Home


Editorial


Free
Medical Advice


Patient Education


Review


Interview


Horizons


Sections


News


Events


Directory


Jokes


Links

All the facts you should know about Obesity

About Miss Noreen Aslam

Are you overweight? Are you obese? Obesity is defined medically as a condition in which a person is 20% or more above the desirable weight. For example if the desirable for your age, sex, height & frame is 100 lbs and your weight is 121 lbs, then by definition, you are obese.

Causes of obesity
Obesity is not just caused by over eating. In fact, it could be caused by multiple causes. Actually obesity is a complex interaction of the factors which interact together to induce obesity:

Psychological ------ Socio-economic ------ Medical ------ Metabolic disorders ------ Genetic ------ Cultural

Indices of obesity
In the past obesity was measured just by a weighing scale and a comparison was made with life insurance tables. Today, the clinically useful parameters of over-weight is Body Mass Index (BMI). BMI is measured by the following formula:

Weight in kilogram/Height in meters x Height in meters (W/H2)

Many scientific studies have proved that the BMI is much more accurate predictor of morbidity & mortality in both men & women.
Normal BMI is 22-25 kg/m2

To compare it to the weight increase of 20% the BMI would correspond 27kg/m2

Assessment of body fat
Skin fold measurements are used to estimate body fat is deposited on the skin. However, fat between the internal organ is also very important to be measured and skin fold measurements do not take that into account.

Today's Technology
Bioelectrical Impedance Analysis is another method used to determine total body fat. Its a machine with electrodes which apply small amounts of current & resistance to the body to estimate the fat levels.

Treatment of obesity
The essential components of treatment include behaviour modification, caloric restriction, nutrition education and exercise. Two criteria must be satisfied if the treatment is to be considered successful.

* Weight loss must be such that desirable weight according to body frame and state of health is achieved.
* The desired weight must be maintained.

Behaviour Modification
This is based on the premesive that excessive food intake is a learned response that can be changed. By means of this concept the individual learns to focus attention on the environmental factors that influence his or her food intake & gradually to modify these so that a change in eating habits & subsequent weight loss occurs.

Some techniques that can be used successfully to control food intake include
* Eating only at specified times & places.
* Learning to eat more slowly.
* Omitting other activities, such as reading or watching television while eating.
* Use smaller plates.
* Use of a reward system.

Calorie-Restricted Diets
Many widely accepted nutritionally sound diets are available and are designed to bring about steady weight loss, to establish good food habits and to promote a sense of well being. Such diets must be palatable, must fit into the framework of family food habits and must not require additional expense or long preparation time. Basic considerations in planning weight-reductions diets include the following:

Energy
A diet that provides 800 to 1000 Kcal below the daily requirements leads to a loss of 3 to 4 kg (6 to 8 lbs) monthly. This gradual loss does not result in severe hunger, nervous exhaustion and weakness that often accompany drastic reduction regimens. For most men 1,400 to 1,600 Kcal is satisfactory level and for women 1,200 to 1,400 Kcal are indicated. Diets that supply 1,000 Kcal or less are rarely necessary except for individual who are bedfast. In many elderly persons satisfactory weight loss is achieved only when energy intake is limited to 1,000 to 1,200 Kcal; this is because of their reduced basal metabolism and reduced physical activity.

Protein
Although 0.8 gm protein/kg desirable body weight is sufficient, an allowance of 1.5 gm/kg improves the satiety value of the diet. Most dietary plans can include 70 to 100 gm protein daily.

Fat & Carbohydrates
Many diets drastically restrict the fat intake and allow a moderate carbohydrate intake.Complex carbohydrates are especially good.

Whats the best Nutrition Advice
The Dietry Guidelines
Following are the dietary guidelines for healthy individuals 2 years of age or more. By following these dietary guidelines, you can enjoy better health.

Eat a variety of foods to get the energy, proteins, vitamins, minerals & fiber you need for good health.
Balance the food you eat with Physical activity to maintain or improve your weight to reduce chances of having high blood pressure, stroke, certain cancers, heart disease and most common kind of diabetes.
Choose a diet with plenty of grain products, vegetables & fruits which provide needed vitamins, minerals, fiber and complex
carbohydrates and can help you lower your intake of fat.
Choose a diet low in fat, saturated fat & cholestrol to reduce the risk of heart attacks & certain types of cancers to help you maintain a healthy weight.
Choose a diet moderate in sugars. A diet with lots of sugars has too many calories & too few nutrients for most people & contribute to tooth decay.
Choose a diet moderate in salt or sodium to help reduce risk of high blood pressure.
Avoid alcohol beverages. Alcohol beverages supply calories but little or no nutrients & its also cause of many health problems.