It is defined as excessive accumulation of fat in the body. This
condition is known as obesity. It is widely regarded as a pandemic
disease condition. It has adverse effects on both mortality and
morbidity. The prevalence of it is increasing day by day. The Body mass
index (BMI), which compares weight and height, is greater than 30 kg/m2
Being
obese and being overweight is not exactly the same thing. An obese
person has a large amount of extra body fat, not just a few extra
pounds. People who are obese are very overweight and at risk for
serious health problems.
Types of Obesity:
The fat distribution in the body is identified among the two types of obesity android & gynoid.
1.
Android: - Android type of obesity is likened to the shape of an apple.
The shoulders, face, arms, neck, chest & upper portion of the
abdomen are bloated. The stomach gives a stiff appearance, as well as
the arms, shoulders and breasts. The back seems to be erect but the
neck is compressed and there will be a protruding chest because of the
bulk in the stomach. The lower portion of the body — the hips, thighs
and legs are thinner beyond proportion in comparison with the upper
part. In these persons the vital organs affected will be mostly the
heart, liver, kidneys & lungs. This type of obesity is found more
in males than females. Android type of obesity is a major risk for
heart damage and heart disease due to high cholesterol.
2.
Gynoid: - In this type the lower part of the body has the extra flesh.
This type of obesity is also common to both sexes though females are
more affected. Gynoid type of obesity is similar to pears. The flesh is
somewhat flabby in the abdomen, thighs, buttocks and legs. The face and
neck mostly give a normal appearance. In some persons, the cheeks may
be drawn too. As these persons grow old the whole figure assumes a
stooping posture and the spine is never erect due to the heavy hips and
thighs. This vital organs affected mostly are the kidneys, uterus,
intestines, bladder & bowels. In this type of obesity, exercises or
dieting will not help appreciably in reducing weight.
3.
The third type: - Besides android and gynoid, there is one more type of
obesity. Some people do not belong to any of the above type of obesity.
Their whole body from head to toe looks like a barrel. Their gait is
more to rolling rather than walking. The fat tissues in their body
hinder the movement of all the internal organs and consequently affect
their brisk functioning. For them any exercise is difficult due to the
enormous size of the body. So such person should follow a strict diet
and do plenty of exercise.
Complications:-
Cause:
There
is a complicated picture of the underlying causes for this condition.
The simple cause is ingestion of more calories than are required for
energy, the excess being stored in the body as fat. Inactivity and
insufficient exercise can be contributing factors; Overeating may
result from unhealthful patterns of eating established by the family
and cultural environment. Certain physical and mental illnesses and the
pharmaceutical substances used to treat them can increase risk of
obesity. Medical illnesses that increase obesity risk include several
rare genetic syndromes as well as some congenital or acquired
conditions: hypothyroidism, Cushing's syndrome, growth hormone
deficiency, and the eating disorders: binge eating disorder like
anorexia nervosa, bulimia, rumination disorder, and pica and night
eating syndrome.
It has been shown, for example, that
binging for some people releases natural opiates in the brain,
providing a sense of well-being and physical pleasure. Other studies
have found a strong relationship between obesity in women and childhood
sexual abuse.
Smoking has a significant effect on an
individual's weight. Those who quit smoking gain an average of 4.4
kilograms for men and 5.0 kilograms for women over ten years. Changing
rates of smoking however have had little effect on the overall rates of
obesity.
Some weight-loss experts see obesity as based upon
genetics and physiology rather than as a behavioral or psychological
problem. There are >90 genes which are responsible for the variation
in the weight and a single gene disorder cause severe childhood
obesity. These include mutations of the melanocrin-4 receptors that
accounts for approximately 5% of the severe early onset obesity,
defects in the enzymes in the hypothalamus, and mutations in the leptin
gene.
Management:
1.Weight loss diets- Low calorie diet
DIET | % of carbohydrate | % of fat | % of protein | Comment |
Normal | 50 | 30 | 15 | |
Moderate fat | 60 | 25 | 15 | Maintains balance between macronutrients and micronutrients while reducing dense fat. |
Low Carbohydrate | 10 | 60 | 30 | Induction of ketosis may suppress hunger |
High protein | 43 | 30 | 27 | Protein has greater satiety effect than other macronutrients |
Low fat | 70 | 13 | 17 |
2.Physical exercise- High levels of physical activity
seem to be necessary to maintain weight loss. Walking, running, and
cycling are the most effective means of exercise to reduce body
fat.
3.Lifestyle
changes- sedentary lifestyle must be avoided. Behavioral modification
to avoid some of the effects of the obesogenic environment. Changes in
eating behaviour including food selection, portion size control,
avoidance of snaking, regular meals to encourage satiety and
substitution of sugar with artificial sweeteners must be
discussed.
4.Homoeopathic remedies are prescribed by
symptoms rather than conditions, as each case of a particular illness
can manifest differently in different people. This means that
homeopathic treatment focuses on the patient as a person, as well as
his pathological condition. It can help in losing weight by improving
digestion, elimination and metabolism.
5.Surgery- Bariatric surgery to reduce the size of the stomach.
Please E-mail dr_ramanand@rediffmail.com for any questions/treatment