Dr. Praveen Garg

Obesity is a medical condition in which excess accumulation of body fat creates an adverse effect on health. Obesity is a leading preventable cause of death worldwide, with increasing rates in adults and children. In 2015, 600 million adults and 100 million children were obese. Obesity is more common in women than men.It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist-hip ratio (WHR) and total cardiovascular risk factors. Body mass index is closely related to both percentage body fat and total body fat.

It is defined as the subject's weight divided by the square of their height and is calculated as follows:

BMI = m/h2(Where m and h are the subject's weight and height, respectively)Waist-hip ratio is the dimensionless ratio of the circumference of the waist to that of the hips. This ratio is calculated as waist measurement divided by hip measurement (W ÷ H)The WHR has been used as an indicator or measure of health and the risk of developing serious health conditions.

The BMR of the body is classified into the following types:

Causes-

• Diet: Excessive food energy intake
• Sedentary lifestyle
• Genetics
• Other illnesses: Hypothyroidism, Cushing's syndrome, growth hormone deficiency, and eating disorders
• Certain medications: Insulin, sulfonylureas, thiazolidinediones, atypical antipsychotics, antidepressants, steroids, certain anticonvulsants, pizotifen, and some forms of hormonal contraception
• Gut bacteria Health risks associated with obesity
• Bone and cartilage degeneration (osteoarthritis)
• Coronary heart disease
• Gallbladder disease (gall stone)
• High blood pressure (hypertension)
• High total cholesterol and high levels of triglycerides (dyslipidemia)
• Respiratory problems
• Several cancers
• Sleep apnea
• Stroke
• Type 2 diabetes mellitus
• Management of obesity

Conservative management

1. Diet: Limit energy intake from total fats and sugars and increase consumption of fruits, vegetables, legumes, whole grains, and nuts.
2. Eat consistently: Resist the urge to overeat. Your food intake should follow a regular routine. Overeating not only upsets your routine but also impacts your metabolism.
3. Breakfast: Never miss your breakfast. Breakfast is a crucial meal; it also helps stave off hunger later on in the day, which often leads to overeating and snacking.
4. Monitor yourself: Keep a close check on what you eat and regularly weigh yourself.
5. Physical activity: Perform at least 200 minutes of moderate-intensity exercise each week. This schedule should be spread out over at least 3 days.
6. Watching TV:  Limit watching TV to no more than 10 hours each week.

Surgical management

The surgical management of obesity involves the following two procedures:

• Restrictive procedures
• Malabsorptive procedures