Obesity or being Overweight; is defined as an excessive accumulation of fat that presents a serious health risk. Obesity is a worldwide epidemic, and India is no exception. Recent data from India shows that approximately 13% to 50% of the urban population and 8%–38.2% of the rural population suffer from obesity. Moreover, the prevalence of obesity in children is on the rise. Nearly 6% to 9% of school children in India are obese.
The major cause of obesity is energy intake/output imbalance. This involves eating too many calories and not getting enough physical activity. The pathogenesis of obesity is multifactorial with genetic, behavioural and environmental factors (i.e., sedentary lifestyles) that result in energy intake/output imbalance and promote excessive fat deposition.
So how does one find out whether they are Obese or overweight?
Body mass index (BMI) is a reliable, widely used system of measurement to learn whether an individual is Obese. BMI is calculated as weight in kilograms divided by height in meter squared. According to the Consensus Guidelines for Asian Indians, overweight and obesity have BMI cut-offs of >23 kg/m2 and >25 kg/m2 respectively.
Obesity leads to serious health consequences such as:
- Type 2 diabetes
- Osteoarthritis of weight-bearing joints
- Varicose veins and some forms of cancer
These conditions can cause premature death and substantial disability. Mood disorders, low self-esteem and poor quality of life have also been associated with obesity.
The basic principle of obesity treatment involves decreasing energy intake (food intake) and/or increasing energy consumption (exercise) to create a negative energy balance. There are four main approaches to obesity treatment – Diet, Increase in Physical Activity, Pharmacotherapy, and Surgery.
Diet recommended for obese patients includes low-calorie, low-fat diet, with an intake of 800 to 1500 kcal of energy per day. Caloric reduction in the range of 500 to 1000 kcal less than the usual intake is appropriate. An increase in physical activity helps in weight reduction. An obese person should perform an hour of physical activity every day or 5 hours of moderate-intensity physical activity per week.
Anyone can incorporate Physical activity into their daily routine.
- Use stairs instead of the elevator
- Walk or ride a bicycle instead of driving to do housework
- To get off the bus/metro one or two stops earlier and walk up rest of the way
While Pharmacotherapy, Bariatric surgery and Medication (drugs) are indicated for weight loss, these are best done under medical supervision. There are drugs approved for weight loss but consult a doctor before you consider taking them.
Bariatric surgery is recommended for severe obesity and with or at risk of comorbidities:
- BMI >32.5 kg/m2 with co-morbidities
- BMI >37.5 kg/m2 without co-morbidities