Obesity and It’s Impact

Hypertension, or high blood pressure, is a condition where the force of blood against the artery walls is too high, often leading to health issues such as heart disease and stroke. It can be caused by factors like stress, poor diet, lack of physical activity, or genetics. Managing hypertension typically involves lifestyle changes, including a balanced diet, regular exercise, and sometimes medication, to reduce the risk of complications.

Defining Obesity

The Lancet Commission aims to redefine obesity as a clinical illness rather than just a risk factor, emphasizing the need for a shift in clinical care and medically meaningful measures of treatment outcomes.
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The current definition of obesity as “abnormal or excessive fat accumulation that presents a risk to health” is considered insufficient, and there is a call to recognize obesity as a direct cause of disease due to its effects on organ function.
The Lancet Commission’s approach to defining obesity emphasizes that obesity can transition from a condition of risk to an illness phase. In this view, obesity is not just a risk factor but can itself lead to sickness through its direct effects on organs, altering their function and structure.
In the illness phase of obesity, clinical diagnosis is warranted when excess adiposity has resulted in measurable health impacts. These are characterized by:
  • Signs and Symptoms: Objective evidence of altered function in tissues or organs due to obesity, such as changes in liver or cardiovascular health.
  • Complications: More severe outcomes that may include end-organ damage or significant dysfunction in organs, leading to observable sickness.
This comprehensive definition shifts focus from obesity as merely excess weight to obesity as a complex, progressive condition that directly impacts health, thereby validating it as an illness when organ function is compromised.
Obesity, has adverse effects on health and often results from both genetic and environmental factors, including sedentary behavior and high-calorie diets. India faces a high prevalence of obesity, especially in urban areas, with approximately one-third of the urban population being overweight or obese. Central obesity (excess abdominal fat) is particularly common.

Diagnosing Obesity

  1. Body Mass Index (BMI)
  • Formula: BMI = weight (kg) / height (m²)
  • Healthy BMI range for Indians: 18.5–23 kg/m²
  • Overweight: BMI of 23–25 kg/m²
  • Obesity: BMI ≥ 25 kg/m²
  1. Waist-Hip Ratio (WHR)
  • Central obesity: WHR > 0.95 in men, > 0.8 in women Indicates health risks based on fat distribution
  1. Waist-Hip Ratio (WHR)
  • Central obesity: WHR > 0.95 in men, > 0.8 in women Indicates health risks based on fat distribution

Types of Obesity Based on Fat Distribution

  1. Android (Central) Obesity: Fat around the abdomen, increasing the risk of diabetes, heart disease, and metabolic disorders.
  2. Gynoid Obesity: Fat in the hips and thighs, often causing joint and mechanical issues.

Causes of Obesity

Obesity results from an imbalance between calorie intake and expenditure, influenced by:

  • Genetics: Predisposition to weight gain
  • Environmental Factors: Accessibility to high-calorie foods, sedentary lifestyle
  • Behavioral Factors: Eating habits, lack of physical activity
  • Medications like Antipsychotics , Steroids etc
While overeating alone isn’t the sole cause, weight management involves balancing calories consumed with those burned.

Importance of Weight Loss

Losing weight brings many health benefits, such as reduced risks for:
  • Cardiovascular diseases (heart attack, stroke)
  • Type 2 diabetes
  • Hypertension and cholesterol issues
  • Certain cancers (breast, uterine, colon, prostate)
  • Joint problems
  • Sleep apnea
Even a modest weight loss of 5–10% can greatly benefit overall health.

Weight Loss Strategies

Weight loss is most effective with a comprehensive approach involving medical, nutritional, behavioral, and physical interventions. A team of healthcare professionals, including physicians, dietitians, psychologists, and exercise experts, can create individualized plans.

Treatment Approaches

  1. Dietary Changes: Reducing calorie intake with a balanced, nutrient-dense diet.
  2. Physical Activity: Regular exercise to burn calories and improve fitness.
  3. Behavioral Therapy: Addressing psychological factors related to eating habits.
  4. Medications: Prescription drugs may aid in weight loss.
  5. Surgery: Bariatric surgery