Obesity

What is Obesity – Obesity is defined as carrying excessive body fat.

A person is considered to be overweight if his BMI (Body Mass Index) is between 25.0 to 29.9 and if his BMI > 30.0, the person is considered obese.
Basal Metabolic Index (BMI) = Weight (in kg)/ height (in sq. m.)

Types of abdominal shape –

  1. Apple-shaped obesity/ Potbelly/ round/ bear belly.
  2. Pear-shaped obesity/ triangle shaped/ gynoid shaped where fats get deposited on buttocks, thighs & hips – here the waist is narrow, hands and neck are slim. This type of obesity is mainly found in women. These types of people are more prone to varicose veins, osteoporosis, Cellulite (with uneven skin areas & dimpled skin) and hormonal disturbance. This is stubborn obesity.

Two types of fat distribution-

  1. Visceral or abdominal fat-
    • Concept of visceral fat- According to the research, 10% of our body fat is stored as visceral fat or the active fat or the intraabdominal fat.
    • If the waist measures greater than 35 inch (>88 cm) for females and 40 inch (102 cm) for males, then it means the content of fats stored in the liver, pancreas, and intestines is in excess. When waist-to-hip ratio increases, chances of diseases & death increase. Obesity is calculated by the circumference of the waist divided by the circumference of the hips. If it is greater than >0.85 for females & >0.9 for males, it is termed as obesity.
  2. Concept of Subcutaneous fat – This is usually harmless and can be seen or pinched just under the skin. This fat plays a protective role in general and even in the patients of central obesity. The two types of fat often coexist. Subcutaneous fats provide resistance, regulate temperature, protect the body from hit & fall and strengthens bones & ligaments & muscles.

Causes of obesity (more than one factor may contribute to obesity)

Genetics Lack of sleep Hypothyroidism
Unhealthy lifestyle Alcohol & drug abuse Prolonged sitting work
Diabetes Type II and insulin resistance Pregnancy & post-delivery weight gain Unhealthy food habits – consumption of high-calorie food
Post hysterectomy or post-menopausal weight gain Natural body constitution (Kaphaj or dwandaj prakriti) Other organic diseases like PCOS and ovarian disorders
Certain kind of nervosa or psychopathological eating behavior High activity of cortisol hormone or the stress hormone (this hormone leads to central obesity, PCOS & insulin resistance) Side-effects of certain medicines like certain antidepressants, glucocorticoids, atypical antipsychotics and corticosteroids

Signs & symptoms –

Fatigue Increased hunger Back, Hip & knee pain Constipation and acid reflux (GERD)
Lethargy Profuse sweating Swelling in lower body parts Early exertion on any physical activity
Snoring Body dissatisfaction Low confidence & self-esteem Flat feet and dislocated hip, pop sound of knees

Risk factors & complications

Stroke High cholesterol High blood pressure
Gallstones Alzheimer’s disease Urinary bladder issues
Liver disease ( Fatty changes) Polycystic ovarian disease (PCOS) Diabetes Mellitus Type II
Hypothyroidism (including subclinical form) Chronic kidney disease including kidney stones Varicose veins, blood clots & venous stasis
Musculoskeletal pain including Osteoarthritis & Gout Breathing difficulty including Respiratory diseases like asthma Coronary artery disease and ischemic heart diseases
Nasal obstruction including obstructive sleep, sleep apnea, and hypoventilation syndrome Certain cancers including colon, breast, endometrial, prostrate, cervix, pancreas, kidney & oesophagus Issues related to the reproductive system like ED, infertility & menstrual issues

Differential diagnosis –

Abdominal gas Ascites

Associated testing – 

Lipid Profile Blood Pressure FBS, PPBS, Hna1c
Hormone profile in females according to signs & symptoms

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