More than 2.8 million people worldwide die each year due to obesity or excess body weight. Excess fat in the body is the cause of many chronic diseases such as heart disease, diabetes, liver disease, various types of cancer. Professor Dr. wrote about the risks of obesity and what to do. H. N. Govt. The first part of this series of reports discusses the causes and primary prevention of obesity.
Lipids or fats are essential to the body; But excess fat causes obesity. Obesity means excess fat in the body. If a person consumes calories in excess of calorie expenditure for a long period of time, he/she becomes fat i.e. obesity occurs. These extra calories are stored as fat in the body.
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Obesity is a physical disorder. Obesity can be determined by various measurements such as BMI (Body Mass Index-BMI), waist circumference, waist-hip ratio and skinfold thickness.
In most cases the cause of obesity is unknown, which we call idiopathic or primary obesity; However, genetic factors play an important role in idiopathic obesity. No single gene is responsible, many genes are responsible for obesity. In some cases, obesity is attributed to hormonal disorders and medications, which are modifiable. These are-
Hormonal disorders
* Hypothyroidism
* Cushing's syndrome
* Craniopharyngioma
Medications: Steroids, sodium valproate, beta blockers, insulin, sulfonylureas and thiazolidinediones.
Obesity is a major risk factor for cardiovascular disease (coronary artery disease, stroke and hypertension) and coronary heart disease. Heart disease is the leading cause of death in obese patients, but cancer rates are also higher in overweight patients, particularly colorectal cancer in men and gallbladder, gallbladder, breast, cervical and endometrial cancer in women. Obesity shortens life expectancy. By age 40, obesity can reduce life expectancy by 7 years for non-smokers and 13 years for smokers. Obesity has a major impact on the patient's life and work.
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resistance
Obesity, which results from gaining a little weight each year over a long period of time, is difficult to treat. A daily extra energy intake of only 50-200 kcal (<10 percent of total energy) will increase weight by 2-20 kg over 4-10 years. So it is better to avoid weight gain from the beginning. Attention should be paid from a very early age, but it is not too late to start this primary prevention in young people at risk of weight gain.
Early prevention is better than overweight and obesity treatment and subsequent prevention. Because once the weight is gained it is difficult to lose it and although it is possible to achieve it, it is very difficult to maintain it.
The goal of primary prevention is to maintain energy balance ie energy intake should equal energy expenditure.
Primary prevention includes the following measures-
Health Education: Health education should be provided to children, parents, target population and general public to increase awareness about adverse effects of obesity, healthy eating habits and physical activity.
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Lifestyle changes: Lifestyle changes play an important role in obesity prevention. For this, the time of watching television and using computer should be reduced. Regular physical exercise like walking, swimming or gardening should be done. Dietary changes such as high fat, high energy foods and sugar avoidance should be avoided.
Steps to prevent childhood and adolescent obesity-
Parents should be aware of their children's health and weight and take steps to make dietary and lifestyle changes to prevent weight gain to prevent overweight and obesity. At the same time, they should be careful not to impose severe dietary restrictions, which may lead to malnutrition.
Parents can take the following steps to prevent overweight and obesity in childhood and adolescence.
* Plan to make dietary and lifestyle changes.
* Work slowly to change family eating habits and activity levels without focusing on weight. Change your habits and the weight will take care of itself.
* Be your own role model. Parents who eat healthy and are physically active, their children are more likely to be as well. These will also help you stay healthy and prevent overweight and obesity.
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eating habits
* Encourage children to eat only when hungry and eat slowly.
* Avoid giving food as a reward or withholding food as a punishment.
* Keep fat-free or low-fat milk and fresh fruits and vegetables in the fridge instead of sugary and fat-laden soft drinks and snacks.
* Serve your child at least five medium-sized pieces of fruit or half a cup of fruit juice and one cup of raw vegetables or half a cup of cooked vegetables each day.
* Encourage children to drink water rather than sugary drinks such as soft drinks, sports drinks and fruit juices.
physical activity
* Encourage physical activity. Children should get an hour of moderate exercise most days of the week. It helps in weight loss and subsequent weight maintenance.
* Allow walking or cycling to school instead of motor vehicle.
* Encourage children to be involved in sports and household chores.
* Reduce sitting time in front of television and computer to less than two hours a day.
Actions to prevent obesity in adults
* There are several strategies, which successfully reduce and maintain weight, which help prevent obesity. Improving your diet and getting more physical activity play an important role in preventing obesity.
eating habits
* Avoid energy dense foods i.e. high calories in a small amount of food such as burgers.
* Choose whole grain foods such as brown rice and whole wheat bread. Avoid highly processed foods made of white sugar, flour and saturated fat.
* Consume at least five medium-sized pieces of fruit or half a cup of fruit juice and one cup of raw vegetables or half a cup of cooked vegetables every day.
* Avoid oversized menu items at fast food restaurants.
* Create food checkbook. Eating more calories than needed for energy leads to weight gain.
physical activity
* Do at least 30 minutes or more of moderate exercise or activity most days of the week, if possible, such as walking a mile in 15 minutes, or weeding and tilling the garden.
* Create opportunities to burn calories during the day and even do some activity at work, such as walking around the office block or taking the stairs for 10 or 15 minutes at work.
Reduce work time in front of the television and computer and sitting at a desk to less than two hours a day.
* Weigh yourself regularly.
Classification of obesity
BMI (kg/weight, meter height)
18 or below — Underweight
18 to 25 — Normal weight
25 to 30 — Overweight
30 to 35 — Obesity-category-
1 35 to 40 — Obesity-category-2
40 or more — Morbid obesity
Hierarchy
normal
Overweight
obesity
Class I obesity
Class II obesity
Class three obesity
For Asians, WHO recommends a BMI above 23.0 as overweight and above 25.0 as obese.
Consequences and complications of obesity
Mechanical:
Accident prone
Varicose veins
Aching pain
Inflammation of the knee and groin
Shortness of breath during sleep
Hiatus hernia
Cardiovascular:
High blood pressure
Excess fat
heart disease
six stroke
Heart failure
Psychological:
Social isolation and depression
eating disorder
Endocrine:
* polyuria (diabetes mellitus-type 2)
* Menstrual abnormalities
* Polycystic Ovarian Syndrome (Female)
Gastrointestinal:
* Hiatus hernia
* Gastro-oesophageal reflux disease
* Alcoholic fatty liver
* Gallbladder disease
* Increases the risk of cancer
* Increases morbidity and mortality.
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