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Obesity (Overweight)

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  3. Obesity (Overweight)

Overview of Obesity (Overweight)

Obesity is one of the leading health concerns worldwide. It originated from the word “obese”, and it is used for the person who has a lot of body fat and is very overweight.

Obesity Meaning in Urdu

موٹاپہ ایک خطرناک بیماری ہے جو کہ دنیا بھر میں کروڑوں لوگوں کو متاثر کر چکی ہے۔ اس بیماری کی وجہ سے جسم میں بہت زیادہ چربی بن جاتی ہے جس سے چھٹکارا پانا قدرے مشکل ہوتا ہے۔ موٹاپے سے اگر بر وقت نجات حاصل نہ کی جائے تو بہت سی بیماریوں جیسا کہ ذیابیطس، ہائی بلڈ پریشر، اور کئی طرح کے کنیسر کے خطرات بڑھ جاتے ہیں۔ موٹاپے سے چھٹکارا پانے کے لیے ورزش کا مشورہ دیا جاتا ہے اور کچھ خاص غذائیں تجویز کی جاتی ہیں۔

Obesity is a complex kind of disease and it involves the excess amount of fat in the body. Obesity meaning in Urdu is موٹاپا and is not a mere concern of appearance. It is a serious medical issue and it increases the risk of several other health issues such as high blood pressure, diabetes, heart diseases, and even cancer.

Various factors contribute to obesity and why people don’t lose weight. Generally, obesity is hereditary and can result from environmental and psychological factors along with lifestyle and eating habits.

But, the good news here is that even moderate weight loss can not only improve our health but prevent serious illnesses that are linked with obesity. Physical activity, a healthy diet, and moderate exercise can help you in weight loss. Medication and other procedures for weight loss can also be recommended by doctors for treating obesity.

How common is Obesity in Pakistan?

Various studies and surveys conducted showed that over half of the population of Pakistan is suffering from obesity, putting them at risk of various health complications. The prevalence of obesity and overweight issues in the Pakistani population was 25%. The occurrence of obesity was found to be highest among women of the age group 35-54 years old (i.e. 42.8%). In the age group of 15-24 years old, 13.8% of women and 12.4% of men were suffering from obesity.

According to the stats of WHO:

  • The rate of obesity has increased triple times since 1975.
  • 39 million children under the age group of 5 years were suffering from obesity in 2020.
  • Obesity is a preventable disease.

Signs and Symptoms of Obesity (Overweight)

To diagnose obesity, body mass index (BMI) is used. BMI is calculated by multiplying the weight in pounds by 703 and then dividing it by height in inches and then again dividing by height in inches. Or you can divide the weight in kg by height in meters squared.

Asians are at higher risk of suffering from heart health issues if they have a BMI of 23 or more. For people generally, BMI can give an idea about body fat. But, it doesn’t directly measure body fat. For example, muscular athletes may have BMI in the category of obesity even when they don’t have excess body fat.

Many health practitioners would also measure the waist of a person for better treatment options. Weight-related health issues are more common in men who have a waist over 40 inches and 35 inches waist measurement for women.

Types of Obesity (Overweight)

Causes of Obesity (Overweight)

Obesity is caused by the fact that you eat more calories than you burn during your daily activity and exercise. If left untreated, these calories would increase and make you gain weight.

It is not always about the sedentary lifestyle and the calories in and out. Obesity can also be due to reasons that you can’t control.

Some of the common causes of obesity include:

  • Genetics – Your genes would affect how the fat is stored in the body and how your body is able to process the food into energy.
  • Age – With age your body starts to have decreased metabolic rate and less muscle mass, leading to weight gain.
  • Sleep Deficiency – If you are not taking enough sleep, it’ll cause hormonal changes that will make you feel more hungry and crave high-calorie foods.
  • Pregnancy – It is normal to gain weight during pregnancy, but it can be difficult to lose weight and can lead to obesity.

There are various health issues, which can also cause obesity. These include:

  • PCOS (Polycystic Ovary Syndrome) – It is a female disease that affects hormones.
  • Cushing Syndrome – In this condition, your body produces a high level of stress hormone i.e. cortisol.
  • Prader-Willi Syndrome – It is a rare syndrome that is present at the time of birth and it causes excessive hunger.
  • Hypothyroidism – In this condition, your thyroid is not producing the necessary amount of certain hormones.
  • Osteoarthritis and related health conditions can cause pain in the body thus leading to reduced physical activity.
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Risk Factors of Obesity (Overweight)

There are various factors that can increase the number of people suffering from obesity. Here are some of the major risk factors:

  • Genetics or Family History – If you have a family history of obesity, it is more likely that obesity runs in your genes. In this case, it would be difficult for you to lose weight.
  • Environment and Community – Your environment such as home, community, school or college can influence your eating habits and how active you are. You are at a higher risk of obesity if you live in a neighbourhood that has limited options for healthy food, don’t know how to cook, can’t afford healthy foods and do not have a place to walk.
  • Psychological Factors – Anxiety and depression can put you at risk of obesity due to emotional eating. There are certain antidepressants that can increase your risk of suffering from weight gain.
  • Lifestyle Choices – Unhealthy diet, high intake of liquid calories and physical inactivity can lead to obesity.
  • Medication – There are certain medical conditions such as arthritis that can lead to physical inactivity that leads to an increase in weight gain. Even medication for such health issues can lead to obesity if not controlled with exercise and diet. These medications include anti-seizure medicines, antidepressants, antipsychotic medications, diabetes, beta-blockers and steroids.
  • Social and Economic Issues – Obesity is linked with socio-economic issues. Obesity is unavoidable if you don’t have access to safe places for exercise and healthier foods.
  • Age – Obesity is a disease not comprehended by any age group. Even children are prone to obesity. However, with age, your physical activity decreases and hormonal changes increase that increasing obesity risk. Decreased metabolism is due to lower muscles mass. With age, your calorie needs to decrease and it ultimately makes it hard to lose weight.
  • Other Factors – Lack of sleep, smoking habits, pregnancy and stress can also put you at risk of obesity. In fact, your microbiome or gut bacteria are highly affected by what you are eating and it does contribute to weight gain and may also pose difficulty in losing weight.

Even if you have one or more of these risk factors, it does not mean that you’ll have obesity. You can easily counter most of these risk factors by your diet, exercise, physical activity and behaviour changes.

Health Complications Due to Obesity

If you are suffering from obesity, it is more likely that you’ll suffer from many other severe health issues. Such as:

  • Heart Disease and Strokes – You are prone to suffering from high levels of cholesterol and high blood pressure if you are suffering from obesity. These two health conditions are risk factors for strokes and heart disease.
  • Cancers – Obesity is the trigger of many health issues. If you are suffering from obesity, it would increase the risk of cervical cancer, uterine cancer, ovarian cancer, colon cancer, breast cancer, esophagal cancer, rectum cancer, liver cancer, pancreatic cancer, gallbladder cancer, prostate cancer, and kidney cancer.
  • Type 2 Diabetes – Obesity can affect your body’s behavior towards insulin and in controlling blood sugar levels. Obesity increases the risk of diabetes type 2.
  • Gut Health Issues – Due to obesity, you are prone to suffer from liver, gallbladder, and heartburn health issues.
  • Sleep Apnea – People suffering from obesity, are more likely to suffer from sleep apnea. It is a serious health issue, in which breathing stops and starts when a person is sleeping.
  • Osteoarthritis – Obesity puts stress on the joints, thus promoting inflammation, leading to obesity.
  • COVID-19 Symptoms – If you are obese and are infected with the COVID-19 virus, then your symptoms worsen. People with severe symptoms of COVID-19 or coronavirus may need treatment in intensive care units.

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Prevention

There is no simple or single solution to prevent obesity. It is a complex health issue and thus it requires multiple strategies. But, preventing obesity is sure to help you in reducing your risk of other health issues such as cancers, diabetes and various heart health issues.

Obesity is preventable like many other chronic health conditions. All you need to do is opting a healthy lifestyle by eating healthy food, exercising properly, and taking sufficient sleep. These preventions are already more for the treatment of obesity.

Here are some of the preventive measures for obesity:

  • Healthy Diet – You need to add fresh fruits and vegetables to your diet every day. As per the stats of WHO, fruits and vegetables can decrease the risk of obesity. These foods are rich in nutrients that are helpful in decreasing the risk of obesity.
  • Avoid Processed Foods – Processed foods are a rich source of calories. So the more you consume processed foods, the more weight you’d gain.
  • Reduce Sugar Intake – Another reason to reduce the intake of sugar is obesity. You need to limit your sugar. Examples of sugary foods are energy drinks, sodas, sports drinks, desserts like pies, cakes and cakes, fruit juices, candies, and even ice cream.
  • Avoid Artificial Sweeteners – You need to limit or avoid intake of artificial sweeteners. Artificial sweeteners are linked with diabetes and obesity. If you really want to have a sweetener, you can opt for the natural alternative i.e. honey.
  • Add Sufficient Water – You need to sip wisely. You need to drink more water and avoid sugary beverages. Water should be your go-to beverage. Avoid sugary drinks as they not only increase the risk of heart diseases but also obesity.
  • Avoid Saturated Fats – Various studies show that food having saturated fats leads to obesity. You need to add a healthy source of fats such as monosaturated and polyunsaturated such as olive oil, tree nuts, and avocados. Even healthy fats are recommended to be taken at a moderate level.
  • Homemade Meal – Research shows that women and men who prepare meals at home at less likely to suffer from obesity or gain weight. In fact, they are less likely to suffer from diabetes type 2.
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Diagnosis

To diagnose obesity, the medical practitioner would firstly perform a physical test and then recommend some of the tests.

These tests and exams include:

  • Medical History – The doctor will review your weight loss effort, weight history, exercise habits, physical activity, eating pattern, control of appetite, any health issue, stress level, medication history, etc. Your medical health practitioner would also check the healthy history of your family and check if there is any hereditary disease.
  • Physical Exam – In this, the doctor would check your vital signs such as temperature, blood pressure, and heart rate, measure height and listen to your lungs and heart, and even examine your abdomen.
  • Calculating your BMI – Your medical health provider would measure your BMI. If the BMI is above 30 or higher, you would be considered obese. This BMI increases your risk of suffering from other health issues. You need to yearly examine your BMI to avoid health risks and for better treatment options.
  • Measuring Waist Circumference – Fat is also stored around your waist. It is known as abdominal or visceral fat. It increases the risk of diabetes and heart disease. Women who have a waist of over 35 inches and men with a waist over 40 inches are considered obese and have more health issues. Just like BMI, you also need to measure your waist yearly.
  • Look Out for Other Health Issues – If you are suffering from any health issue, your doctor would evaluate it first. Your medical health practitioner would also check your high cholesterol, high blood pressure, diabetes, liver problems, an underactive thyroid problems.

Treatment of Obesity (Overweight) | When to Consult a Doctor

The ultimate goal of obesity treatment is to reduce weight, stay active and achieve a healthy weight. This reduces the risk of health complications and overall health.

For obesity treatment, you may need the help of one or more health practitioners such as a dietitian, obesity specialist or behavioural counsellor.

The initial treatment goal of obesity is to lose moderate weight. In this case, increased physical activity and changes in eating habits are required. The treatment method would vary from person to person depending upon the age, severity of obesity and overall health in general.

Let’s have a look at the treatment options for weight loss.

1: Dietary Changes

Healthy eating habits and cutting calories is a must for overcoming the problem of obesity. You may end up losing weight quickly. But, the safest and long term treatment for weight loss is steady weight loss instead of a quick one.

No diet is considered as best weight loss diet as it would vary from person to person. So, you need to talk with your nutritionist or dietitian to opt for the best suited for you. However, the dietary changes that you need to opt for should include:

  • Cutting the Calories – The first step toward losing weight is to cut the calories. Typically recommended calorie intake while losing weight is 1500-1800 for men and 1200-1500 for women. However, you need to discuss this with your doctor first.
  • Feel Full on Less – You need to know the food you are eating. Fruits and vegetables can provide a large portion of food in just a few calories. While, sweets, desserts, fatty foods and processed food products have a large portion of calories even for smaller portions. So, when you eat a larger portion of food that has few calories, you feel full and is best for weight loss.
  • Healthy Diet Choices – You need to make healthy eating habits. For this, you need to add whole grains, fruits and vegetables to your diet. If you like meat or fish, you need to cut it down twice a week. Add lean sources of protein to your diet such as soy, lentils and beans. Avoid artificial sweeteners and added sugar. Eat healthy fat sources but in small amounts.
  • Restrict Intake of Certain Foods – You need to avoid or restrict certain full fat or food rich in carbohydrates. You need to restrict the intake of sugary beverages as well. Restricting or simply eliminating these beverages is good for your overall health.
  • Meal Substitutes – The plan in this is that you replace one meal with other. For example, you are required to replace high-calorie foods with low-calorie healthy meals and snacks. This can help you lose weight. But, these diets won’t help you how to improve your lifestyle habits so you need to work on them for a healthy life.

However, be wary of the quick diet fixes. You may be tempted by them in your quest of losing weight quickly, but you are likely to gain weight once you stop that diet. The reality is that there is “no-magic food”. So, you need to adopt healthy eating habits.

2: Exercise

Exercise and increased physical activity are necessary for losing weight. You need to:

  • Exercise – People suffering from obesity need to exercise at least 30 minutes a week to maintain a healthy weight and prevent further weight gain. You may also need to increase the time of exercise to improve your fitness and endurance level.
  • Keep Yourself Active – Even though aerobic exercise is one of the best ways to burn extra calories but needs to be physically active to burn extra calories. You can do this by avoiding elevators and taking steps. Try to walk, at least 10,000 steps every day and with time, increase the steps to reach your goal.

3: Behavioural Changes

Behavioural therapy helps not only help you maintain a healthy lifestyle. But, it can help you overcome obesity. You need to examine your behaviour and look for the triggers for your stress.

  • Go for Counselling – You can reach out to a psychiatrist/psychologist or counsellor and talk about your eating disorders. This will help you address the trigger causing emotional eating. Therapy can help you in a miraculous way by making you understand why you overeat. You’ll learn healthy eating options and ways to cope with your stress and anxiety. This counselling can be a one-on-one session or in form of a group.
  • Join Support Groups – Joining a support group can help you cope with obesity. A place, where people find similar issues and challenges towards obesity can make you feel being understood and supported. You can ask your doctor or lookout for this in a local hospital or in your community for such support programs.

4: Medication for Weight loss

Medication for weight loss should be taken with a healthy diet, behaviour changes and exercise, not without them. Your doctor will inquire about your medical history, possible side effects and overall health before prescribing the medication.

Most common FDA approved obesity medications include:

  • Bupropion-naltrexone (Contrave)
  • Orlistat (Alli, Xenical)
  • Liraglutide (Saxenda)
  • Phentermine-topiramate (Qsymia)
  • Weight-loss medicines might not be effective for everyone. The effect of these medications may even wear out over time once you stop taking the medication.

So, you must take medication only after prescribed by the doctor and discuss its pros and cons with your doctor.

5: Weight Loss by Endoscopic Procedure

Incisions are not done in these procedures. In these procedures, you are given anaesthesia and then flexible tools and tubes are inserted into your stomach via the mouth. These procedures include:

  • Endoscopic Sleeve Gastroplasty – In this, the size of the stomach is reduced by stitching to limit the amount of food and liquid intake. Thus, over time since the intake of food and liquid is reduced, it helps in losing weight.
  • Intragastric Balloon – A small balloon is placed in the stomach in this procedure. In order to make you feel full and reduce food intake, this balloon is filled with water. This way, the balloon reduces the space in the stomach.

6: Surgical Procedure for Weight Loss

Weight loss surgery is also known as bariatric surgery. This surgical procedure limits the amount of food intake or simply decreases food absorption.

Following are some of the common bariatric surgeries:

  • Adjustable Gastric Banding – In this procedure, the stomach is separated into two pouches by an inflatable band. A tiny channel is created in these two pouches when the surgeon pulls the band tight. This band keep the stomach in check from expanding. The band is normally designed to stay in place permanently.
  • Gastric Bypass Surgery – A small pouch is created on the top of a stomach in this surgery. Below the stomach, the small intestine is cut and connected with this pouch. Liquid and food than directly flow from this pouch into that certain part of the small intestine hence bypassing the stomach.
  • Gastric Sleeve – A part of the stomach is removed in this surgery. Thus there is a small reservoir for the food. Compared to gastric surgery, it is a less complicated surgery.

Weight loss after these surgical treatments depends that how committed you are to your health and eating habits.

7: Other Weight Loss Treatments

There are other weight loss treatments that include:

  • Hydrogels – These are edible capsules and can only be used after prescription. These capsules absorb water from the stomach and increase in size in the stomach, making you feel full. The capsules are to be taken before eating food and are removed via stool.
  • Gastric Aspirate – A tube is placed in the stomach through the abdomen in this procedure. After each meal, a portion of the stomach contents is then drained out.
  • Vagal Nerve Blockade – In this procedure, a device is planted under the abdomen in the skin. This transmits signals to the abdominal vagus nerve telling the brain that the stomach is full.

In case of any concerning signs and symptoms, you need to reach out to a certified family physician or bariatric surgeon. 

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