Obesity

   What is Obesity

Obesity is defined as the accumulation of excess fat in the body and this arises as a result of an imbalance between energy expenditure and energy intake. This has serious implications for health, as an obese person has a much greater risk of dying prematurely and developing chronic and potentially disabling diseases, the commonest being cardiovascular disease, Type 2 Diabetes and osteoarthritis. Morbid obesity may have serious implications for day to day functioning.

Obesity levels are generally higher in women than men, though there are exceptions to this. Obesity, although affecting almost all ages and socio- economic groups, affects the lower socio-economic groups more and this is believed to be related to patterns of behavior in eating and taking exercise.

Obesity has major implications throughout the world because of the impact of its medical, psychological, social and financial effects.

Measuring Obesity

A crude population measure of obesity is the body mass index (BMI) which is a simple index of weight-for-height that is commonly used in classifying overweight and obesity in adult populations and individuals - a person's weight in kilograms is divided by the square of the height in meters (kg/m2). BMI provides the most useful population-level measure of overweight and obesity as it is the same for both sexes and for all ages of adults but it is merely a rough guide because it may not correspond to the same degree of fatness in different individuals.

The WHO defines an adult who has a BMI between 25 and 29.9 as overweight - an adult who has a BMI of 30 or higher is considered obese - a BMI below 18.5 is considered underweight, and between 18.5 to 24.9 a healthy weight .

 BMI provides a benchmark for individual assessment, but experts suspect that the risk of chronic disease in populations increases progressively from a BMI of 21 upwards.

Measuring overweight and obesity in children aged 5 to 14 years is challenging - the WHO Child Growth Standards includes BMI charts for infants and young children up to age 5 - childhood obesity is associated with a higher chance of premature death and disability in adulthood.

BMI ranges for children and teens are defined so that they take into account normal differences in body fat between boys and girls and differences in body fat at various ages. However although BMI correlates with the amount of body fat, BMI does not directly measure body fat and some people, such as athletes, may have a BMI that identifies them as overweight even though they do not have excess body fat.

Other methods of estimating body fat and body fat distribution include measurements of skin fold thickness and waist circumference, calculation of waist-to-hip circumference ratios, and techniques such as ultrasound, computed tomography, and magnetic resonance imaging (MRI).

Prevention

In terms of public health, healthcare professionals have a part to play in lobbying for initiatives to:

• Facilitate healthier travel (e.g. walking and cycling to work or school)
• Promote more active recreation in society
• Facilitate better access to healthy foods
• Promote sport and physical recreation in schools
• Improve opportunities to lead a healthier lifestyle

Treatment

Although obesity in itself is associated with increased morbidity and mortality, massive poorly monitored weight loss and/or weight cycling can have equally dire consequences. Among the important potential complications to watch out for in the setting of weight loss are cardiac arrhythmias; electrolyte derangements, of which hypokalemia is the most important; hyperuricemia; and psychologic sequelae, including depression and the development of eating disorders (particularly binge-eating disorders).

Obesity treatments can include dieting and exercise, behavioural therapy, weight loss drug therapy and surgery. These options are usually recommended by a health professional or your doctor, after your body mass index (BMI) has been calculated and factors such as your health history, mobility, and ability to comply with dietary and other behavioural treatment have been considered and assessed. You may be encouraged to combine two or more treatments to achieve better results.

Prescription Xenical tablets are proven to have a higher success rate than ordinary slimming pills. They work by preventing your body from absorbing all the fat within your food. You can obtain Xenical if you have a BMI of 30 and above, although patients who have a BMI of 27 may be approved for treatment if they are at risk of serious health problems.

Xenical usually starts to affect how you digest fat within one to two days. Studies show that Xenical can help to block up to a third of the fat in your diet from being absorbed. Treatment should only continue beyond three months if you have lost less than 5% of your body weight. If the drug has not worked after this timeframe, you may look to alternative treatment methods such as surgery.

If you have been following a healthy diet and have increased your physical activity, but have not witnessed any positive transformation in your weight, you can purchase slimming pills or ask your doctor to prescribe you a course of Xenical tablets.

Non-prescription slimming pills work by increasing your metabolic rate and helping you to burn more fat. There are minimal side effects associated with taking slimming pills as they are usually naturally formulated, which means they can be purchased freely over-the-counter. However, there is no guarantee that your weight loss goals will be achieved. This is why manufacturers often market products as supplements for a healthy diet and exercise plan, rather than as an obesity treatment.

The recommended rate of weight loss is 0.5 to 1kg (1 to 2 lbs) per week. When trying to lose weight, a common mistake is to try various methods of fast weight loss, which generally do more harm than good. When this proves unsuccessful people can become disheartened, sometimes making the situation worse by comfort eating. You should ensure you leave plenty of time to practice new eating patterns, so your body stands a much better chance of adjusting to the reduced food intake.

A new diet regime can be aided by separate exercise sessions of ten or 15 minutes. To see a noticeable improvement in your weight, you should be aiming to do 30 minutes of exercise at least five times per week. Increasing your amount of physical activity doesn't necessarily mean joining a gym; you can carry out everyday activities such as gardening, washing the car, walking up stairs or planning outdoor activities with your friends.

Diet and exercise is an important part of any obesity treatment. Regardless of which treatment you choose, you will need to make important lifestyle changes to achieve real weight loss.

Surgical procedures

Weight loss surgery is carried out to restrict the amount of food a person can eat. The most common types of surgery include gastric band surgery, gastric bypass, bilopancreatic diversion and sleeve gastrectomy. Operations can take anything from 30 minutes to several hours to successfully complete and if performed privately, can cost as much as £20,000.

Surgery is recommended for people with obesity who:

Have a BMI of 40 or higher

Have a BMI between 35 and 40 with diabetes or high blood pressure

Have tried other suitable ways of losing weight without any success

Repeated surgical procedures may be needed to keep the results in place. This may leave behind further swelling, bruising and scarring. For these reasons, patients should first try less complicated and safer treatment methods such as prescription medication.