The World health Organization (WHO) has declared Obesity to be a worldwide epidemic. In developed countries obesity is a prominent public health concern and is second only to smoking in terms of its adverse impact on health. While obesity is a serious problem, it can be treated successfully.

Obesity in India and the Middle-East

In 2010, overweight and obesity were estimated to cause 3.4 million deaths. Globally, the proportion of adults with a body mass index (BMI) of 25 or greater increased from 28.8% in 1980 to 36.9% in 2013 for men and from 29.8% to 38.0% for women. An increase in obesity has been observed both in the developed and developing world. However, since 2006 an increase in adult obesity has stabilized in the developed world.

A large Indian study, commissioned by the Indian Council of Medical Research indicated that the prevalence of Obesity had attained epidemic proportions in India. The paper suggests that rapid urbanization and a change in food habits along with a less active life style predisposes to this shift. Nearly 16% of urban men and 24% of urban women are affected by this obesity epidemic. Another concern has been the extremely high incidence of abdominal obesity, which is approximately 44% in Indians. According to this study, the prevalence of obesity in women in Kochi, Kerala is 46% (ICMR-INDIAB Study).

Similarly, the epidemic of obesity is widely prevalent in countries of the middle east. Countries like Saudi Arabia, Kuwait, Oman, United Arab Emirates have a significant proportion of population which is obese (44-48%). Another worrying factor is the presence of obesity in children between the ages of 12 and 17 years of age, with some reports indicating a prevalence of as much as 26%.

Defining Obesity

bmiObesity may be defined as a disorder in which excess body fat has accumulated to an extent that health may be adversely affected. The most commonly used measure of body fatness is Body Mass Index (BMI), which is calculated as weight in kilograms divided by the square of height in metres.

BMI = Weight (kg)/Height (m)2

Individuals with a BMI of over 25 are considered overweight. A BMI over 30 is considered obese. A BMI of over 40 is considered Morbidly Obese and requires early intervention.

What must be noted however is that BMI does not keep in mind the body structure of the patient or whether the excess weight is due to an increased fat or muscle content. Abdominal obesity is a major risk factor and various complimentary measurements are used to measure it and stratify the risk.

Causes of Obesity and factors promoting weight gain

• Inactivity
• High calorie (energy), high fat diets
• Family history of obesity

Information on molecular mechanisms for obesity, some of which stimulate food intake and some of which decrease food intake, is advancing.

Consequences of Obesity

  1. Heart and peripheral vascular disease. The risk of coronary heart disease is doubled if BMI is over 25kg/m2 and quadrupled if BMI is over 30kg/m2 the incidence of peripheral vascular disease is increased.
  2. Diabetes. People with a BMI over 35kg/m2 have a forty times greater risk of developing Type 2 diabetes mellitus than non-obese people.
  3. Hypertension. Blood pressure rises with obesity and this leads to an increased incidence of stroke.
  4. Cancer. Obesity increases the risk of developing certain cancers, such as cancer of the large bowel and endometrial cancer.
  5. Diseases of the locomotor system. The incidence of osteoarthritis and varicose veins increase with obesity.
  6. Others. There is a link between obesity and infertility. Sleep apnoea and psychological distress (social isolation, low self-esteem) are more common with obesity.

How to tackle obesity and how we can help you lose weight

A multi-disciplinary approach is the most likely to be of maximum benefit in obsese patients. It begins with understanding the severity of the problem. The root cause for obesity is then determined with the evaluation of the patient’s dietary habits, activity levels, blood tests to determine problems with hormone levels, psychological and finally clinical assessment.

Following this the patient is advised, lifestyle modification, dietary changes, medications for weight loss and if all else fails surgery is recommended.

We, at SIGMA Gastrocare have a team of Gastroenterologists, Physicians, Dieticians and Surgeons who can help you lose weight and achieve optimum results.

Do get in touch with the team for further information as to how we can help you.