How is obesity defined? What is its prevalence? Let us delve into its causes and effects and how we can eliminate obesity. We will also try to take measures to prevent it.
Definition: Obesity is the abnormal and excessive fat accumulation in the body. It is a chronic disease associated with other chronic diseases. The word obesity originates from the Latin ‘Obesitas, ‘ meaning fat, stout, or plump. Obesity was known in the early historical period.
Obesity is related to various conditions and syndromes, especially with Diabetic type 2, osteoarthritis, cardiovascular diseases, hypertension, obstructive sleep apnea, asthma, some cancers, etc.
Incidence: It is more common in females and is prevalent in adults as well as in children. Globally, 650 million people are obese, which is rising rapidly.
Diagnosis: The diagnosis of obesity is based on the Body Mass Index (BMI) and is further evaluated in terms of the Waist-Hip ratio, waist-to-height ratio, and total cardiovascular risk factors.
Category BMI Kg/meter square
Underweight >̲18.5
Normal weight 19.5–24.9
Overweight 25—29.9
Obese class I 30-34.5
Obese class II 35-39.9
Obese class III >40
Some countries use lower values. For example, in Japan, BMI >25 is considered obese, while in China, it is >28.
Causes: Obesity is due to
1. Persistent positive energy balance is responsible for obesity.
2. The body weight set point is raised.
3. Genetic factors: Alterations in the various genes controlling appetite and metabolism predispose to obesity. Fat mass and obesity-associated genes (FTO gene ) are detected. Many hypotheses exist, but none are widely accepted.
Obesity shows inheritance. If both parents are obese, 80% of children will be obese. When both parents are normal, children are only 10% likely to be obese.
It is associated with rare genetic syndromes like Prader-Willi, Bardet-Bedi, Crohn’s, and MOMO.
4. Individual causes are -diet habits, physical activity, and sedentary lifestyle.
A calorie model- excess food intake and lack of physical activity.
5. Eating disorders like ‘binge eating syndrome ‘and night eating syndrome ‘are also responsible for obesity.
Carbohydrate insulin model –High glycemic load causes hormonal changes that promote caloric deposits in adipose tissue.
6. Socioeconomic factors,
Malnutrition in early life causes endocrinal changes, which may promote obesity later.
7. Environmental factors
8. Endocrinal factors: Hypothyroidism, Cushing syndrome, Growth hormone deficiency, etc.
Gut flora also plays a vital role in the development of obesity.
9. Drugs: Insulin, sulfonylurea, steroids, phenytoin contraceptives, and many more.
Obesity increases the risk of clinical depression, and depression increases the chance of developing obesity.
The complications of obesity:
Complications of obesity were well known. The great surgeon of India, Sushruta, had reported about obesity. He related it to heart disease and mentioned that physical activity would cure it.
Obesity directly :
Increases fat mass
Causes osteoarthritis,
Non-alcoholic fatty liver,
Alters the body’s response to Insulin.
Cardiovascular disease,
Hypertension,
Lung diseases,
Mental disorders, depression, anxiety and stress.
Gout,
Low back pain,
Multiple sclerosis,
Carpal tunnel syndrome, etc.
Pregnancy-related complications:
Congenital disabilities
Intrauterine fetal death,
Infertility,
Pregnancy and delivery complications, etc.
In certain conditions, obesity is helpful –positive effect, e.g., in heart failure or hemodialysis. This is the ‘Obesity survival paradox.’
Prevention of obesity:
Lifestyle change-give up smoking and alcoholic drinks.
A healthy and timely diet rich in dietary fiber.
Reduce intake of high fat and high carbohydrate diet
Start an active life.
Regular exercise.
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