of individuals diagnosed with arthritis are overweight or obese.
- Both overweight and obesity at midlife independently increase the risk of dementia, Alzheimer’s disease and vascular dementia.
- Other mental health conditions.
Treatment
- Diet, exercise, and behavioral modification should be included in all obesity management approaches for body mass index (BMI) of 25 kg/m 2 or higher.
Medications – A variety of over-the-counter and prescription weight loss drugs are available. Some people find these drugs help curb their appetites. Studies show that patients on drug therapy lose around 10 percent of their excess weight, and that the weight loss plateaus after six to eight months. As patients stop taking the medication, weight gain usually occurs. Weight loss drugs, approved by the U.S. Food and Drug Administration (FDA) for treating obesity, include:
- Beta-methyl-phenylethylamine (Fastin) — This is a stimulant that increases fat metabolism.
- Orlistat (Xenical) — This drug works by blocking about 30 percent of dietary fat from being absorbed. Alli is a lower-dose, over-the-counter formula of the same medication.
- Phentermine — Phentermine, an appetite suppressant, has been available for many years. It is half of the “fen-phen” combination that remains available for use. The use of phentermine alone has not been associated with the adverse health effects of the fenfluramine-phentermine combination.
- Sibutramine (Meridia) — This is an appetite suppressant approved for long-term use.
Surgeries – In patients with morbid obesity associated with comorbidities, bariatric surgery is the only available therapeutic modality associated with clinically significant and relatively sustained weight loss. Well-performed bariatric surgery, in carefully selected patients and with a good multidisciplinary support team, substantially ameliorates the morbidities associated with severe obesity.
- Roux-en-Y procedure (gastric bypass) – Permanently reduces the size of the stomach; vomiting is the most common side effect.
- Gastric banding – An adjustable silicone band is placed around the stomach, decreasing the amount of food that can be eaten. The band can be adjusted or removed.
- Laparoscopic vertical sleeve gastrectomy – The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. The stomach that remains is shaped like a very thin banana.
Behavior Modification – The goal of behavior modification therapy is to change your eating and exercise habits to promote weight loss. Examples include:
- Setting realistic weight loss goals — short term and long term.
- Recording your diet and exercise patterns in a diary.
- Identifying high-risk situations and avoiding them.
- Rewarding specific actions, such as exercising for a longer time or eating less of a certain type of food.
- Adopting realistic beliefs about weight loss and body image.
- Developing a support network, including family, friends and co-workers, or joining a support group that can help you focus on your goal.
Alternative Treatment
5-Hydroxytryptophan (5-HTP) – 5-HTP is thought to reduce hunger cravings by boosting serotonin levels in the central nervous system, which may reduce appetite and lessen food cravings.
Fiber – Fiber may help lower insulin levels (insulin controls the amount of sugar in the blood) and help you feel fuller.
Calcium – Calcium may play an important role in fat burning. Population studies show that higher dietary calcium levels are associated with lower BMIs.
Zinc – Zinc may increase lean body mass and reduce or stabilize the amount of fat. The reason may be that zinc increases levels of leptin, a hormone in the body that helps you feel full. Zinc can interact with certain medications, including Cisplatin, and some antibiotics.
Pyruvate – Pyruvate is a substance that occurs naturally in the body, where it is converted to lactic acid. There is some evidence that it may help reduce body fat, possibly by increasing the body’s metabolic rate.
Vitamin D and Calcium – Studies found that in postmenopausal women, those who took calcium and vitamin D supplements were less likely to gain small to moderate amounts of weight than those who took placebo. Calcium can interfere with certain medications, including some antibiotics and thyroid medications. Calcium must be in balance with other minerals and electrolytes in the body, such as magnesium and phosphate.
Hydroxycitric acid (HCA) – This substance, extracted from the fruit Garcinia cambogia, is similar to citric acid (found in oranges and citrus fruits). HCA stops carbohydrates from being stored as fat, and some animal tests indicate HCA can suppress appetite.
Chitosan – Chitosan is a fiber-like supplement made from the shells of crustaceans, such as shrimp and crab. While some studies show that chitosan (in addition to a low-calorie diet) reduces weight, it is unclear whether the supplement itself, the low-calorie diet, or a combination of both led to the weight loss. Other studies show mixed results. Chitosan may have a blood-thinning effect, and therefore can interact with blood-thinning medications, such as warfarin (Coumadin) and aspirin.
Glucomannan – Glucomannan is a kind of insoluble fiber that appears to reduce blood sugar levels and may help promote weight loss. People with diabetes should not take glucomannan without their doctor’s supervision. Glucomannan may interfere with the absorption of several medications.
Psyllium – Psyllium, a kind of soluble fiber, may reduce hunger cravings by making you feel full. Adding psyllium and other sources of fiber into your diet may aid weight loss.
Guggul – A common ingredient in several Ayurvedic medicines used to treat obesity. Studies suggest that overweight people who take these Ayurvedic remedies lose slightly more weight compared to those who do not take them. Guggul can cause mild diarrhea and nausea, and may interact with the following medications: blood-thinning drugs (anticoagulants), birth control pills, thyroid hormone, tamoxifen, and estrogens.
Green tea – Green tea extract may boost metabolism and help burn fat.
Cayenne or capsaicin – Preliminary evidence indicates that capsaicin (the substance that makes chili peppers taste hot) may reduce hunger and help the body burn fat, particularly when eating a high-fat diet.
Hoodia – A number of media reports on hoodia have suggested it could be an effective weight loss supplement.
Reference –
http://www.nhlbi.nih.gov/health/health-topics/topics/obe/treatment
http://www.cdc.gov/obesity/adult/causes.html
http://www.mayoclinic.org/diseases-conditions/obesity/basics/causes/con-20014834
http://www.nhs.uk/Conditions/Obesity/Pages/Treatment.aspx
http://www.medicinenet.com/obesity_weight_loss/page2.htm
http://www.medindia.net/patients/patientinfo/obesity.htm
http://www.webmd.com/diet/obesity/obesity-treatment-overview
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776037/
http://treatment.hpathy.com/homeo-medicine/homeopathy-obesity/