OBESITY is defined as a state of excess accumulation of body fat. It can result from increased energy intake, decreased energy expenditure or a combination of both.
The most widely used method to gauge obesity is BODY MASS INDEX
|Healthy weight||18.5 - 24.9||--||--|
|Overweight||25 - 29.9||--||Increased|
|Obesity||30.0 - 34.9||I||High|
|Obesity||35.0 - 39.9||II||Very High|
|Extreme Obesity||≥ 40
30 - 50% of variability in fat stores is believed to be genetically determined.
Increased mortality from obesity is primarily due to Cardiovascular disease, hypertension, Gall bladder disease, Diabetes mellitus, sleep apnoea, osteoarthritis and certain forms of cancer such as uterine cancer, breast cancer, prostate cancer and colorectal cancers.
Obesity is a chronic medical condition that requires ongoing treatment and lifestyle modifications.
What are the factors considered as complicating in Obesity / Metabolic Syndrome?
- Increased waist circumference.
- Raised waist to hip ratio.
- Fasting Blood Glucose = 100mg/dl.
- Diagnosed Diabetes Mellitus Type 2 (On/Off medication).
- High Serum Insulin Levels.
- High Blood Pressure.
- High Triglycerides.
- High LDL - Cholesterol.
- Low HDL- Cholesterol.
- High Serum Uric Acid Levels.
- Male Sex.
- Age < 40 years at the time of diagnosis.
The medical management for weight management has to be taken strictly under medical supervision of a consultant.
How Is Obesity related with Premature Aging?
As we pack more and more into each day, we also start aging faster. There are two schools of thought :
- Obesity itself is a risk factor or a direct cause for many diseases like Diabetes Mellitus-II , Insulin Resistance, Metabolic syndrome, Hypertension, Heart diseases, Obstructive sleep apnea, Respiratory diseases, Gall stones , PCOD, Impotence, Infertility, Backache, Depression, Cancers (Breast, Cervix, Uterus, Colon, Rectum, Pancreas etc.)
- Obesity is a consequence of many underlying diseases like Diabetes Mellitus-II, PCOD, Hypothyroidism, and Other hormonal imbalances like Hypogonadism, Menopause, Andropause, somatopause, Depression, Central Nervous System pathology and many more conditions.
All these conditions influence the quality of life and survival adversely.
What is the role of Pharmacotherapy in obesity management?
- As per the latest guidelines from Ministry of Health, India : BMI > 25 with or without co- morbidities need pharmacotherapy.
- Waist circumference of Men > 90 cm and Women > 80 cm need screening for underlying medical disorders and pharmacotherapy.
What are the factors considered as complicating in Obesity?
- Raised waist to hip ratio
- Diabetes Mellitus
- Male Sex
- Age < 40 years
The pharmacotherapy for weight management has to be taken strictly under medical supervision of a consultant.
What is the Antiaging approach of Obesity Management?
- Obesity management is not merely the weight management. It should not be dealt by temporary measures.
- Obesity is a syndrome giving clues for possibility of many underlying health issues.
- Obesity has emerged as a modern epidemic.
- The economy of Obesity is worth understanding. The days of absence from work because of obesity related complications and the money spent in merely weight management in gyms and other places without identifying the treatable causes is a matter of great concern.
- The screening for underlying causes and risk factors is of prime importance.
- Obesity management should be an integrated approach comprising of all the components of Modern Medicine.
- The causes and complications of Obesity should be found out and treated.
- Life style should be modified with right eating pattern, exercise and avoidance of risk factors.
- Role of Yoga, Meditation and Stress management cannot be under estimated.
- Hormone Replacement Therapy has to be kept under consideration as and when needed under strict supervision of an M.D.
- There should not be apprehension of using pharmacotherapy after full understanding and informing the patient about the approach.
- Each patient has right to information and education. Our responsibility does not end simply in giving advice to medicines but we have to educate our patients about their health related issues and all the details about our approach to their problems.
- Just because two people have the same problem does not mean they need the same solution. Not everyone's bodies are the same and neither their physical conditions. Each patient should be treated as an individual with an individualized and customized approach with high quality care in an environment of discretion and safety.
- The pound or inch loss should not be the only goal. The goal should be to give our patient a healthy and productive life.
- Weight management is a process and we all should enjoy that. It's not over the counter solution or a miracle. It's about changing you by yourself. It's a life time process. It's like attaining stardom and now you have to maintain that.
- Just believe in yourself. You can do it.