Get Fat Free, Get Healthy

Obesity not only affects your health, but also hampers the entire quality of life

Illustration of fat and thin girlsIn our society, which is so obsessed with looks, people think that being obese is only an appearance issue. Obesity is actually a medical concern because it can seriously affect a person’s health irrespective of his/her age. Thanks to obesity, younger people are now developing health problems that earlier affected only the adults – like high blood pressure, high cholesterol and Type-2 diabetes.

What is obesity?

When people eat more calories than they burn, their bodies store the extra calories as fat. Obesity is an accumulation of this excess body fat to an extent that may impair health. This occurs over a period of time. The balance between calories-in and calories-out varies from one person to another. Factors that might tip the balance include your genetic makeup, overeating and eating high-fat food with very little or no physical activity.

Measuring Obesity

A crude measure of excess fat is the body mass index [BMI], which is a person’s weight [in kilograms], divided by the square of his/her height [in metres]. WHO defines overweight as a BMI of 25 or more, and obesity as a BMI of 30 or more. There is also evidence that the risk of chronic disease increases progressively as average BMI raises above 21.

Threats of obesity

Obesity comes with its bag and baggage of threats. Some of them are listed below:

Years of life lost – People who are obese do not live as long as those who are not obese. The earlier a person becomes obese, the more years of his/her life are lost.

Dysmetabolic Syndrome X – This syndrome involves abdominal obesity, abnormal blood-fat levels, changes in insulin sensitivity and inflammation of the arteries. It is associated with a markedly increased risk of heart and blood vessel disease – a precursor to the onset of diabetes in adults.

Heart disease – Severely obese persons are approximately six times more likely to develop heart disease as those who weigh in the normal range for their body type.

High blood pressure – Essential hypertension, the progressive elevation of blood pressure, is more common in obese persons leading to development of heart disease, and damage to the blood vessels, causing susceptibility to strokes, kidney damage, and hardening of the arteries.

High blood cholesterol – Cholesterol levels are commonly elevated in the severely obese – another factor predisposing to development of heart and blood vessel disease.

Diabetes Mellitus – Overweight persons are 40 times more likely to develop Type-2 diabetes! Elevation of the blood sugar, which is the essential feature of diabetes, leads to damage of tissues throughout the body. Diabetes is the leading cause of adult-onset blindness, kidney failure and also of over one-half of all amputations.

Sleep Apnea Syndrome – The stoppage of breathing during sleep is commonly caused in the obese, by compression of the neck, closing the air passage to the lungs.

Obesity Hypoventilation Syndrome – It is characterised by episodes of drowsiness, or narcosis and is caused by abnormalities of breathing and accumulation of toxic levels of carbondioxide in the blood.

Respiratory Insufficiency – Obese persons find that exercise causes breathlessness very quickly, even during ordinary activities. This condition prevents them from doing normal physical activities and exercise, often interfering with usual daily chores.

Heartburn – The real problem is not with digestion, but with the powerful acid from the stomach that reaches the oesophagus causing a burning sensation.

Asthma and Bronchitis – Obesity is associated with a higher rate of asthma, about three times more than normal.

Gallbladder disease – Gallbladder disease occurs much more frequently in the obese, leading to stones in the gallbladder, abdominal pain and ultimately needing removal of the gallbladder.

Besides the above, there are other health problems like stress, urinary incontinence, degenerative disease of Lumbo-Sacral Spine, degenerative arthritis of weight-bearing joints, venous stasis disease, embolism and many social and psychological effects, which may be serious.

Some surgical options

Losing even 5-10 per cent of your weight can delay or prevent some of the diseases discussed above. These results can often come from fitness centres, dieticians and nutritionists. But, there are conditions when surgery alone is the best option to deal with obesity.

You can choose from Gastric Banding or Gastric Bypass surgeries that automatically restrict eating, leading to decreased absorption of food that you eat. In Gastric Banding, a band is placed in the upper stomach to create a smaller stomach pouch to decrease the capacity of the stomach and its ability to eat. In Gastric Bypass surgery, the capacity of the stomach is reduced by stapling the intestines to create a smaller pocket of the stomach. These operations are done by laparoscopy and are keyhole surgeries, which leave only tiny scars as they are minimal access surgeries and assure a quick recovery.

Apart from these surgical remedies, it’s never too late for you to make lifestyle changes that can effectively control weight. The changes need not be big. For a start, make a plan to eat healthy and exercise regularly, even if it’s just for 5-10 minutes a day. Build your way up to bigger changes by making a series of such small ones. And most importantly, never be afraid to ask for help.

M G Bhatt
Dr M G Bhatt, MS [General Surgery] and FRCS [England], is a consultant for gastroenterology and laproscopy at Wockhardt Hosptial, Bangalore, India.


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