Obesity- A real problem??

Dr Qazi Arif

Are you always being teased by your friend as obese?
Does your spouse always insist you to lose some weight?
Are your clothes becoming tighter day by day?
Are you really worried being obese?
If answer to any of the question is YES then go on reading

What does overweight or obesity mean?
“Excessive fat accumulation that is hazard for health is obesity”

Why a person becomes obese?
Obesity is usually the result of an imbalance between calories consumed and calories expended by a person.
A combination of increased consumption of highly calorific foods, without an equal increase in physical activity that leads to a positive energy balance which causes increase in weight.
What we eat should be expended or else it leads to excess.
How some persons put on weight despite dieting or regular exercise? That can be explained on the basis of their genetic susceptibility.
A few cases are caused by some endocrine disorders, medications, or mental illness, stress or some genetic diseases.

What is the current trend?
Obesity is one of the leading causes of death worldwide, with increasing rates in adults and children particularly in urban areas. Evidence suggests over the last 35 years, the no. of obese people has become double. In modern era easily accessible and palatable diet, increased use of vehicles and mechanized manufacturing are the possible causes.
Obesity is more common in women than men. Earlier obesity was supposed to be symbol of wealth (
) but now scene has changed and everybody wants to be slim n fit due to increased awareness about hazardous effects of obesity.
Obesity and Diet

Our diet consists of mainly carbohydrates proteins and fat. And it is observed that most of the extra food energy comes from an increase in carbohydrate consumption rather than fat consumption. The primary sources of these extra carbohydrates are consumption of fast foods, sweetened drinks such as soft drinks, fruit drinks, and energy and potato chips etc. is believed to be contributing to the rising rates of obesity.
Sedentary lifestyle

Another important factor that plays significant role in obesity is sedentary lifestyle. Day by day world is shifting towards less physically demanding work, in addition to insufficient exercise. Increasing mechanized transportation and a greater prevalence of labour-saving technology in the home also making the things easy for obesity. Spending leisure time in front of television cannot be ignored.
Other illnesses

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Certain physical and mental illnesses and medicines used to treat them can increase risk of obesity.
Certain medications may cause weight gain or changes in body composition; these include some medicines used against diabetes, psychiatric diseases depression, convulsions. Not all but some commonly used medicines also contribute to it. Some forms of hormonal contraception and steroids are also responsible factors.
How it is diagnosed?
Whenever any person asks me, am i obese? Then as a doctor asking simply weight of that person is not enough, we ask height also so that we can calculate BMI. If 2 persons are having same weight, one can be obese and can have other normal weight, its due to difference in their heights.
Now what is BMI?
Body mass index (BMI) is a commonly used tool used by us to classify overweight and obesity in adults.

BMI is the weight in kilograms divided by the square of the height in metres (kg/m2).
Depending on that person is classified into different categories:

So our goal should be to keep the BMI in the range of 18.5 – 24.9.
WHO defines overweight as a BMI equal to or more than 25, and obesity as a BMI equal to or more than 30.
Advantage of using BMI is that it can be used for both males and females and give rough estimate of your obesity status. But BMI cannot suggest the total body fat so we have other parametres.
Waist circumference
It is a simple and practical method of identifying overweight people who are at increased risk of obesity. It’s a good screening tool and does not depend on height.
Correct method to measure your waist circumference is:
1. In standing position place a measuring tape around your middle, midway between your lower point of rib and highest of your hipbones.
2. Keep the tape horizontal around the waist.
3. Do not compress the skin but keep the tape snug.
4. Just after you breathe out take the reading.

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If waist circumference is greater than 40inches for men and 35inches for women, it means they have excess abdominal fat, which puts them at greater risk of health problems, even if their BMI is about normal.
Waist to Hip Ratio (WHR)
Calculation of WHR is easy and you can easily do at your home. It’s better to have lower waist-to-hip ratio as more the WHR more is the risk. If you are wider at the waist then more is the chances to have obesity related health problems.
Women with a waist-to-hip ratio of 0.8 or less, or men with a ratio of 0.9 or less, are considered “safe.” A WHR of 1.0 or higher, for both gender, is considered “at risk” for overweight-associated health problems.
How to calculate WHR
Measure waist circumference with the technique as above then write it down.

Now again in the standing position wrap a flexible tape measure around your hips below the most prominent bony point as shown in the picture.
The resulting measurement is your hip circumference. Again, write it down.

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Divide your waist circumference by your hip circumference. The result is your waist-to-hip ratio or WHR.
For example: A waist measurement of 30 inches (75 cm) divided by a hip measurement of 36 inches (90 cm) would calculate to a WHR of 0.83.
So I have provided you the methods, now just apply it and see are you really obese???