Dr Samir Chaukkar
Obesity is a condition in which the natural energy reserve, stored in the fatty tissue of humans and other mammals, is increased to a point where it is associated with certain health conditions or increased mortality.
Although obesity is an individual clinical condition, it is increasingly viewed as a serious and growing public health problem: excessive body weight has been shown to predispose to various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, sleep apnea and osteoarthritis. If you are obese, losing even 5 to 10 percent of your weight can delay or prevent some of these diseases.
Definition: Obesity can be defined in absolute or relative terms. In practical settings, obesity is typically evaluated in absolute terms by measuring BMI (body mass index), but also in terms of its distribution through waist circumference or waist-hip circumference ratio measurements.
The normal amount of body fat (expressed as percentage of body fat) is between 25-30% in women and 18-23% in men. Women with over 30% body fat and men with over 25% body fat are considered obese.
Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat and/or body water. Both terms mean that a person’s weight is greater than what’s considered healthy for his or her height.
Causes of Obesity:
In India, a changing environment has broadened food options and eating habits. Grocery stores stock their shelves with a greater selection of products. Pre-packaged foods, fast food restaurants, and soft drinks are also more accessible. While such foods are fast and convenient they also tend to be high in fat, sugar, and calories. Choosing many foods from these areas may contribute to an excessive calorie intake. Some foods are marketed as healthy, low fat, or fat-free, but may contain more calories than the fat containing food they are designed to replace. It is important to read food labels for nutritional information and to eat in moderation.
Portion size has also increased. People may be eating more during a meal or snack because of larger portion sizes. This results in increased calorie consumption. If the body does not burn off the extra calories consumed from larger portions, fast food, or soft drinks, weight gain can occur.
Our bodies need calories for daily functions such as breathing, digestion, and daily activities. Weight gain occurs when calories consumed exceed this need. Physical activity plays a key role in energy balance because it uses up calories consumed.
Physical activity is any bodily movement produced by skeletal muscles that results in an expenditure of energy with a range of activities such as
- Occupational work
- Carpentry, construction work, waiting tables, farming
- Household chores
- Washing floors or windows, gardening or yard work
- Leisure time activities
- Walking, skating, biking, swimming, playing Frisbee, dancing Structured sports or exercise Softball, tennis, football, aerobics.
Regular physical activity is good for overall health. Despite all the benefits of being physically active, many Indians are sedentary. Technology has created many time and labor saving products. Some examples include cars, elevators, computers, dishwashers, and televisions. Cars are used to run short distance errands instead of people walking or riding a bicycle. As a result, these recent lifestyle changes have reduced the overall amount of energy expended in our daily lives. The belief that physical activity is limited to exercise or sports, may keep people from being active. Another myth is that physical activity must be vigorous to achieve health benefits. Physical activity is any bodily movement that results in an expenditure of energy. Moderate-intensity activities such as household chores, gardening, and walking can also provide health benefits. Confidence in one’s ability to be active will help people make choices to adopt a physically active lifestyle.
People may make decisions based on their environment or community. For example, a person may choose not to walk to the store or to work because of a lack of sidewalks. Communities, homes, and workplaces can all influence people’s health decisions. Because of this influence, it is important to create environments in these locations that make it easier to engage in physical activity and to eat a healthy diet. There are certain identified action steps for several locations that may help prevent and decrease obesity and overweight. The following table provides some examples of these steps.
Genes and Family History
Studies of identical twins who have been raised apart show that genes have a strong influence on one’s weight. Overweight and obesity tend to run in families. Your chances of being overweight are greater if one or both of your parents are overweight or obese. Your genes also may affect the amount of fat you store in your body and where on your body you carry the extra fat.
Sometimes hormone problems cause overweight and obesity. These problems include:
- Underactive thyroid (also called hypothyroidism).
- Cushing’s syndrome.
- Polycystic ovarian syndrome (PCOS).
Certain medicines such as corticosteroids (for example, prednisone), antidepressants (for example, Elavil®), and medicines for seizures (for example, Neurontin®) may cause you to gain weight.
Some people eat more than usual when they are bored, angry, or stressed. Over time, overeating will lead to weight gain and may cause overweight or obesity.
Some people gain weight when they stop smoking. One reason is that food often tastes and smells better. Another reason is because nicotine raises the rate at which your body burns calories, so you burn fewer calories when you stop smoking. However, smoking is a serious health risk, and quitting is more important than possible weight gain.
As you get older, you tend to lose muscle, especially if you’re less active. Muscle loss can slow down the rate at which your body burns calories. If you don’t reduce your calorie intake as you get older, you may gain weight.
During pregnancy, women gain weight so that the baby gets proper nourishment and develops normally. After giving birth, some women find it hard to lose the weight. This may lead to overweight or obesity, especially after a few pregnancies.
Lack of Sleep
Studies find that the less people sleep, the more likely they are to be overweight or obese. People who report sleeping 5 hours a night, for example, are much more likely to become obese compared to people who sleep 7–8 hours a night.
Also, people who don’t get enough sleep on a regular basis seem to have high levels of a hormone called ghrelin (which causes hunger) and low levels of a hormone called leptin (which normally helps to curb hunger).
Overweight and Obesity-Related Health Problems in Adults
High Blood Pressure (Hypertension)
Type 2 Diabetes
Abnormal Blood Fats
A large waistline. This is also called abdominal obesity or “having an apple shape.” Having extra fat in the waist area is a greater risk factor for heart disease than having extra fat in other parts of the body, such as on the hips.
- Abnormal blood fat levels, including high triglycerides and low HDL cholesterol.
- Higher than normal blood pressure.
- Higher than normal fasting blood sugar levels.
Treatment of Obesity:
Successful treatments for weight loss include setting goals and making lifestyle changes such as eating fewer calories and being more physically active. Drug therapy and weight loss surgery are also options for some people if lifestyle changes don’t work.
Set Realistic (“Do-able”) Goals
Setting the right weight loss goals is an important first step to losing and maintaining weight.
For long-term weight loss success, it’s important for you and your family to make lifestyle changes:
- Focus on energy IN (calories from food and drinks) and energy OUT (physical activity)
- Follow a healthy eating plan
- Learn how to adopt more healthful lifestyle habits
Over time, these changes will become part of your everyday life.
Cutting back on calories (energy IN) will help you lose weight. To lose 1 to 2 pounds a week, adults should cut back their calorie intake by 500 to 1,000 calories a day.
In general, 1,000 to 1,200 calories a day will help most women lose weight safely.
In general, 1,200 to 1,600 calories a day will help most men lose weight safely. This calorie range is also suitable for women who weigh 165 pounds or more or who exercise routinely.
Healthy Eating Plan
A healthy eating plan gives your body the nutrients it needs every day. It has enough calories for good health, but not so many that you gain weight.
A healthy eating plan also will lower your risk for heart disease and other conditions. A plan low in total, saturated, and trans fat; cholesterol; and sodium (salt) will help to lower your risk for heart disease. Cutting down on fats and added sugars also can help you eat fewer calories and lose weight. Healthful foods include:
- Fat-free and low-fat milk and milk products such as low-fat yogurt, cheese, and milk.
- Lean meat, fish, poultry, cooked beans, and peas.
- Whole grain foods such as whole wheat bread, oatmeal, and brown rice. Other grain foods like pasta, cereal, bagels, bread, tortillas, couscous, and crackers.
- Fruits, which can be canned (in juice or water), fresh, frozen, or dried.
- Vegetables, which can be canned (without salt), fresh, frozen, or dried.
Canola or olive oils and soft margarines made from these oils are heart healthy. They should be used in small amounts because they’re high in calories. Unsalted nuts, like walnuts and almonds, also can be built into a healthful diet as long as you watch the amount you eat, because nuts are high in calories.
Foods to limit. Foods that are high in saturated and trans fats and cholesterol raise blood cholesterol levels and also may be high in calories. These fats raise the risk of heart disease, so they should be limited.
Saturated fat is found mainly in:
- Fatty cuts of meat such as ground beef, sausage, and processed meats such as bologna, hot dogs, and deli meats
- Poultry with the skin
- High-fat milk and milk products like whole-milk cheeses, whole milk, cream, butter, and ice cream
- Lard, coconut, and palm oils found in many processed foods
- Trans fat is found mainly in:
- Foods with partially hydrogenated oils such as many hard margarines and shortening
- Baked products and snack foods such as crackers, cookies, doughnuts, and breads
- Food fried in hydrogenated shortening such as french fries and chicken
Cholesterol is found mainly in:
- Egg yolks
- Organ meats such as liver
- Whole milk or whole-milk products, including butter, cream, and cheese
Limiting foods and drinks with added sugars, like high-fructose corn syrup, is important. Added sugars will give you extra calories without nutrients like vitamins and minerals. Added sugars are found in many desserts, canned fruit packed in syrup, fruit drinks, and nondiet drinks. Check the nutrition label on food packages for added sugars like high-fructose corn syrup. Drinks with alcohol also will add calories, so it’s a good idea to watch alcohol intake.
Staying active and eating fewer calories will help you lose weight and keep the weight off over time. Physical activity also will benefit you in other ways. It will:
- Lower the risk of heart disease, diabetes, and cancers (such as breast, uterus, and colon)
- Strengthen your lungs and help them to work better
- Strengthen your muscles and keep your joints in good condition
- Slow bone loss
- Give you more energy
- Help you to relax and cope better with stress
- Allow you to fall asleep more quickly and sleep more soundly
- Give you an enjoyable way to share time with friends and family
In general, adults should follow these guidelines in relation to physical activity.
- For overall health and to lower the risk of disease, aim for at least 30 minutes of moderate-intensity physical activity most days of the week.
- To help manage body weight and prevent gradual weight gain, aim for 60 minutes of moderate-to-vigorous intensity physical activity most days of the week.
- To maintain weight loss, aim for at least 60 to 90 minutes of daily moderate-intensity physical activity.
In general, children and teens should aim for at least 60 minutes of physical activity on most, if not all, days of the week.
Many people lead inactive lives and may not be motivated to do more physical activity. Some people may need help and supervision when they start a physical activity program to avoid injury.
If you’re obese, or if you haven’t been active in the past, start physical activity slowly and build up the intensity a little at a time. When starting out, one way to be active is to do more “everyday” activities such as taking the stairs instead of the elevator and doing household chores and yard work. The next step is to start walking, biking, or swimming at a slow pace, and then build up the amount of time you exercise or the intensity level of the activity.
To lose weight and gain better health, it’s important to get moderate-intensity physical activity. Choose activities that you enjoy and that fit into your daily life. A daily, brisk walk is an easy way to be more active and improve your health. Use a pedometer to count your daily steps and keep track of how much you’re walking. Try to increase the number of steps you take each day.
Other examples of moderate-intensity physical activity include dancing, bicycling, gardening, and swimming. For greater health benefits, try to step up your level of activity or the length of time you’re active. For example, start walking for 10 to 15 minutes three times a week, and then build up to brisk walking for 60 minutes, 5 days a week. You also can break up the amount of time that you’re physically active into shorter amounts such as 15 minutes at a time.
Changing your behaviors or habits around food and physical activity is important for losing weight. The first step is to understand the things that lead you to overeat or have an inactive lifestyle. The next step is to change these habits.
The list below gives you some simple tips to help build healthier habits.
Change your surroundings. You may be more likely to overeat when watching TV, when treats are available in the office break room, or when you’re with a certain friend. You also may not be motivated to take the exercise class you signed up for. But you can change these habits.
- Instead of watching TV, dance to music in your living room or go for a walk.
- Leave the office break room right after you get a cup of coffee.
- Bring a change of clothes to work. Head straight to the exercise class on the way home from work.
- Put a note on your calendar to remind yourself to take a walk or go to your activity class.
Keep a record. A record of your food intake and the amount of physical activity that you do each day will help to inspire you. You also can keep track of your weight. For example, when the record shows that you’ve been meeting your goal to be more active, you’ll want to keep it up. A record is also an easy way to track how you’re doing, especially if you’re working with a registered dietitian or nutritionist.
Seek support. Ask for help or encouragement from your friends, family, and health care provider. You can get support in person, through e-mail, or by talking on the phone. You also can join a support group.
Reward success. Reward your success for meeting your weight loss goals or other achievements with something you would like to do, not with food. Choose rewards that you’ll enjoy, such as a movie, music CD, an afternoon off from work, a massage, or personal time.
Weight Loss Medicines
Weight loss medicines approved by the Food and Drug Administration (FDA) may be an option for some people. If you’re not successful at losing 1 pound a week after 6 months of using lifestyle changes, medicines may help. These medicines should be used only as part of a program that includes diet, physical activity, and behavioral changes.
Homeopathy offers treatments for various aspects of obesity.
Homeopathic medicines can help you lose weight by improving digestion, elimination, and metabolism. But the medicines need to be individually prescribed, based on your own unique pattern of symptoms. Constitutional treatment is most appropriate, but some of the following remedies might be useful.
Antimonium crudum is usually indicated if you become very irritable when someone warns you not to overeat. You also have belching and diarrhea, and may have a coated tongue. Take one dose of Antimonium crudum 30x or 7c each morning and another in late afternoon for up to five days.
Argentum nitricum. This remedy reduces cravings for sweets. Take one dose of Argentum nitricum 30x or 9c twice daily for up to one week.
Calcarea carbonica This remedy is useful if you have difficulty controlling your appetite and eat to calm your nerves. You suffer from indigestion, and crave hot food and eggs. Take one dose of Calcarea carbonica 12x or 6c three times daily for up to one week when beginning a new dietary program.
Coffea cruda is indicated if you are excitable and nervous, and eat primarily to calm down. Take one dose of Coffea cruda 12x or 6c three times daily for up to three days.
Capsicum is indicated if you are lazy, have a red face, and suffer from burning sensations in the digestive tract.
Ferr. phos. is often prescribed if you are oversensitive and flush easily.
Graphites This is the remedy of choice for the perimenopausal woman fighting weight gain. The patient may be pale and very sensitive to cold. You suffer from constipation and skin problems. Your feet feel cold. Take one dose of Graphites 30x or 9c each morning and another in the afternoon for up to five days.
Ignatia is generally prescribed if you are anxious and fearful, and feel you simply must eat when you are tense and nervous. Take one dose of Ignatia 30x or 9c each morning and again in the afternoon for up to five days.
Kali carb is often indicated if you are clogged with catarrh, have backache, and your feel is cold.
Lycopodium Taking one dose of homeopathic Lycopodium 30c can help tame cravings for sweets.
Staphysagria This remedy is indicated if you tend to eat out of repressed anger. Your weight gain problem may be compounded by oppressive, even abusive, relationships in your life. Take one dose of Staphysagria 30x or 9c each morning and another in the late afternoon for up to five days.
If your weight does not improve in one to two months after beginning at-home homeopathic treatment, see a professional.
Weight Loss Surgery
Weight loss surgery may be an option for people with extreme obesity (BMI of 40 or greater) when other treatments have failed.
Treatment for overweight and obesity includes lifestyle changes. These changes mean cutting back on calories, following a healthy eating plan, being physically active, and making behavioral changes. When lifestyle changes aren’t enough, other treatment options for some people are weight loss medicines and surgery.
Overweight and obesity in children and teens can be prevented with healthy food choices and more physical activity. Parents and families should create habits that encourage healthful food choices and physical activity early in a child’s life.
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Dr. Chaukkar S & Dr. Sharma V, Comparative Materia Medica for Students, First edition, B. Jain Publishers, 2007.
R. Douglas Collins Algorithmic Diagnosis of Symptoms and Signs Publisher: Lippincott Williams & Wilkins Springhouse Professional Guide to Diseases (Eighth Edition) Publisher: Lippincott Williams & Wilkins
Dr.Samir Chaukkar M.D.(Hom), P,G.Diploma addiction treatment(Canada)
Professor- Dept of HMM-Y.M.T.Hom.Medical College and P.G.Institute, Kharghar, Navi Mumbai, Maharashtra
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