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Obesity ‘epidemic’ on the rise
Just
look around. No matter where you go, chances are you will find overweight
or obese people. Obesity bariatric surgeon Dr Abhay Agrawal says for
several people, reducing weight has become an urgent need. “A lazy
lifestyle, coupled with unhealthy eating habits, have made us obese, not
just overweight. According to the National Family Health Survey of India,
approximately 15% of our country’s population is obese. That’s more than 10
million people. This is a side-effect of prosperity, stress and the lack of
time for maintaining one’s health.”
Laparoscopic surgeon and obesity expert Dr Muffazal
Lakdawala defines obesity as accumulation of fat that exceeds the existing
standards. “The National Institute of Health (NIH) states that excessive
weight becomes a health hazard when it is 20% or more above the ideal body
weight. More and more youngsters these days are becoming obese,” he says.
CAUSES
Research blames changed lifestyles,
energy-dense diets and low-levels of physical activity for the rise in
obesity. “However, various other factors may also trigger the problem.
These include heredity , hormonal imbalance, side-effects of certain drugs
and psychological problems like depression or boredom due to which people
tend to eat more. Several studies have attributed the problem to eating out
frequently. This leads to increased calorie intake -- one meal in
restaurants and fast-food outlets is all that it takes to exceed a person’s
caloric requirement for the entire day. A sedentary lifestyle with little
or no physical activity also leads to weight gain and obesity,” adds Dr
Lakdawala.
EFFECTS
Obesity is linked to diseases like Type-2
diabetes mellitus, hypertension, dyslipidemia, coronary heart disease and
stroke. Other complications include obstructive sleep apnea, gall bladder,
liver and musculoskeletal disease, osteoarthritis, fertility issues and
certain types of cancers. Being overweight may also delay healing of wounds
and cause poor antibody response to hepatitis B vaccine.
Bariatrician Dr Deepak Chaturvedi says obesity has
become a modern epidemic. “Statistics prove that death rate is 50% higher
if a person is 40% overweight. Obesity is an underlying cause of many
diseases, which requires prompt medical attention. For healthy weight
management, appropriate nutrition and scientifically determined caloric
value is required. Starvation or skipping meals may create hormonal changes
that conversely contribute to obesity.”
EMOTIONAL EATING
Says Dr Agrawal, “Today’s youngsters overeat to
reduce their anxiety, which can be caused by trauma, social insecurity,
neglect or abuse. Here’s what one should keep in mind:
All foods have calories, so avoid large servings
and second helpings. Portion control is very important. Limit
alcohol consumption. Don’t skip meals because this can lead to
overeating the next time. Monitor your calorie intake. Avoid eating while
watching TV or sitting in front of a computer. Limit eating out.
TREATMENT
Obesity can be treated with diet regulation,
physical activity, medical management and, in extreme cases, bariatric
surgery. “Following a healthy diet and exercising regularly is the first
recommended step. Behavioural therapy helps obese people develop eating and
exercise habits that enable them to decrease their weight. Pharmacological
therapy may also be added to diet, exercise, and behavioural therapy.
Medications are an adjunct to lifestyle modifications, not a replacement.
Pharmacological therapy includes medicines that work as appetite
suppressants, block digestion and absorb only onethird of the dietary fat
ingested. Unfortunately, the safety and efficacy of weight-loss medications
has not been established, and discontinuation of medication usually results
in regaining the weight. Bariatric surgery is a proven longterm weight loss
method. It works by either causing restriction in the amount of food eaten
and/or causing incomplete digestion,” says Dr Lakdawala.
Obesity management is not merely weight management
and hence, cannot be dealt with temporary measures. “Going to the gym and
other weight-loss parlours without identifying the underlying cause is
foolish. A patient needs to be interviewed in detail about his/her past,
family and occupational history, interpersonal relationships and drug
intake. A thorough clinical examination follows, to identify the root cause
and related complications. Treatment also includes lifestyle modifications,”
says Dr Chaturvedi.
DID YOU KNOW?
A normal person’s Body Mass Index (BMI) is usually between 18 and 25.
If your BMI is in the range of 25 to 30, you are overweight. And if it
exceeds 30, you are medically termed morbidly obese.
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