History: Centuries ago, when famines were a regular feature, obesity was a status symbol! It was even thought to be erotic. However, today obesity is seen as a stigma and an obese person is a subject of ridicule.
Though in common parlance the words ‘obese’ and ‘overweight’ are used as synonyms, medical science makes a clear distinction between the two. The criteria for distinction is – Body Mass Index – also referred to as BMI. BMI is the ratio of a person’s mass in Kg to square of his height in meter. Persons with BMI between 25-29.9 kg/m2are classified as ‘overweight’ while those exceeding 30 are classified as ‘obese’.
Well-established causes for obesity are dietary ( high calorie intake) and sedentary lifestyle. A person becomes more prone to obesity when these two factors are combined. Other less well-established factors are genetic, medical illness, neurobiological mechanism, microbiological or social. These are discussed below.
Dietary :People tend to overeat. The problem has become more acute with onset of fast food culture.
Sedentary lifestyle: Industrial revolution and the ongoing computer revolution have made our lives very ‘comfortable’. Studies have shown strong correlation between hours of television watched and obesity.
Genetic: Certain genes make bodies more vulnerable to obesity.
Medical Illnesses: Certain physical and mental illnesses and the pharmaceutical substances used to treat them can increase one’s risk of obesity.
Neurobiological Mechanisms: Flier made pioneering work in this field.
Microbiological aspects: Bacteria present in digestive tract participate in digestion process. There are two types of bacteria present in intestines. When the proportion of a particular type of bacteria becomes higher, it leads to obesity.
Social Determinants: Person’s social status also decides one’s vulnerability to obesity. Quitting smoking also makes a person more prone to obesity.
Effects Of Obesity:
The first victim of obesity is your heart. Remember that it is heart that pumps blood throughout your body. From birth till death heart does not get even a moment’s respite, it is working even while we are asleep. With increase in body dimensions, the heart is subjected to more workload. So it is no surprise to see strong relation between obesity and cardiac problems.
The key to cure of obesity lies in its causes. One needs to follow dietary controls along with exercise. But sometimes even this does not work. In such situations, doctors can make use of drugs, especially orlistat and sibutramine. But what if even drugs fail? In such situations, doctors have no option but to use surgery. This surgery goes by the name “Bariatric surgery”. However, this option should be taken with a pinch of salt. It may lead to complications. This surgery is based on various principles; the most common approaches are reducing the volume of the stomach, producing an earlier sense of satiation. Bariatric surgery results in decrease in risk of diabetes mellitus, cardiovascular diseases and cancer.