Understanding of Obesity and how it is measured as per WHO

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Obesity is a disease characterized by excessive body fat caused by taking more calories than utilized or burnt. Junk food, alcohol and sedentary lifestyle are prime determinants of obesity in India. Two quantitative measures are deployed in measurement of obesity namely, Body Mass Index, that is the ratio of a person’s Weight (kilograms) and Height (meters)2.

 

  1.  WHO Criteria for defining Obesity and Overweight person.

BMI

Category

18.5-24.9

Normal Weight

25-29.9

Overweight

30-34.9

Obesity(Class I)

35-39.9

Obesity(Class II)

>40

Obesity(Class III or overweight)

As per World Health Oganisation standards an adult person with Body Mass Index of 25 kg/m2 to 30 kg/m2 is considered over weight and Body Mass Index of more than 30 kg/m2 is considered obese.

Once examined as medically obese, people are affected by behavioral, genetic and environmental factors that are beyond comprehension of dietary control. India ranges third behind US and China with 30 million Indians population as obese, which is predicted to double in next 5 years as per a study published in journal Lancet. Excessive weight is linked to health risks, including cancers (breast, colon, gallbladder, uterus, colon and prostrate), gout (joint pain caused by excess uric acid), sleep apnea (interrupted breathing during sleep), strokes, blood pressure, osteoarthritis (wearing away of the joints), cardiovascular ailments(atherosclerosis or hardening of the arteries.), diabetes(Type II Diabetes), Metabolic syndrome(abdominal obesity, elevated blood cholesterol, elevated blood pressure, insulin resistance), Psychosocial effects(lazy or weak-willed). The reason for childhood obesity includes childhood obesity includes Dietary patterns, Lack of physical activity, Environment, Heredity & Family genetics and socioeconomic status. To understand the patterns, Weight categories for children and teens are defined so as to take into account normal differences in body fat between boys and girls and differences in body fat at various ages. Education on healthy food, diet check, understanding of the food pyramid and eat smaller bites at a smaller pace through use of visual aids and interactive sessions can develop a child’s understanding of food.

Morbid obesity is a disease, where patient is having a BMI of 40 or greater, or weighing more than 40 kilograms over their ideal body weight. The symptoms for the  morbid obesity include: High blood pressure, High cholesterol, Diabetes, Heart disease, Stroke, Gallbladder disease, Osteoarthritis, Sleep apnea and respiratory problem, cancers (endometrial, breast and colon), Liver disease, Venous disease, Acid reflux, Menstrual irregularities and infertility.

Psychiatric evaluation is required to understand behaviors that have contributed to developing obesity and appealing behavior modification is one way to treat the disease either alone or in conjunction with other treatments such as physical activity, non clinical weight management programs and medically managed weight-loss and surgical bariatric treatment. Physical activity should be done under care and supervision of experts. Medically managed weight-loss programmes include prescription of weight-loss medications, nutrition education, physical activity instruction and behavioral therapy. There is a small number of medications that are approved for weight-loss. These include: sibutamine, orlistat, and Noradrenergics products. These medications are used in-tendom with a reduced-calorie diet, exercise, total meal replacement and behavior modification. 

The bariatric surgical weight removal is done in patients classified as morbidly obese or a patient having a BMI of 40 or greater, or weighing more than 40 kilograms over their ideal body weight  or Patients with BMI of 35 or greater who also suffer from a severe medical condition related to obesity (sleep apnea, diabetes, heart failure, high blood pressure). The procedures for bariatric surgical weight removal includes procedures such as Laparoscopic Adjustable Gastric banding, Roux-en-Y Gastric Bypass and Gastric Sleeve Resection.

 

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