Obesity

Obesity is one of the chronic conditions and is a risk factor for many other chronic conditions.

Obesity is expanding at an alarming rate as a major health concern throughout the world.

Obesity, one of the chronic conditions is caused by various factors. One or more of the below mentioned factors may cause obesity.

  • Energy Imbalance: Obesity happens gradually if the amount of energy or calories you consume is more than the amount of energy spent on your daily activities.
  • Sedentary Lifestyle: People leading an inactive or sedentary lifestyle are more likely to become obese as they do not burn down the calories they consume.
  • Environmental factors: Lack of safe places for exercising and walking (sidewalks or parks), busy work schedule, eating larger food portions, and junk food are contributing factors to gain weight.
  • Family history: The genes inherited from your parents have an effect the amount of fat stored in your body and your chances of being obese is higher if one or both your parents are obese. Obesity tends to run in families.
  • Disease conditions: Hormonal disorders such as hypothyroidism, Cushing’s syndrome, and polycystic ovarian syndrome may cause weight gain.
  • Medicines:  Certain medicines such as corticosteroids, antidepressants and seizure medications are known to decrease the rate of metabolism, increase your appetite and retain excess water in the body leading to weight gain.
  • Emotional factors: Unusual eating habits such as excessive eating when under stress or anger. Overeating will cause weight gain.
  • Age: Aging results in muscle loss in the body which is even more if you are inactive. Muscle loss reduces the calorie consumption and consequently uncontrolled diet may increase the chances of becoming obese.

Consequences

If you are obese, severely obese, or morbidly obese, you may have the following health consequences:

Major health consequences

Premature death (shorter life expectancy):  Obese people have a 50% to 100% increased risk of premature death

Obese people have more risk for heart diseases, type 2 diabetes, certain cancers (breast, uterine, colon), breathing difficulties (e.g., sleep apnea, asthma), arthritis, pregnancy complications, gall bladder problems, urinary incontinence, depression and digestive disorders (gastroesophageal reflux disease)

Risks to psychological and social well-being

  • Negative self-image
  • Social isolation
  • Discrimination
  • Difficulties with day-to-day living
  • Normal tasks become harder when you are obese
  • You tend to tire more quickly and you find yourself short of breath
  • Public transport seats, telephone booths, and cars may be too small for you
  • You may find it difficult to maintain personal hygiene

Treatments

It is important to modify your diet and be involved in physical activities to lose excess weight and maintain the weight loss over the long term.

Diet and exercises

Regular physical activity combined with healthy eating habits is the most efficient and healthful way to control your weight. Physical activity helps to control your weight by using excess calories that otherwise would be stored as fat.

Medications

Most available weight-loss medications are "appetite-suppressant" medications. Appetite-suppressant medications promote weight loss by decreasing appetite or increasing the feeling of being full. These medications decrease appetite by increasing serotonin or catecholamine - two brain chemicals that affect mood and appetite. Prescription weight-loss medications should be used only when there is increased medical risk because of your weight and not for cosmetic reasons. 

Surgical Procedure

Gastrointestinal surgery for obesity, also called bariatric surgery, changes the normal digestive process. The operations promote weight loss by decreasing absorption of nutrients and thereby reducing the calorie intake. Some of the common bariatric surgeries include:

  • Adjustable Gastric Banding
  • Sleeve Gastrectomy
  • Gastric Bypass

Adjustable Gastric Banding

In this procedure, a hollow band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The band is then inflated with a salt solution. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution.

Sleeve Gastrectomy

Sleeve gastrectomy, also referred to as tube gastrectomy, involves removing the lateral 2/3rds of the stomach with a stapling device. It can be done laparoscopically (keyhole surgery) but is not reversible. It basically leaves a stomach tube instead of a stomach sack.

Gastric Bypass

Here a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This bypass reduces the absorption of nutrients and thereby reduces the calorie intake.

After care

Weight loss after surgery will be gradual, about 1-2 pounds per week. The success of the surgery depends on the way you adopt lifestyle changes. Your post-operative diet should include clear liquids in the first week followed by pureed or soft foods in the next week. Regular food can be started after 6 weeks. Here are some of the dietary modifications necessary to maintain weight loss:

  • Plan three well-balanced meals in a day and avoid eating snacks between meals
  • Eat solid foods that fill your stomach and relieve hunger
  • Eat small portions at a time
  • Avoid fatty and high calorie foods
  • Fibrous foods are recommended after surgery to avoid constipation
  • Drink plenty of water
  • Eat food slowly, a meal should last for 30-45 minutes
  • Stop eating when you feel your stomach is full

Exercise

Exercising regularly helps for your long-term success. You must exercise for at least 30 minutes in a day and also perform activities such as walking, running, swimming, aerobics and hiking.