Obesity: Cause, Consequences and Implications

There are many causes and health implications of obesity. Many people are in illusion about the quantitative parameters of obesity. The obesity can be defined in terms of Weight/Height (^W/_H) ratio or index: where weight is in kilograms (kg) and height is in meters (m). This index should be 25 to 30 normally. If your weight is 47 kg and your height is 1.60 m (160 cm); your ^W/_H index will be 29.375. An ideal weight of an individual with reference to sex, age, height and body build has already been documented somewhere else. The cause of obesity may be genetic, metabolic, physiological, lifestyle or pathological (as in cases of hypothyroidism). Take your weight on the same scale daily for a week. If you are overweight or your ^W/_H index is considerably more than 30, then plan to loose your weight through dieting and exercise. Never starve yourself. You can eat as desired from the unrestricted food items' list but remain within limits on restricted food items' list and keep away from prohibited food items' list:

Unrestricted Food Items' List
Unrestricted food items for the obese are fresh fruits, fresh vegetables, chicken, fish, poached eggs, boiled eggs (do not eat yellows), tea, coffee, skimmed milk and products made from skimmed milk.

Restricted Food Items' List
Restricted food items for the obese are all cereals and products made from cereals. Obese person should avoid eating more than 100 gm cereal products in a day. Fat consumption should not be more than 15 gm in 24 hours.

Prohibited Food Items' List
Prohibited food items for the obese are jams, honey, ice cream, dry fruits, nuts, cold drinks, alcohol, sugar and products containing sugar.


Obesity is associated with hyperlipidemia (elevated level of cholesterol and triglyrerides in blood), hypertension (high blood pressure), non-insulin dependent diabetes mellitus (NIDDM) and high prevalence of some cancers. Other serious implications of obesity are coronary heart disease and renal disease. Abdominal fat has been documented as major risk factor for coronary heart disease. The risk of NIDDM is more in overweight men aged between 25-50 years of age. The patient is said to have severe obesity if his ^W/_H index is more than 40. Natural history and consequences of obesity in children are not well understood till date. Strict dietary control and weight reduction would definitely help patients with severe obesity to overcome its serious implications like - NIDDM, hyperlipidemia, hypertension and coronary heart disease.

Diarrhoea and Oral Rehydration Therapy

Diarrhoea or acute gastroenteritis is a universal problem. The most frequent cause of acute gastroenteritis is an infection of the intestines. Such an infection results in an outpouring of fluid and electrolytes (sodium, potassium, chloride and bicarbonate) from the intestinal epithelial cells into the intestinal lumen, which is then purged out as diarrhoeal stool. Diarrhoea has been defined as passing of three or more loose or watery stools in a day. If there is vomiting along with loose stools; loss of large amount of body water and salts is imminent and would lead to dehydration. Infants and young children develop dehydration faster than adults especially in hot climates, when diarrhoea is also associated with fever. So the most significant harmful effect of diarrhoea is major loss of fluid and electrolytes. However during the infective diarrhoea the intestinal ability to absorb of glucose, salts, water and nutrients remain well preserved. Since the absorptive ability of intestines is not altered by diarrhoea, so the management of diarrhoea or acute gastroenteritis is possible with oral rehydration therapy (ORT).

For ORT, a standard solution of oral rehydration salts (ORS) prepared under the recommendations of World Health Organization (WHO) is administered through mouth in small amounts (50 to 100 ml) depending on the age of patient at regular intervals of time. For preparing a standard solution of ORS, the powder is dissolved in known quantity of boiled cooled or purified drinking water as mentioned on the packet of ORS. With oral rehydration therapy the death rate of people dying of severe dehydration due to diarrhoea has significantly come down and the requirement of intravenous drips has become almost negligible.

A packet of ORS contains 27.5 grams of essential salts to be dissolved in a litre of boiled cooled or purified drinking water. An ORS packet contains 20 grams of glucose, 3.5 grams of sodium chloride (common salt or table salt), 2.5 grams of sodium bicarbonate (backing soda) and 1.5 grams of potassium chloride. Packets of ORS are supplied free of cost at Primary Health Centers and Government Hospitals and dispensaries. Low salt content home-made fluids are equally good in emergency if a packet of ORS is not available immediately. Children with diarrhoea should be treated with ORS without loss of time.

The solution of ORS should be kept covered and used within 20 hours. If need be, fresh ORS solution should be prepared after 20 hours. Adults and older children should drink as much as they like from a cup or tumbler of ORS. A child under two years of age should be given half to one cup of ORS solution after each stool to compensate the loss of water and salts. Older children and adults should drink at least one to two cups after each stool. Easily digestible solid food such as boiled rice, soups, porridge, banana shake, curd, eggs, fish and well cooked meat are allowed even during diarrhoea. Treatment in hospitals and health centers depends on the degree of dehydration and other complications like fever and shock.