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What is Obesity?

When fat inside the body accumulates in an excess proportion such that it leads to negative health effects, the condition is called obesity. This is calculated by a parameter called Body Mass Index {BMI}, a measurement that is obtained by dividing a person's weight by the square of a person's height. When BMI is between 25- 30kg/sq.m, and over it, then the person is termed overweight or obese. It is more common in women than in men and children who tend to be obese, grow as obese adults. Obese individuals, in contrast to their non-obese counterparts, have leptin resistance, a protein hormone expressed by adipocytes (fat cells) that have a great impact on weight maintenance.

What causes Obesity?

A sedentary lifestyle and lack of physical activity play a significant role in Obesity. Globally, there has been a major change in work patterns due to increased mechanized conveyance methods and technological advancements. Today's schools giving less importance to physical education and restricting children only to books leads to childhood obesity. Genes and environmental factors also play a major role in causing obesity. Mutations in genes like FTO (fat mass and obesity associated gene) that control appetite and metabolism predispose to obesity. Hormonal imbalances like hypothyroidism, Cushing syndrome, Growth hormone deficiency and certain drugs that are used to treat specific diseases also cause this disease. Psychiatric disorders like binge eating syndrome, night eating syndrome increase the risk of obesity.

What are the symptoms of Obesity?

Some of the symptoms of obesity are breathlessness, inability to cope with sudden physical activity, feeling very tired every day, back and joint pains, low confidence, and self-esteem, feeling isolated, increased sweating, snoring and more.

Should you notice that your body mass index is 30 and above, then speak to a doctor online who can correctly advise you to get in shape.

What is the treatment for Obesity?

Obesity is considered the leading preventable disease worldwide. This can be achieved mainly by lifestyle modification that includes diet control and physical activity. Behavioral therapy, drug therapy and surgery also aid in reducing the illness.

The treatment can include diet control and weight loss management, behavioral therapy (through stress management, counseling people for psychological eating disorders, anti-depression therapies), drug management (consisting of medication for specific hormonal imbalances and other co-morbidities) and the last resort being surgery (Bariatric surgery and procedures like gastric sleeve and Roux--En-Y gastric bypass surgery).

Types of Obesity

Obesity can be classified as below[1]

Factors Types
Age of onset Childhood obesity Adult Obesity
Distribution of fat Abdominal or central obesity Peripheral /Gluteal Obesity
BMI Overweight Obesity (Class 1,2,3)

Abdominal or Central Obesity is the classical apple type appearance when excess fat is distributed in the abdomen. Peripheral Obesity is called as female obesity when excess fat is distributed around hips and thighs giving pear type appearance[2]

Body Mass Index (BMI)

BMI (Quetelet's index) is used to evaluate the % of fat in a person and defines obesity[3]

Calculation of BMI [4] = weight in kg/square of height in meters

BMI Categories[5]

  • Underweight = <18.5
  • Normal weight = 18.5–24.9
  • Overweight = 25–29.9
  • Obesity = BMI of 30 or greater

Classification of Overweight and Obesity by BMI

Table 2 classifies the obesity and the associated risk for diabetes, hypertension and cardiovascular diseases by BMI[6]

BMI (Kg/m2) Obesity Class Disease Risk
Overweight 25.0–29.9 Increased
Obesity 30.0–34.9
35.0–39.9
I
II
High
Very High
Extreme Obesity ≥ 40 III Extremely High

Normal Calorie Requirement

The requirement of calories is different in every individual based on age and physical activity. The Dietary guidelines[7] have estimated that an adult may need 2000 calories per day [Table 3] for weight maintenance.

Adult Calories per day
Male 2,000-3000
Female 1,600-2,400

How to lose weight?

Physical exercise coupled with decrease intake of calories is a perfect blend to lose weight[8]. Exercise: Burn calories and maintain weight loss with daily workouts, cycling, swimming, etc. Reduce Calorie Intake: A diet is recommended that reduces ≥500 kcal/d [usually 1200 to 1500 kcal/d for women and 1500 to 1800 kcal/d for men]

Dos Don’ts
Consume more fruits and vegetables Avoid sugary drinks
Add protein to Diet[10], eat legumes, whole grains, nuts, seafood, and lean meats Avoid foods with more than 2 gm of saturated fat
Eat fat-free and low-fat dairy Avoid junk food
Decrease salt intake (<6g/d) Limit food rich in saturated fat and cholesterol

Many popular diet plans for weight loss [Table 5] have their share of pros and cons.

Diets Inclusion Exclusion
The Paleo Diet[11] Food that was eaten before agriculture era: Lean protein, vegetables, fruits, nuts, and seeds Dairy products, grains, and legumes
The Atkins Diet[12] Animal protein and fat consumption Carbohydrate restriction
The Vegan Diet[13] Strict vegetarian diet Meat, dairy, eggs, and animal-derived products
Low-Carb Diets[14] Meat, fish, eggs, vegetables, fruit, nuts, seeds, high-fat dairy, fats Sugar, wheat, refined and processed foods, starchy vegetables

Medicines are prescribed to obese people who are not able to lose weight with dietary changes and exercise. Bariatric surgery[15] is advised to morbidly obese with associated health conditions

FAQ

Lack of physical activity, excessive calorie intake, genetic predisposition, medical disorders, and certain medications may cause obesity

Obese is a person with excess fat and BMI equal to or over 30 kg/m2

People with obesity usually have low self-esteem and are prone to get high BP, diabetes, high cholesterol, etc.

Obesity is classified as 2 types

  • Male or the android type [Apple type] with excess fat deposition in the abdomen
  • Female or the gynoid type [Pear type] with excess fat around the hips and thighs

Yes, but an effective way to lose weight would be diet coupled with exercise.

REFERENCES

[1] http://www.iosrphr.org/papers/v3i4/Part.3/J0343060066.pdf

[2] http://medind.nic.in/iaa/t13/i5/iaat13i5p791.pdf

[3] https://www.ncbi.nlm.nih.gov/pubmed/11115784

[4] https://www.cdc.gov/healthyweight/assessing/bmi/index.html

[5] https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

[6] https://www.ncbi.nlm.nih.gov/books/NBK279167/

[7] https://health.gov/dietaryguidelines/2015/resources/2015-2020_dietary_guidelines.pdf

[8] https://ahajournals.org/doi/10.1161/01.cir.0000437739.71477.ee

[9] https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight

[10] https://www.ncbi.nlm.nih.gov/pubmed/20847729

[11] https://www.ncbi.nlm.nih.gov/pubmed/17522610

[12] https://www.ncbi.nlm.nih.gov/pubmed/19082851

[13] https://www.ncbi.nlm.nih.gov/pubmed/16873779

[14] https://www.ncbi.nlm.nih.gov/pubmed/12761365

[15] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003641.pub4/full

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