Obesity is a condition in which the body has accumulated excessive fat that negatively impacts health. Obesity is measured using the body mass index (BMI), which is obtained by dividing a person's weight in kilograms by the square of his or her height in meters (kg/m²).
The World Health Organization (WHO) considers obesity as a BMI of 30 or more.
Waist circumference is measured at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest. It indicates abdominal obesity, which increases the risk of type 2 diabetes and cardiovascular diseases.
Generally, a waist circumference greater than 35 inches (88 cm) in women and 40 inches (102 cm) in men is considered as abdominal obesity.
Hip circumference is measured at the widest part of the buttocks. While waist circumference mainly reflects the accumulation of abdominal fat. Waist-to-hip ratio, measured by dividing waist circumference by hip circumference, is often used to measure obesity.
Neck circumference is measured just below the laryngeal prominence (Adam's apple). Neck circumference is associated with upper body fat distribution and obstructive sleep apnea. Individuals who are obese have been shown to have increased neck circumference.
Mid-upper arm circumference (MUAC) is measured on the arm at the midpoint between the tip of the shoulder and the tip of the elbow. Waist or hip circumference is not commonly used in children; MUAC is sometimes used instead to measure nutritional status and body composition.
These circumference measurements, indicators such as BMI and body composition analysis provide important information for assessing obesity-related health risks.
What causes obesity?
Obesity can have many causes, including genetic, environmental, socioeconomic, and behavioral.
Experimental studies have shown that genetics play an important role in obesity. For example, studies suggest that genetic factors are a significant factor in the variability in body mass index (BMI).
Lack of access to parks and walking facilities or physical exercise.
What problems can obesity cause?
Here are some of the major health problems that can arise as a result of obesity -
1.Cardiovascular disease:
Obesity substantially increases the risk of cardiovascular diseases, such as coronary artery disease, heart failure, and stroke. Excess body fat can lead to high blood pressure, abnormal lipid levels, and inflammation, all of which can cause cardiovascular disease.
2.Type 2 diabetes:
Obesity is a major factor in type 2 diabetes. Accumulation of excess adipose tissue leads cells to insulin resistance, leading to high blood sugar levels and the development of diabetes. Type 2 diabetes causes serious illnesses such as heart disease, kidney disease, and nerve damage.
3.Respiratory disorders:
Obesity can also lead to respiratory disorders such as obstructive sleep apnea, which involves difficulty breathing during sleep. Excess fat around the neck can obstruct the airways, leading to difficulty breathing and negative changes in sleep patterns.
Obesity also causes asthma and other respiratory disorders.
4.Musculoskeletal disorders:
Excess weight can lead to joint pain, osteoarthritis, and problems with walking. Obesity increases the risk of osteoarthritis in the knee and hip joints. Chronic joint pain and reduced mobility can significantly impact quality of life.
5.Cancer:
Obesity can increase the risk of certain types of cancer, including breast, colorectal, endometrial, kidney, and pancreatic cancer. Fat tissue produces hormones and specific substances that can promote cancer growth and spread. Insulin resistance and chronic inflammation can also contribute to cancer development.6.Gastrointestinal disorders:
Obesity is associated with a variety of conditions, including gastroesophageal reflux disease (GERD), fatty liver disease, and gallbladder disease. Excess abdominal fat increases pressure on the abdomen, which can lead to GERD symptoms. Non-alcoholic fatty liver disease (NAFLD) and gallstones are also more common in obese individuals.
7.Mental health disorders:
Obesity can lead to mental disorders such as depression, anxiety, and low self-esteem. Additionally, obesity-related health problems and functional limitations can adversely affect mental health.
8.Reproductive health issues:
Obesity affects the reproductive health of both men and women, leading to menstrual irregularities, infertility, polycystic ovary syndrome (PCOS), and pregnancy complications such as gestational diabetes and preeclampsia.9.Sleep disorders:-
Obesity is a major risk factor for sleep disorders such as obstructive sleep apnea (OSA) which causes interruptions in breathing during sleep.
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Excess weight around the neck obstructs the upper airway, leading to breathing difficulties and irregularities in sleep patterns. OSA is associated with daytime fatigue and an increased risk of cardiovascular problems.
Lifestyle changes are important to overcome obesity.Changes need to include medical support and a conducive environment for healthy behaviors.
Health Risks of Obesity in India:
- 64% of Indians are overweight, with 20% of Indians being obese. This equates to millions of people suffering from heart disease and heart stroke.
- More than 70 million Indians have diabetes, of which 40% are obese.
- 13-15% of Indians suffer from obstructive sleep apnea, a problem exacerbated by obesity.
- More than 25% of obese adults in India have osteoarthritis.
- 11% of cancer cases every year are caused by obesity, and 30,000 new cases are linked to obesity.
- 9-32% of Indians have non-alcoholic fatty liver disease, which is linked to obesity.
- 15% of obese Indians have symptoms of depression.
- Obese women are 2-3 times more likely to suffer from infertility.
- 30-40% of obese people in India suffer from obstructive sleep apnea.
How is obesity treated ?
Lifestyle changes, dietary changes, physical exercise and in some cases surgery are needed to reduce obesity.
1.Lifestyle changes:
Dietary changes:
To reduce obesity, it is important to adopt a balanced and nutritious diet. This includes consuming low-calorie foods, controlling portion sizes and eating nutrient-rich foods such as fruits, vegetables, whole grains and lean proteins.
Physical activity:
Regular exercise is very important for weight loss and maintenance. Generally, one should aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity activity or anulom vilom per week.
2.Medically assisted:
Some individuals may benefit from prescription weight loss medications. These medications work by suppressing appetite, preventing excess fat accumulation. They are typically prescribed to individuals with a body mass index (BMI) of 30 or higher.
Individuals with severe obesity may need to seek the help of bariatric surgery as prescribed by a doctor. Medical procedures such as gastric bypass, sleeve gastrectomy or gastric banding work to reduce weight by restricting food intake or altering digestion.
Bariatric surgery is typically recommended for individuals with a BMI of 40 or higher or a BMI of 35 or higher with obesity-related comorbidities.
