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Obesity

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. Body mass index (BMI), which compares weight and height, is greater than 30 kg/m 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:
  • Enlargement of the liver due to high fat content.
  • Extra weight puts a lot of pressure on the heart and peripheral vascular system and usually leads to high blood pressure and heart disease.
  • Type 2 diabetes mellitus can be triggered by even a moderate rise in fat.
  • Colorectal cancer and breast cancer has been associated with obese people.
  • Respiratory problems are also aggravated by excessive weight gain.

DIET

% of carbohydrate

% of fat

% of protein

Comment

Normal

50

30

15

 

Moderate fat

60

25

15

Maintains balance between in 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

 

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
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.

 

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