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Obesity

Obesity is an abnormally high body weight brought about by an excessive accumulation of fats (in the form of adipose tissue) in the body. Obesity occurs when the caloric intake is greater than the energy requirement of the body. In addition to its content of neutral fat which is its chief constituent, the adipose tissue has also water, protein and small amounts of glycogen.

Normally the intake of food calories is adjusted quite accurately according to the needs of the body. This is done by the appetite regulating center situated in the hypothalamus. The center may be destroyed by disease and this lead to overeating. Some obese persons show a specific block in the utilization of fatty acids by peripheral tissues; this block can be removed by tri-iodothyronine. However, the vast majority of over-weight person do not suffer from any organic disease and arise from an interaction of cultural forces that encourages excess food intake with genetic factors, that other things being equal, favor the synthesis of fat.

   Harmful Effect of Obesity

  1. The increased body weight leads to a greater work of the heart. A greater load is put on the cardiovascular system. Arterial hypertension and atherosclerosis is relatively commoner in obese people.
  2. The weight-bearing joints show a greater incidence of osteoarthritis because of greater stress and strain.
  3. There is an excessive sweating because deposits of subcutaneous fact acts as an insulating material making it difficult for the body to lose heat by radiation and convection.
  4. Diabetes mellitus is called the fat man’s folly because it is commoner in the obese; in the same way, obesity has been called open door to diabetes.
  5. Sexual disorder like menstrual disorders and sterility are common in obese women.
  6. The resistance to infections is less in the obese.
  7. The incidence of disease of gall bladder is higher in the obese.
  8. The obese persons are poor surgical risks.
  9. The obese persons are poor surgical risks.
  10. The obese have a shorter life expectancy. It has been said “longer the belt, shorter is the life span”

   General Ways to Overcome Obesity

  1. The caloric intake must be decreased. A reducing diet is prescribed which supplies lesser number of calories than expended by person. Enough proteins (at least 1 gram per Kg body weight), Vitamins and mineral should be included in the diet. The patient should be advised to eat high fibre food items such as grains, vegetables and salad which serve to satisfy hunger but are low in calories. Soft cola drinks, fruit juices etc have large amount of sucrose and must be avoided. Artificial sweeteners like saccharides (sweetex) and cyclamate (sucaryl) may be used instead of ordinary sugar. When the patient comes to have his ideal weight, then the intake of the reducing diet is stopped and he is given a diet which will have the same energy content as he would expend. The patient should be made to realize that in order to maintain his ideal weight he will have to change his way of life so that he eats for the purpose of living and does not live for the purpose of eating.
  2. In order to dissipate calories the patient should be asked to increase his physical activity. A minimum amount of physical activity is essential for the normal functioning of the appetite center. A sedentary person usually tends to take more calories than his needs.
  3. Thyroid hormone stimulates the metabolic activity and reduces weight; it may be used in selected cases under the supervision of physician.

Many obese people may again start over-eating after reducing their ideal weights. Such patients usually have an underlying psychological trouble which must receive due attention from the physician.