Learn about Obesity

Learn about Obesity Learn about Obesity

Does obesity have a cure?

As of now obesity does not have a cure. The closest thing that comes to a cure is the substantial reduction in weight  that we achieve following bariatrics surgery. Even in these patients who have undergone bariatric surgery weight regain could happen after many years following surgery. The main reason for obesity being curable is the fact that obesity is the result of multiple genetic abnormalities which are accumulated in a single person. It could also be due to some changes at the genetic level which happen in Utero during fetal life or due to environmental exposure in infancy. Due to these reasons, the cure of obesity is extremely difficult and has been frustrating.

What does BMI Mean? or Understanding the BMI?

BMI or body mass index is the ratio of your weight in kilograms divided by your height in meters square. Generally BMI is considered as a measure of the amount of body fat that is stored in your body, which is more true above a BMI of 27 or 28 kg/m². Normal BMI is considered between 18.5 to 25 kg/m². Even in this BMI, some people do have excess body fat which is stored around the waist. This is central obesity and can have adverse consequences in the form of high BP, diabetes, mellitus, and excess cardiovascular risk. 

What are the main causes of obesity?

Obesity at its core is a genetic disease. Instead of a single gene encoding for a protein being responsible, obesity is due to multiple genes being abnormal and being present in the same individual. Twin studies have shown that BMI is similar even if the environment is very dissimilar.

Apart from genes other influences that can contribute to obesity include:

  • Certain medication.
  • Long-standing hypothyroidism
  • Shift Work
  • Poor sleep with or without depression
  • Excess cortisol production (Cushing syndrome)

Obesity is classified based on the distribution of body fat into two broad categories:

  • Android obesity /Central Obesity : Fat distribution over abdomen and trunk and relatively sparing arms and legs
  • Gynoid obesity/gluteofemoral: Fat distribution over buttocks, thighs and upper arms.

How is obesity graded?

Obesity is graded based on its severity as measured by body mass index. The following classes of obesity are broadly recognised as:

  • Overweight (not obese), if BMI is 25.0 to 29.9.
  • Class 1 (low-risk) obesity, if BMI is 30.0 to 34.9.
  • Class 2 (moderate-risk) obesity, if BMI is 35.0 to 39.9.
  • Class 3 (high-risk) obesity, if BMI is equal to or greater than 40.0

What are the symptoms of obesity?

Obesity is not uniformly symptomatic in most patients who are obese. It does produce symptoms in a significant minority. Symptoms will include fullness or bloating, poor physical capacity, breathlessness on exertion and fatigue etc. Excess daytime sleepiness can be a symptom of obesity if it causes OSA or obstructive sleep apnoea.  Above a BMI of 35 kg/m² a good number of patients will have lower limb edema. Obesity can cause type2 diabetes and hypertension and these conditions can lead to symptoms. For example if someone with obesity gets diabetes, they can have sudden weight loss if the blood glucose is very high. They can develop tingling, burning or numbness in feet if there is neuropathy. Hypertension can cause heaviness in the head or buzzing in the head. If you have a BMI above 30 and if you have any of the above symptoms, it is important that you meet a doctor to verify whether the symptoms are due to any complications of obesity or due to obesity itself.

What are the complications of obesity?

 Almost all the system of the body obviously there will be some degree of impairment can be seen severe that it reduces the quality of life and a day to day activities in the obese person. These are some of the organ specific complications that could occur in obesity: 

Respiratory complications

  • Obstructive sleep apnea
  • Obesity hypoventilation syndrome
  • Pulmonary thromboembolism
  • Pulmonary artery hypertension

 

Cardiac complications

  • Heart failure with normal ejection fraction
  • Obstructive coronary artery disease
  • Right heart failure secondary to Pulmonary artery hypertension

 

Vascular complications

  • Chronic lower limb venous insufficiency
  • Pedal edema

Musculoskeletal complications

  • Osteoarthritis of knee and ankle
  • Frozen shoulder
  • Carpal tunnel syndrome

Metabolic complications

  • Diabetes mellitus
  • Dyslipidemia

Reproductive complications in women

  • PCOS worsening
  • Endometriosis
  • Fibroid uterus
  • Subfertility due to multiple factors

Reproductive complications in men

  • Erectile dysfunction
  • Central Hypogonadism due to obesity
  • Varicocele

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