To begin with our topic, Obesity is a global problem due to over nutrition. It can assessed by body mass Index (BMI), which is calculated by Quetelet's formula, BMI = W/H, where W= weight in kg, H= height in m².
The defined criteria are:
•18.5 - 2.4 = Normal
•25-29= Overweight
•>30= Obesity
Waist hip ratio, waist circumference>100 cm in males and >90 cm in females is referred to as truncal obesity. Obesity is considered as a behavioral disorder since the major determinant is Eating behavior. Signals from gastrointestinal tract, to induce feeling of satiety and prevent further eating.
Growth hormone release inhibitor secreted by stomach is a hunger signal. Appetite enhancing this peptide increases before a meal and then decreases. It is a 28 amino acid peptide that increases food intake, but fat utilization is decreased which induces adiposity.
Biochemical abnormalities in obesity include:
☆Hyperinsulinemia
☆Insulin resistance
☆Hyperlipidemia
☆Low leptin levels.
Obesity is associated with substantially increased cardiovascular risk. Increased waist to hip ratio (abdominal obesity) is a greater risk. In metabolic syndrome (Syndrome-X) insulin resistance, hyperglycemia, hyperlipidemia (increased LDL and decreased HDL), and obesity are seen. The major ill effects of obesity are increased risk of coronary artery disease, diabetes mellitus, hypertension, metabolic syndrome, and a reduced lifespan. Calorie fat-restricted diet may retard aging process and extend the lifespan.
Management of obesity include:
●Lifestyle modification
●Weight reduction Controlled exercise
●Reduction of calorie intake.
Maintenance of weight loss is more important than losing weight since it is easier to gain weight than lose weight. Diet and exercise are the only available means, since there are no approved drugs for weight reduction. Current trend in obese people is surgical management, which is called bariatric surgery. But this may lead to deficiency of essential nutrients in the long run.
Deit for obesity:—
Different types of diets are prescribed during dieting, all of which aim at a negative calorie balance. Consuming less food or consuming a low fat diet will not have the desired effect, because the body will have a tendency to switch to the fasting metabolic profile soon after meals. Robert Atkins proposed a low carbohydrate ketogenic high protein diet (Atkin's diet) for losing weight. According to Atkins, only 20 g of carbohydrate per day is given (normal desirable intake is 100-120 g/day), but unlimited consumption of fat and proteins are permitted. When such a diet is consumed, the liver will be predominantly glucogenic and ketogenic. Peripheral tissues will utilize the excess ketone bodies for their energy needs. ATP is provided by oxidation of fatty acids. This low carbohydrate diet was found to give promising results in 6-12 week trials compared to low calorie, low fat diets. The efficacy of the low carbohydrate ketogenic diet is not yet proved.
Treatment of OBESITY:—
Lifestyle modification is the best suitable technique. The goal is to reduce the intake of calories and fat. Frequent small meals with lots of vegetables will make the food palatable and give a feeling of satiety. Controlled exercise is very useful.
In patients with higher grades of obesity, drugs may be given to decrease appetite. But there is no drug approved for clinical use.
Consuming milk at breakfast may cut the risk of obesity by reducing appetite at lunch time. The whey and casein proteins in the milk release gastric hormones that slowed digestion and increased feelings of fullness, which could reduce the risk of Obesity due to a subsequent decrease in appetite.
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