Understanding Obesity

Basically the term obesity means excess of body weight due to increase in adipose tissue-mass. It is important to understand the cause of obesity for its effective management. Weight measures in excess of 'ideal body weight' with reference to normal range ideal for age, sex, height and body built. To define obesity we should measure the adiposity by measuring the skinfold thickness at triceps (normal: 23mm in males and 27mm in females) or at inter scapular region (normal: 35mm in males and 42mm in females). In most of the cases the obesity is due to overeating while in minority it could be associated with the metabolic and endocrine disorders. Beyond certain degree, obesity may increase the state of morbidity and cause associated diseases like diabetes mellitus, hypertension, coronary artery disease (CAD), gall stones, osteoarthritis etc.

Understanding patient's eating habits, likes & dislikes, temperaments, lifestyle, work schedules and adaptability to environment are important to decide a course of treatment. Compliance of doctor's advice is important for effective treatment of obesity. Dietary measurements, exercise and slimming pills are always helpful in controlling the obesity. Treatment of associated metabolic or endocrine disorders should be pursued effectively.

Dietary management:

A variety of dietary schedules ranging from zero calorie to isocaloric high protein diets are available for the treatment of obesity. Diet should be adjusted in such a way that weight loss is not in excess of one kg/week. For the success of diet regime it is important to keep a balance between 'forbidden' and 'permitted' items. Too much recommendation of low carbohydrate diet sometimes leads to a notion that non-carbohydrate diets are absolutely harmless. Rapid weight loss through zero calorie diet or fasting may sometimes be non productive as the weight lost due to loss of water would be regained quickly. The 'ad lib' items should be salads and leafy vegetables.

Exercise:

Exercise is known to increase calorie expenditure and thus leads to loss of adiposity. Exercise also increases our metabolic rate and thus supports the weight loss. In practice, however, exercise alone cannot be sufficient way to try to reduce weight. Exercise along with dietary control is good for both the general fitness and weight loss.

Anti-obesity drugs:

There are a variety of drugs for combating the food-obesity axis. There are drugs for decreasing appetite, digestion, absorption and inhibiting lipogenesis. There drugs for increasing heat production or thermogenesis. The drug treatment of obesity is not very promising, as the majority of drugs at effective therapeutic level have been found toxic.