Obesity is a complex multifactorial chronic disease developing from interactive influences of numerous factors- social, behavioral, psychological, metabolic, cellular and molecular (genetic).
The desire and drive to eat food, satiety, choice of food, digestibility of food eaten and its absorption in the body, metabolism of nutrients and the metabolic rate, drive and ability to exercise are the factors that determine the body weight. There are certain habits that has to be avoided to practice the weight loss and avoid adding on weight;
Nibbling between meals is common among people which is a potential cause of obesity, some may eat faster taking less time for chewing therefore they tend to eat more than others, neurotransmitters or chemicals in the brain that respond to outside stimuli such as sight, taste, smell and temperature transmit signals to other areas of brain and body. Obese respond to external cues to eat rather than internal hunger signals. They eat when it is mealtime or when they are surrounded by tasty foods instead when they are hungry.
Business executives who frequently attend business lunches have more chances of becoming obese. Housewives who don't want leftover foods to be thrown out may consume forcibly and put on weight. Certain cultural practices like making and distributing sweets on festive occasions contribute to increased calorie consumption. Non inclusion of fruits and vegetables and non-vegetarians with high fat favor weight gain.
It is generally found in people who lead sedentary lives and pay less importance to physical activity. Though obesity can occur at any age, this is more common during middle age when physical activity decreases without corresponding decrease in food consumption.
Food is one of the many stimulants of endorphin ‘feel good’ neurotransmitters self gratification, self punishment, depression, anxiety and stress may lead to excess caloric intake. Recent studies have shown that school children tend to take more fatty foods in their lives and grow stressed. Chronic sleep deprivation may increase appetite in some.
Obesity is found in hypothyroidism, hypogonadism and cushing’s syndrome. It is common at puberty, pregnancy and menopause, suggesting edocrine may be a factor in obesity.
It is a chronic disease that requires long-term treatment. Even a 5-10 percent los from initial weight may produce marked improvement in diabetes, dyslipidemia and even sleep apnea. The ease of weight gain and difficulty in losing and maintaining weight all make obesity a challenging illness to treat. The goals set for weight loss should be realistic. Unreachable targets result in frustration and failure. Multidisciplinary approach is used in treating obesity.
The strategies for weight loss and weight maintenance include diet therapy, physical activity, stress management, pharmacotherapy, behavior therapy and weight loss surgery.
Very low calorie diet <800 Kcal; although much weight is initially lost on very low calorie diets, more weight is usually regained. Rapid weight reduction can be proven dangerous for health. The initial goal of weight loss therapy should be 10 percent from baseline. If this goal is achieved further weight loss can be attempted.A reasonable timeline for a 10 percent reduction in body weight is 6 months of therapy.
Drug therapy may be used as a part of a comprehensive weight loss programme, including diet therapy and physical exercise for patients with a BMI of 30 with no concomitant obesity related risk factors or disease. Weight loss drugs should never be used without lifestyle modifications. Continual assessment of drug therapy for efficacy and safety is necessary.
Psychological problems involved in overeating need to be understood. Behavioral therapy strategies to promote diet and physical activity should be used routinely. Long term changes in eating behavior are required to maintain weight loss. Eating behavior is not instinctive but learned.
Weight loss surgery. For morbidly obese patients bariatric surgery remains the only option. Bariatric surgery is the use of surgical interventions in the treatment of obesity. The most common approach is to reduce the volume of the stomach, producing an early sense of satiation. It is advised in patients with a BMI>40. Persons with a BMI in the 35-40 range having a comorbid factor such as diabetes are also considered candidates for surgery.
People trying to follow the weight loss diet should keep in mind that the diet should consist of a variety of whole grains.. White rice to be replaced with brown rice or whole grains. Oats should be included in the diet. Millets like ragi, jawar, bajra are to be included. The quantity of cereal should be reduced. Refined cereals such as polished rice and maida are avoided. Plenty of colorful fruits and vegetables to be added to the diet. To add nuts and seeds in the diet. Have 8-10 glasses of water.
Thanks Giving
This article is written and submitted to The E Today by Shrushti Mehta.
We thank her for her research and analysis and hope to see the awareness about health and nutrition being spread ahead to larger mass of our citizens.