As per new guidelines released by the American Heart Association, doctors should consider obesity as a disease and not merely an attribute

Doctors  should more actively treat obese patients for weight loss.  The weight loss is recommended to prevent heart disease and stroke, the USA’s No. 1 and No. 4 killers respectively (other countries also may match the statistics).
Obesity, a life style disease, means having too much body fat whereas being overweight means weighing too much. Obesity is an abnormal accumulation of body fat, generally 20% or more over an individual’s ideal body weight and this has adverse impact on the health of the person. Obesity affects people of all ages and socio-economic divide. The branch of medicine that deals with the study and treatment of obesity is known as Bariatrics.

Key facts about obesity (as per World health Organization)

• Worldwide obesity has nearly doubled since 1980.
• In 2008, more than 1.4 billion adults, 20 yr and older, were overweight. Of these over 200 million men and nearly 300 million women were obese.
• 35% of adults aged 20 and over were overweight in 2008, and 11% were obese.
• 65% of the world’s population live in countries where overweight and obesity kills more people than underweight.
• More than 40 million children under the age of 5 were overweight or obese in 2012.
• Obesity is preventable.
• Measurement of obesity is done by Body Mass Index (BMI), which is weight of the person divided by the square of their height.
• Severe obesity: Any BMI ≥ 35 or 40 kg/m2
• Morbid obesity: A BMI of ≥ 35 kg/m2 and experiencing obesity-related health conditions or ≥40–44.9 kg/m2
• Super obesity: A BMI of ≥ 45 or 50 kg/m2.
• It has been seen that Asian population develop adverse health consequences related to obesity at a comparatively lower BMI than their western counterparts; as a result some nations have redefined obesity; the Japanese have defined obesity as any BMI greater than 25 kg/m while China uses a BMI of greater than 28 kg/m2.
• Although Genetic factors play an important role in the cause of obesity; obesity is generally caused by consuming more calories in the form of fats and sweetened foods and less amount of physical activity. This excess energy is then stored by the body as fat. Thus eating habits and amount of physical activity one does play a very significant role in the quantum of weight a person gains.

Leading causes of obesity can be enumerated as follows

• Genetics
• Endocrine disorders
• Junk food/unhealthy food
• Alcohol
• Sedentary lifestyle
• Obesity is one of the leading risk factors of various diseases like
• High blood pressure
• Diabetes
• Coronary artery disease
• DiabetesStroke
• Early osteoarthritis
• Gall bladder disease/ stones
• Fungal skin disorders from increased friction between thick folds of skin
• Obstructive sleep apnoea
• Metabolic syndrome
• Heartburn (riflux disease)
• Hernia
• Disability
• Gynecological problems, such as infertility and irregular periods
• Erectile dysfunction and sexual health issues
• Low self esteem
• Depression/ Social isolation

Studies have conclusively shown that as high as 85% of persons who go on a diet to lose weight, do not exercise regularly and as a result regain the lost weight within 1-2 years. This losing and gaining weight, known as yo-yo effect, causes the body fat percentage to go higher and higher. E.g. a person who starts from 100 kg, goes down to 90 kg body weight thrice and each time bounces back to 100 kg, will have much more of body fat that when he started. This stored fat is a significant risk factor for developing heart disease, diabetes, high blood pressure etc.

Following steps are recommended to prevent and manage obesity

• Monitor fat consumption rather than just counting calories
• Keep a detailed food diary to assess eating habits and share with your dietician.
• Eating three balanced moderate-portion meals a day with the main meal at mid-day is a more effective way to prevent obesity rather than fasting or crash diets, which never work
• Regular and effective exercise along with regular, healthy meals causes calories to burn continuously at an accelerated rate for several hours. Small steps like climbing instead of taking elevator, walking for small chores than taking car or bike do make an impact.
• Prevent childhood obesity and the other health problems by encouraging healthy habits in children

Thus to achieve and maintain healthy ideal body weight for a long period (read lifelong) strong commitment towards regular exercise and sensible eating habits is needed.

In addition to her MBBS & DNBE in Family Medicine, , Dr Asmita Shah possesses a Diploma in YOGA (Mumbai University) and has a Speciality Certificate in ANC Exercise. She is a Fitness Consultant, Family Planning Counsel and a Member of Association for Advance Research in Obesity AARO). She is in clinical practice for over 30 years