Obesity - Causes, Illeffects and Types of Management

Obesity, has become an increasingly prevalent disorder even in developing nations like India, which was previously more prevalent in developed nations. With prevalence of more than 60 crore adults and around 4.2 crore children below age of 5, obesity has truly become a global menace the humanity needs to fight against in unison.

Causes

In the era of globalization, due to the exchange of ideas, people and cultures, people from even developing nations have become exposed to new varieties of foods rich in fats and carbohydrates. Also, enhanced income levels in tandem with rise in consumerism and promotion of a particular lifestyle as an aspirational one by mass media led to increased adoption of western diet and food habits which is also one of the reason for the rapid rise in obesity in urban areas particularly in children from higher socioeconomic background. Genetic predisposition also plays a role in people becoming prone to obesity.

However, adoption of western diet was a cherry picked one because consumption of raw vegetables and fruits which is widespread in west that could compensate diet rich in fats and carbohydrates, is often missing. Rapid rise in obesity is seen in all population subgroups in developing nations as well as developed ones, which is a dangerous trend that needs to be tackled by policymakers of health.

Ill Effects

Obesity is a risk factor to many serious diseases like atherosclerosis ( blockage of blood vessels) that could lead to myocardial infarction ( heart stroke) and stroke that could lead to paralysis of limbs. Obesity has led to an increase in prevalence and led to early age of onset of such grave disorders.

Diabetes Mellitus Type 2 has increased association with obesity than genetic predisposition. Diabetes, which could lead to multitude of disorders and enhances morbidity along with mortality, could be controlled by effectively tackling rise in obesity. Hypertension ( rise in blood pressure) is increasingly associated with the presence of obesity. Osteoarthritis ( knee pain) is more prevalent in obese individuals. Snoring and Obstructive sleep apnea, a condition where a person stops breathing for very short time  while sleeping,  are also increased due to obesity.

Obesity decreases the life expectancy in an individual and individuals within a normal range of BMI are proven to be leading more healthier lives with better quality.

Management

• Following a healthy and balanced diet is one of the earliest steps needed to control the obesity. Increased use of vegetables, fruits, fiber and decrease in fats and oils, sugar sweetened cold beverages needs to be adopted by individuals who are obese.
• Lifestyle modifications like changing from sedentary lifestyle to a one with regular exercise is indispensable. Crash diet and exercise regimens need to be avoided as they can’t be used as a long term solution.
• Less energy dense foods like fruits, vegetables should be an essential part of one’s diet. Behavioral changes like avoiding late night food should be followed along with decreasing stress in workplace and at home.
• Practice of yoga regularly  can lead to better BMI and helps to maintain body in a good shape.
• Weight loss medications should be used carefully because of the side effects of the medications in the presence of pre-existing diseases and pregnancy. Some of them can be misused because of the other stimulating effects of medications, that can lead to addiction. Also, medications have a very limited effect in loss of weight.
• GASTRIC BYPASS SURGERY is commonly used for rapid loss of weight. Stomach is directly connected to the distal part of small intestine bypassing early part of small intestine. But, risks of major surgery like infections, embolisms do exist.
• GASTRIC BANDING is a reversible, safe option with quick recovery where a band is placed across stomach leading to early stomach fullness. But, slipping of band and risk of infection do exist. Also, rapid loss of weight can’t be seen as in gastric bypass surgery.
• GASTRIC SLEEVE is a technique where certain volume of stomach is decreased after suturing. Capacity of stomach decreases because of surgery. It can be used when gastric bypass surgery can’t be performed first. It has no slips as in banding. Weight loss is much more rapid than banding along with decrease in surgical complications. However, it is irreversible and at the same time stomach can stretch back to its normal size years later.
• GASTRIC BALLOON : It is a quick, relatively safe with less complications, reversible procedure where deflated balloon is inserted on an out-patient basis and later it is inflated. Early satiety due to balloon helps in moderate weight loss. However, weight gain is possible later.
• Promising procedures with less complications, more weight loss, less recovery time are actively researched upon. Endoscopically pursued bariatric surgeries might become better management options in future.

However, dietary modifications and exercise can’t be replaced by medications or surgeries. They are the essential component of any weight reduction regimen. Importance of lifestyle modification should be disseminated by governments through mass media actively and non-governmental organizations should support those efforts actively.

“PREVENTION IS BETTER THAN CURE” is an apt saying for the management of obesity. Better diet and lifestyle practiced from childhood go a long way in making people healthier, happier and efficient.