Dr. Shiva Narayan Gupta
Obesity means deposition of excess fat in the body. It is a result of some dietary imbalance, over nutrition and some diseases. In obesity there is excess accumulation or storage of adipose tissue in the subcutaneous tissues, skeletal muscles and internal organs such as the kidney, heart, liver and omentum. A body weight of 20% excess over ideal weight for age, sex, and height is considered as obesity. It is one of the Jaldobaldo health problems in the world. Similarly it is one of the main causes of non-communicable disease.
Obesity can be classified:-
1. On the basis of cause:
1. Primary obesity- this obesity is result from dietary imbalance and over nutrition.
2. Secondary obesity- This obesity results following a number of underlying diseases such as Cushing’s disease, insulinoma, hypothalamic disorders and hypothyroidism.
2. On the basis of Clinical feature:
1. Mild obesity: 20-40 % over weight
2. MOderate obesity: 41-100 % over weight
3. Severe obesity: >100 % over weight
Obesity can be measured by Body Mass Index (BMI): BMI = Weight in kg/Height in m2. Value more than 25+ signifies nearing Obesity.
Etiology of Obesity:
1. over nutrition or over Eating
2. Inactivity and sedentary life style i.e. decreased physical activity
3. Genetic factor e.g. inherited nature
4. Psychological factor e.g. over eating or abnormal feeding behavior due to emotionally upset condition.
5. Endocrine and metabolic factors e.g. hyper adrenocorticism
6. Childhood over nutrition
7. Greater energy intake than energy expenditure
8. Developmental factors- e.g. hypertrophic obesity, Hyperplastic obesity, Hypertrophic-hyperplastic obesity.
9. Neurogenic abnormaities
10. Hypothalamus injury
11. Excessive intake of sweet substances, cold and unctuous food
12. Lack of exercise and day sleep
13. Lack of thinking
14. Certain therapeutic measures like santarpana, brimhna
15. Some drugs such as tricyclic antidepressant drugs, sulphonyl urea drug, oral contraceptive pills, and corticosteroids
16. A number of diseases such as hypothyroidism,Cushing’s disease, Insolinoma and hypothalamic disorders
Clinical sign and symptoms of Obesity:
1. An increase in body weight and evident mass of fatty tissue
2. Inability to work
3. Mal dour in body
4. Hypertension
6. Amenorrhea and other menstrual disturbances in female
7. Excessive perspiration and skin disorders
8. Excessive hunger
9. Cardiovascular related abnormalities are seen
Complications of Obesity (Invited diseases by Obesity)
1. Related to Cardiology:
-Ischemic heart diseases: Angina and Myocardial Infarction
-Congenital heart failure
-High blood pressure
-Abnormal cholesterol levels
-Deep vein thrombosis and pulmonary embolism
2. Related to Endocrine and Reproductive:
-Diabetes Mellitus
-Polycystic ovarian syndrome
-Menstrual disorders
-Infertility
-Complication during pregnancy
-Birth defects
-Intrauterine fetal death
3. Related to Neurology:
-Stroke
-Meralgia peresthetica
-Migraines
-Carpel tunnel syndrome
-Dementia
-Idiopathic intracranial hypertension
-Multiple sclerosis
4. Related to Psychology:
-Depression in women
-Social stigmatization
5. Related to Rheumatology and Orthopedics:
-Gout
-Poor mobility
-Osteoarthritis
-low back pain
6. Related to Dermatology:
-Stretch marks
-Acanthosis nigricans
-Lymphoedema
-Cellulitis
-Hirsutism
-Intertrigo
7. Related to Gastrointestinal:
-Gastroesophageal reflux disease
-Fatty liver disease
-Cholelithiasis
8. Related to Respirology:
-Obstructive sleep apnea
-Obesity hypoventilation syndrome
-Asthma
-Increased complication during general anaesthesia
9. Related to Urology and Nephrology:
-Erectile dysfunction
-Urinary incontinence
-Chronic renal failure
-Hypogonadism
10. Related to Onchology:
-Breast, ovarian
-Oesophageal, colorectal
-Liver, stomach
-Endometrial, cervical
-Prostate, Kidney, Non-Hodgkin’s lymphoma, Multiple myeloma
Preventive and Some Curative Measures:
1. Weight management by yoga and pranayam, aerobics etc.
2. Risk factor management such as substitute intake of junk food by natural healthy diet
3. Adopt one day water dietary fasting per week (as recommended by physician, vaidya, or naturopath)
4. Manage obesity caused diseases
5. BMI assessment helps the person to undergo weight reduction therapy
6. Screening of High Risk People to obesity
7. Modification in lifestyle and reduction of calorie intake and increase physical activity
8. Use of Tikta ans Katu rasa dravya such as Maricha, Pippali, Vidanga etc.
9. Use of some drugs such as Amphetamine, Sibutramine
10. Surgery
For the management of obesity, low calorie diet, regular yoga, pranayam or suitable physical exercise are the best choices.
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