Causes and risk factors
The exact etiology is not known, however the major contributing factors for obesity are excessive food intake and lack of physical activity. In certain cases genetic susceptibility is seen. Neurological diseases and endocrine disorders like hypo or hyper thyrodism, Cushing syndrome etc can also lead to obesity. Excessive weight gain can occur as a result of adverse effect of certain medications especially those which are used for treatment of mental illness. Studies have shown that sudden withdrawal of smoking after a long duration can also result in gaining of weight. Weight gain during pregnancy is physiological however certain women tend to gain weight after parturition or find difficulty in losing the gain weight.
Clinical presentation:
To label a person as obese the BMI is to be calculated. The BMI of the obese person is more than 30. The waist to hip ratio is also more. Sluggishness in activity is a common associating symptom. If obesity is caused due to some underlying diseases various symptoms related to the diseases can be seen. Excess weight gain can lead to various complications like heart diseases, type 2 diabetes mellitus, osteoarthritis and sleep apnea.
| BMI | CLASSIFICATION |
| <18.50 | Underweight |
| 18.50–24.99 | Normal weight |
| 25.00–29.99 | Over weight |
| 30.00–34.99 | Class I obesity (mild) |
| 35.00–39.99 | Class II obesity (moderate) |
| >40 | Class III obesity (morbid) |
BMI is calculated as weight in kilograms divided by height in centimeters.
However in some of the obese patient the BMI may be normal or high as seen in athletes who have a lean musculature but they are not claimed as obese.
In such cases body fat analysis and other tests decide the obesity.
Investigations:
The physical appearance of the patient is usually sufficient to diagnose the person as obese. However certain test can be done. These include the Body mass index, waist to hip ratio, Analysis of the fat distribution in the body. Certain other investigations like routine blood and urine test, lipid profile, Thyroid test, renal or live function test, ultrasonaography of abdomen or pelvis can be done to find out the underlying diseases.
Treatment:
Dietary and life style modification is the essential measure of treatment. Low carb and low fat diet is effective. Intake of well planned balanced diet should be implemented. Along with this regular physical exercises should be done. If obesity is due to the underlying cause, correction of the disease should be done. Certain medications for regulating the fat deposition are currently available. However no medicine has found to 100 % effective. For obesity control a complex treatment plan of medication good diet counseling and exercise is required. Use of Gastric balloon or reduction of the size of stomach by surgery can be done. Bariatric surgery is one the most recent techniques available for weight loss.
Recent updates:
The JAMA Network Journal published that the use of broad-spectrum antibiotics by children before the age of 24 months was associated with increased risk of obesity in early childhood.
Studies carried out by British Medical Journal have revealed that Obesity is linked to a heightened risk of dementia in later life.
