OBESITY

Pretty much ironic and not exactly accurate, the one-time known ‘diseases of affluence’ have transcended in a huge way to the low socio-economic strata of the population; and this trend has been widely prevalent since the end of the Second World War. ‘Diseases of affluence’ are mostly non-communicable diseases of which economic development is a risk factor, and Obesity makes the cut in the host of these conditions.

Obesity; often defined as a medical condition in which the body collects excess body fat to a point when it begins to have a negative effect on health. Obesity was rare in the historical periods and it was known to be widely prevalent among the elite of society, most often seen as a sign of wealth. Modern societies often characterized by coalesced settlements living together for much longer periods ushered in a new age where prevalence of Obesity steadily rose. The World health Organization recognized it as a global epidemic in 1997. According to WHO, as of 2008, it was estimated that 500 million adults (greater than 10%) are obese, the rates were higher in women that in men.

A parameter known as the BMI (Body Mass Index) is used to determine obesity. BMI is often defined as a measure of whether someone is over or underweight; calculated by dividing their weight in kilograms by the square of their height in meters. Conventionally; although it may differ in different populations:

  1. Any BMI greater or equal to 35 or 40 kg/m^2 is severe obesity
  2. A BMI of greater or 35 kg/m^2 and experiencing obesity-related health conditions or greater or equal to 40-44.9 kg/m^2 is morbid obesity
  3. A BMI of greater or equal to 45 or 50 kg/m^2 is super obesity

There are known causes of Obesity and these include:

  1. Diet: Oftentimes, a mix of high amounts of food intake and poor dietary choices on types of food have been confirmed to cause obesity. The intake of very high calorie containing foods is a factor.
  2. Sedentary lifestyle: Exercise drills are known to burn body calories into energy that is expended through light exercises or strenuous activities. The lack of it leads to a collection of fat often seen in those living sedentary lifestyles.
  3. Genetics: Polymorphisms in various genes controlling appetite and metabolism predispose individuals to Obesity in the presence of sufficient food.
  4. Illnesses and medications: Hypothyroidism, Cushing’s syndrome, growth hormone deficiency and eating disorders such as binge eating disorder and night eating syndrome are culpable in causing obesity. Some medications cause weight gain or changes in body composition; these include Insulin, Sulfonylureas, atypical antipsychotics, steroids among others.

It is estimated that Obesity may soon replace the endemic public health concerns such as under nutrition and infectious diseases as a significant cause of poor health.

Management of Obesity is often complex and involves a mix of meticulously planned interventions and subsequent follow up that carries with it a task of assessments and reassessments to achieve gains.

It mainly involves weight loss through restricted dieting and physical exercise. Medical interventions have been utilized and include the use of drugs such as Orlistat, Naltrexone-Bupropion among others, and these are initiated by qualified health personnel to assess long term risks of intake and side effects. However, Bariatric surgery is the most effective treatment.



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