9 Jun 2014

Obesity a rising problem

Obesity is a chronic metabolic disorder with excessive fat deposition in the body .WHO defines obesity as body mass index more than  30 kg/m2. Incidence of obesity is increasing worldwide, also in developing countries. As the people get older they accumulate more fat. Obesity indicate an excess fat storage, and looking at the undressed patient it can be easily identified. The term  overweight (rather than obese) indicate individuals with BMI between 25 and 30. It is medically significant and worthy of therapeutic intervention, especially in persons with  risk factors such as hypertension and glucose intolerance.

The distribution of adipose tissue in the body is important and has implications for morbidity. Intra-abdominal and abdominal subcutaneous fat have more significance compared to subcutaneous fat in the buttocks and lower extremities. This is clinically  detected  by the waist-to-hip ratio, with a ratio > 0.9 in women and >1.0 in men being abnormal. This may be because intra-abdominal adipocytes are more lipolytically active than those from other sites. 

Incidence of obesity is increasing  because of the following 
  1. Increased availability of energy rich drinks and foods.
  2. Increase in labour-saving devices (e.g. lifts and remote controls).
  3. Increase in passive transport(cars as opposed to walking)

Obesity can be simple obesity or it can be associated with other conditions. Most  patients have simple obesity, Even when it is associated with other conditions, excess calories consumed in the diet  than expenditure through exercise and body functions, is the main cause of obesity.

Energy balance
  1. 1 kg body weight gained has energy of approx 7000 kcal.
  2. 10 kg weight gain over 5 years -70000/5*365=_ _38 kcal/day.
  3. This is a daily error of energy balance of _1.5%.
  4. OR 10 minutes’ walk.
  5. OR one square (1/8) of a 2oz milk chocolate bar.
  6. OR half a digestive biscuit.

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