DR K TAMILSELVAN

How to get away from Obesity

The term obesity implies an excess of adipose tissue or body fat ( is loose connective tissue composed mostly of adipocytes).By this article we can know all the facts and also how to get away from obesity.Generally a 20 percent excess over the desirable weight for height and age is called obesity. Obesity can be expressed in terms of body mass index (BMI) and BMI above tenth percentile is certainly a health risk.

Causes for obesity

Inactivity. If you’re not very active, you don’t burn as many calories. With a sedentary lifestyle, you can easily take in more calories every day than you use through exercise and normal daily activities.
Food and Nutrition. Having a diet that’s high in calories, lacking in fruits and vegetables, full of fast food, missing breakfast, and laden with high-calorie beverages and oversized portions all contribute to weight gain.
Pregnancy. During pregnancy, a woman’s weight necessarily increases. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women.
Lack of sleep. Too little sleep can cause changes in hormones that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
Certain medications. Some medications can lead to weight gain if you don’t compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, corticosteroids and beta blockers.

BMI Calculation (BMI Calculator)

BMI            =       Wt. in kg / height in m²

Normal BMI      –        Male 20-25, Female 18-23

Over weight       –        25-29

BMI                     –        30-35 Grade I Obesity

BMI                     –        35-40 Grade II Obesity

BMI                     –        > 40 Grade III Obesity

Ideal gross body weight in kg be height in cm – 100 (Broca’s index) (or) 0.94 X 22.5 X height m²

Carbohydrate or fat consumed in excess of body requirement is stored as adipose tissue. Besides regular over eating other factors responsible for obesity are sedentary habits, increased levels of lipoprotein lipase (is a water soluble enzyme and found in very low-density lipoproteins-VLDL), the enzyme stores body fat and decreased thermic response to ingested food. Secondary obesity occurs in hypothyrodism, Cushing’s disease (diseases that result in excess cortisol,adrenocorticotropic hormone (ACTH) or CRH levels) and hypothalamic disorders.

A plumpy child grows into an obese adult because the adipose tissue cell mass is determined during childhood. Severely obese adults have increased adipocyte size and number. Weight reduction in them leads to shrinkage in size of adipocytes but their number remains constant.

Obese people are more prone to have diabetes, hypertension,heart disease, CVA, hiatus hernia, osteoarthritis and cronic hypoventilation.

Complications of obesity

Medical problems of obesity

Obesity can sometimes be traced to a medical cause, such as Prader-Willi syndrome, Cushing’s syndrome, and other diseases and conditions. Some medical problems, such as arthritis, can lead to decreased activity, which may result in weight gain. A low metabolism is unlikely to cause obesity, as is having low thyroid function.

How to get away from Obesity

Weight reduction can be achieved by calorie restriction, exercise and drugs. To loose 1 kg of body fat means burning of 7700 calories. A calorie deficit diet full or roughages and fibers is prescribed to provide 20-25 cal / kg. The rate of weight loss ideally be < 2 kg per month. Patients become symptomatic with weight loss exceeding this rate. 40-80 gm of protein intake is essential so also 120gm of carbohydrate to prevent ketosis. With calorie restriction, initial weight loss is rapid, mainly due to water loss but then slows down. Creash dieting with formula preparation containing 350-380 calorie /day can achieve relatively rapid weight loss but should not be continued for more than 6 weeks. Heart disease, renal insufficiency and out should be excluded before such crash diet regimes.

Dieting without good aerobic exercise (cycling, swimming and running) is not good. With exercise one looses more fat and less muscle. The body adopts to dieting programme by a decrease in BMR and enhanced activity of lipoprotein lipase, hence the weight loss is regimes rapidly. The puzzling problem is that a 10% reduction in weight reduces the risk of coronary disease by 20% but if the weight lost is regained, the risk of coronary artery disease is increased by 30%.

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