Obesity || How to Prevent ? Assessment of Obesity

                           OBESITY 

 Obesity is a state in which there is a generalist accommodation of excess adipose tissue in the body leading to more than 20% of the desirable weight. Overweight is a condition where the body weight is 10% to 20% greater than the mean standard weight for age, height and sex.

                                          

ASSESSMENT :

 1.  BMI ( Body Mass Index ) : Also called Quetlet Index. This index does not require any standard tables.

            Weight (kg)

 BMI = ---------------- 

            Height² (m)

 Grading of obesity can be done based on BMI.

  Grade III - >40

  Grade II  - 30-40

  Grade I   - 25 - 29.9

  Not obese - <25

                                

 2.  Broka's index  :  the formula for broka's index is 

  Height (cm) -100 = ideal weight (kg).

  This measurement it is easy to calculate and accurate.

                                           

 COMPLICATIONS OF OBESITY :

 • Physical disability : Since the feet have to carry extra load, complications like flat feet, lumbar spine are common.

 • Metabolic disorders : Like diabetes, gout, atherosclerosis are common for excess cholesterol in plasma.

                                                      

 • Cardiovascular disorder : Apart from atherosclerosis, obese people develop high blood pressure and increased incident of varicose veins.                                          

 • Sleep apnea : A transitory cessation of breathing is increasingly identified in obese children and adolescence.

 • Gall stones : Obese people have higher output of cholesterol in bile, with a lower concentration. So their bile is constantly in danger of of forming gall stones.

                                                            

 • Osteoarthritis : It is a very common complication of obesity, in the knees of middle aged women and causes significant disability.

 • Obsterical risks : obese women when pregnant have greater Obsterical risk because of hypertension, diabetes and postpartum infection.

                                                       

 • Low life expectancy : The statistics of of Metropolitan Life Insurance USA, shows that for a man aged 45, an increase of 12kg above standard weight reduces his life expectancy by 25%.

 • Cancer : Certain cancers, colon, rectum and prostate in men.

    Uterus, biliary tract, breast and ovary in women.

  CAUSES OF OBESITY  :

a.  Genetic factors : Genetic inheritance probably influences 50% to 70% a person's chance of becoming fat more than any other factor.

b.  Age and Sex : It can occur at any age in either sex as long as the person in under positive energy balance.

c.  Eating habits : 

    • Nibbling between meals is common among housewives and is a potential cause for obesity.

    • Some may eat faster taking less time for chewing, therefore they tend to consume more food.

    • People who eat junk food ( high fat, high carbohydrate ) may become obese.

    • Non-inclusion of fruits and vegetables and non vegetarian diet favour weight gain.

    • Some may eat more food when they are unhappy as a compensation mechanism.

                                               

d.   Physical activity : Obesity is found in Parsons who lead sedentary lives and pay less importance physical education.

 e.  Stress : food is one of the many stimulants of endorphin, "feel good" neurotransmitter. Self gratification, self punishment, depression, anxiety, stress may lead to excess calorie intake.

f.  Endocrine factor : Obesity is common at puberty, pregnancy and menopause, suggesting endocrine maybe a factor in obesity.

  

  DIETARY GUIDELINES :

 • The patient should be convinced that there is no other way of reducing weight except by consuming less calories than needed by the body. 

 • The diet should be high in fibre.

 • Maintaining weight is lifelong process. Hence after 40, one should know appreciating low calorie foods and rejecting heavy sweets should become natural way of life.

 • Exercise reduces body fat and increases muscle mass brings down blood pressure, blood sugar, blood cholesterol, reduces stress and improves feeling of well being.

                                            

 • Obese patient should be encouraged to eat "unprocessed" foods and foods in their natural forms.

 • They should limit fat, sucrose and alcohol.

 SUGGESTED RECIPES :

FOODS                                                                    REASON

1.Vegetable salads                                                 Low calorie and high fibre.

2.Chapaties without oil                                           More proteins and high fibre and give                                                                                        satiety.

3.Thin dals, steamed foods like-                             To limit calories, increase protein content.

    like- idlis                                  

4.Thin soups                                                           Provide fluids, low calorie value, provides

                                                                                fullnes.

5.Poached fish                                                       Low in calories, high in proteinof good                                                                                       quality.

6.Boiled chowli                                                       Rich in protein and B vitamins.

7.Greens Porial                                                      High in fibre.

8.Coffee, tea without sugar                                     Low calories.