Obesity: Beware of crossing the line

Indians are genetically predisposed to gaining fat, making it easy for us to go from overweight to obese

Increased awareness

In India, obesity is not considered a serious disease. Hence, people are not aware that it can be treated medically. Perhaps that’s why the number of morbidly obese individuals has risen at an alarming rate; currently, India alone accounts for about 30 million such people.

Obesity is a progressive, life-threatening, genetically-related and a multi-factorial disease. It’s time we understand the severity of the condition, which is a result of more factors than just excess eating or lack of exercise.

Asians are genetically predisposed to having high body fat content even at a lower body weight. And most of our fat gets deposited in the central region of our bodies [known as central obesity] increasing our risk factors for various diseases.

Further, we are more resistant to insulin than other races, and hence, are at more risk of developing diseases like type-2 diabetes and other metabolic disorders at a comparatively lower body weight and lower age than Caucasians. South Asians around the globe have highest rate of cardio vascular disease or CVD [heart attack with high death rate]. And statistucs predict that there will be around 62 millions patients of CVD in India by 2015 and out of these 23 million will be people less than 40 years of age.

Being Asians, Indians too are vulnerable to obesity and its related disorders. Apart from the discomfort of carrying so much weight around, obese people have to also bear the burden of several diseases that weight brings with it. Obesity is associated with major health problems like type-2 diabetes, high blood pressure, polycystic ovarian disease [PCOD], infertility, gall stones, high cholesterol, early heart diseases, acidity and joint pain. In addition, obese people also face a host of psychological problems like depression, loneliness and suicidal tendencies.

Social discrimination and psychological impairment are the obvious, but somewhat neglected—issues faced by an obese person. They grossly impair the person’s family life, and emotional relationships, and hence his overall quality of life.

Under these circumstances, even a small reduction in weight gives a tremendous boost to the self-confidence and self-esteem of an obese person.

There is much truth in the cliche, prevention is better than cure. We must inculcate healthy eating habits right from childhood to avoid even becoming overweight. For instance, in India we have the age-old practice of celebrating with sweets and high calorie foods. This should be kept at a minimum or even completely avoided. Genetic predispositions aside, lifestyle modification is of prime importance, as lifestyle is the main cause of obesity. Following a properly designed diet with physical exercise can only help till you are overweight. But when you allow ourselves to cross the line into obesity, other interventions like pharmacotherapy [treatment with the help of medicine] have to be considered.

However, medical approaches including pharmacotherapy and behavioural modification will only work in case you are obese. But if you are morbidly obese they may not work. Research shows that the success rate for all such procedures is extremely poor in case of morbidly obese individuals. An estimated 95 per cent of morbidly-obese patients subjected to medical weight-reduction programmes regain their lost weight within two years of the onset of the therapy. Because of the extremely high failure rate of all non-surgical attempts to correct morbid obesity, including diet, behaviour modification and hypnosis, morbid obesity is an indication for surgical correction with the help of bariatric surgery.

Bariatric surgery [term for a group of surgical weight loss procedures] helps obese individuals lose weight and when done under proper guidance, yields good results. It also helps the patient to get rid of the other associated problems obesity brings along like type-2 diabetes and cardiovascular diseases within a short period after the surgery—before the significant weight loss takes place. Since all procedures under bariatric surgery are done using laparoscopic techniques—a key hole technique—they offer quick recovery and are safe.

Some of the common bariatric procedures are:

  • Restrictive operations, where the size of the stomach is reduced. The person undergoing this procedure feels full after consuming a small quantity of food. This restricted diet along with moderate exercise results in a steady weight loss. Adjustable gastric band and sleeve gastrectomy are two such restrictive procedures [they are done laparoscopically].
  • Gastric bypass involves laparoscopically creating a small stomach pouch. It uses both principles restriction and malabsorption of food as its basis—eating a small quantity of food results in a feeling of fullness, and only part of the food consumed is digested.

When considering a bariatric surgery, care should be taken to choose a surgeon who is well-trained about the pre-operative assessment and post-operative follow up.

Women and obesity

Obesity can have an adverse impact on health at each stage of a woman’s life cycle—obesity impacts a young woman’s psychosocial health and she grows older even her reproductive health. Obesity also imposes a number of serious risks during pregnancy—right from the first month. In fact, most young mothers gain weight during their pregnancy and then remain obese for the rest of their lives.

Some tend to gain weight during their menopause. In older women, obesity is associated with the emergence of a number of chronic diseases such as type-2 diabetes, cardiovascular disease, and increased risk for almost all types of cancer.

Some women suffer from obesity for identifiable psychological reasons that manifest themselves as expressions of their underlying unhappiness or depression.

Obesity also has a marked impact on life expectancy, which can affect her children as well. As per a recent study by International Day of Evaluation of Abdominal Obesity [IDEA], almost 75 per cent Indian women suffer from abdominal obesity [58 per cent Indian men have that problem].


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