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This article was written for the Anguillian by Dr. T.N. Patil, Professor of Biochemistry, as part of Saint James School of Medicine’s regular series of columns. 

Obesity has currently reached epidemic proportions and has been declared a major health problem. At the same time, in today’s body-conscious society, overweight individuals are subjected to diverse degrees of subjective and objective discrimination.  This causes social adjustment disorders and a lowered self-esteem that can lead to mental instability. In addition to this, obese individuals also must cope with external and internal threats.

What is obesity?

Obesity is a condition in an individual who consumes a high calorie diet supported by a sedentary lifestyle as well as genetic susceptibility. A slow metabolic rate results in ingested fat getting stored instead of getting broken down. Metabolism also slows down with age. People with endocrine disorders and those taking steroid-based medication are also prone to obesity. Obesity does not discriminate based on age or sex.

Assessment of obesity:

1.Body weight: Obesity can be defined as an increase in body weight. Recently, relative weight (actual wt/ideal wt) has become popular. A relative weight of 1.20 or greater (i.e. 20% or more over ideal weight) defines obesity.
2. Body mass index(BMI): Body Mass Index ( BMI ) (W/H2:Kg/M2) is also a popular method. BMI between 25-29.9 is considered overweight, above 30 is obese.

3.Obesity by fat content: Body fat can be estimated by various methods by clinicians in routine consultation.

Health risks of Obesity

Hypertension or high blood pressure is the most common ailment associated with obesity as walls of blood vessels get lined with fatty tissues to constrict blood flow. This increases the risk of cardiovascular diseases like valve damage and myocardial infarction.

Dyslipidemia is an elevation of total cholesterol levels in the blood with a higher level of “bad” LDL cholesterol and triglycerides and lower “good” HDL cholesterol. It may be genetic but has been linked to poor, high fat diet and a sedentary lifestyle. There are no symptoms but can lead to coronary artery disease and peripheral arterial disease.

Type 2 Diabetes (non-insulin dependent diabetes mellitus) also called adult onset diabetes. It comes with high blood glucose and can be managed by increased exercise and dietary changes. Of the nearly 24 million people with diabetes in the US, about 80% have Type 2 diabetes.

Coronary Heart Disease is coronary circulation failure that affects about 14 million people in the US. It occurs when fatty deposits, calcium or plaque accumulates in the arteries that supply blood to the heart. These constrict the flow so that the heart pumps harder and can initially cause chest pains or angina. If the arterial narrowing blocks the flow, you can get a heart attack or myocardial infarction or a fatal rhythm disturbance (cardiac arrest).

Stroke results when blood supply to the brain is disrupted due to thrombosis, embolism or hemorrhage. It can cause permanent neurological damage and even death. It is the main cause of disability in the US and Europe and the second cause of death worldwide. Risk factors leading to a stroke include diabetes, high cholesterol, arterial fibrillation and hypertension.

Gall Bladder Disease like gallstones which are crystals formed by excess cholesterol, can be triggered by high cholesterol intake. There is increased risk with people who are obese and those with high cholesterol levels.

Osteoarthritis involves degradation of joints, most commonly in the fingers. It may be caused by mechanical stress and misalignments of the bones, but also may be caused by obesity that puts undue pressures on these joints.

Sleep Apnea is a sleep disorder that involves long pauses in breathing during sleep and could lead to breathing misses. The risk of this is proportionate with increased body weight, age, smoking and diabetic condition. Related to this are  respiratory problems like shortness of breath, chest discomfort, wheezing and coughing. Overweight individuals face a higher risk of breathing problems.

Cancers: Uterine cancer, mainly cancer of the endometrium, is the most common gynecological cancer in the US afflicting around 35,000 women with a high probability of death. These are mostly linked to high levels of estrogen, diabetes, hypertension, high intake of animal fat and obesity. Research has linked other cancers, like breast and colon cancers with dietary habits. The risks increases with a high fat diet, obesity and alcohol intake.

Treatment

The main treatment of obesity is exercise and a reduced calorie intake. Increase in physical activity elevates the body’s aerobic capacity, increases the activity of plasmatic neuropeptides which creates a sense of well-being, and replaces body fat with muscle mass (which is lighter, but has better aerobic turnover rate).You can augment your diet with prescription or OTC diet pills and supplements. In extreme cases, surgery may be needed to reduce stomach size and increase satiation and reduce fat absorption of ingested foods. But whichever way you choose, obesity needs early solution to prevent any of the above disorders.

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