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Overweight and ObesityRead more wellness Resources

Obesity has reached epidemic proportions in India in the 21st century, affecting 5% of the country's population. The problem grows with affluence in society – 33% of the US population is obese.

What is obesity?

Obesity is a condition in which excess body fat accumulates to such an extent that health is negatively affected

What is overweight?

Overweight is a condition in which the body fat is more than what is normal for an individual's height and if unattended can lead to obesity. According to the National Institutes of Health (NIH) in the US, overweight refers to increased body weight that is at least 10 percent over a recommended weight relative to the individual. Overweight may not only be the result of increases in body fat, but lean muscle as well. While exact statistics are not available for India, without doubt, India is the country with two extremes – People who do not have sufficient food and people with obesity and the country is slowly becoming one with obesity as a dangerous epidemic.

What are the causes of obesity?

Diet, sedentary lifestyle, smoking, genetics, socio economic status, certain medical illness, depression, the micro organisms present in your stomach etc, all contribute to obesity. A large quantity of soda intake, fried foods, unhealthy and reused oil cooking and lack of good diet fibres and vegetables, contribute to obesity.

How are obesity and overweight detected?

Both are based on your BMI or Body Mass Index, a measure of weight per unit height. A BMI under 25 is normal, 25-29.9 is overweight and anything beyond 30 is considered obese. Recent data has suggested that the cut off for overweight be reduced to 23, however, this is still under debate and anything less than 25 can be considered to be within the healthy scale.

What is BMI? How is it calculated?

The body mass index (BMI), or Quetelet index, is a statistical measurement which compares a person's weight and height. It is calculated by dividing your weight in kilograms by the square of your height in meters. So if your weight is 65 kg and your height is 1.7 meters (170 cm), your BMI will be 65/(1.7*1.7)= 22.5

Is BMI fool proof?

No. But for most of us, BMI is an accurate method of measuring the ideal weight for a given height.

When can BMI go wrong?

The only known defect in this calculation is that BMI depends on the whole weight and therefore does not distinguish between muscle and fat. Therefore BMI could go wrong in people with excessive muscle mass such as body builders.

Are there other ways to measure and detect overweight and obesity?

Yes. Waist to hip ratio and body fat percentages are other ways to detect obesity. Waist hip ratio greater than 1 for men and 0.8 for women are considered to signify overweight. Body fat percentage of more than 18% for men and 23% for women are unhealthy, where as the body fat % more than 25% for men and 33% for women is definitely a risk factor for diseases.

What is BMR?

BMR is the abbreviation for Basal Metabolic Rate, which is an approximate estimate of the number of calories you use up on a daily basis. While accurate calculation needs to be done on an individual basis, a rough idea can be obtained using a formula that incorporates the weight, height, age and sex.

What are the dangers of obesity?

A large number of physical and mental conditions have been associated with obesity. Health consequences can be categorized by the effects of increased fat mass (osteoarthritis, obstructive sleep apnea, social stigmatization) or by the increased number of fat cells(diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease)

How does being fat cause diabetes?

Increases in body fat alter the body's response to insulin, potentially leading to insulin resistance. Excess weight is behind 64% of cases of diabetes in men and 77% in women! So…………

But my recent Lipid Profile is within normal limits!

Lipid profile measures the blood levels of your lipids (Total cholesterol, good cholesterol and bad cholesterol etc). Obesity, however, is an independent risk factor for diabetes, high blood pressure, cardiac diseases and all other diseases mentioned above. Obesity is detected by your weight to height and therefore does not correlate with your lipid profile results. Though it is usual to have high blood lipid values in obesity, normal values are not rare and therefore normal values should not deter you from losing weight.

Next Steps!

I am overweight. What should I do?

Acceptance is the first step to treatment. However the more important step is to follow a disciplined routine with regards to diet and exercise.

Are there alternative medical ways to treat obesity?

Most of the alternative forms of medicine including Ayurveda and Acupuncture almost universally agree that the best treatment for obesity is to lead a healthy life with good exercise and the right diet. So this is one disease where modern medicine and alternate forms of medicine completely agree on treatment.

Which diet should I follow?

There are a number of fad diets available online. However most of them are now not recommended or no real data is available on their efficacy. Talk to your doctor about a structured diet tailored to your BMI and your food preferences. Dieting does not mean you have to give up your favorite foods - it only means we strike a balance. Talk to us if you need help.

If so, then what changes should I make to my diet?

There are three aspects to diet-the food, the quantity and the time. With regards to the timing, it is ideal to have a heavy breakfast, a moderate lunch and a light dinner. Yes, Grandmom's wisdom! With regards to the food, it is best to include a large portion of boiled vegetables in your diet and to reduce the intake of fried foods and red meat. Do not fill your stomach with rice, but make sure you get a small portion of rice in your diet. Avoid taking rice and potato together or any such two high starch foods in the same meal. Do not eat to your stomach (and heart's content), but eat till you are half full. For most people a simple diet and lifestyle change goes a long way in weight management. Adding a lot of fiber to your diet with vegetables (except potato) can aid in weight loss. Again, there is no one size that fits all, but in general, your rice or chappati or any other grain should account for only 30% of your meal! If the above diet does not help in weight loss over a period of 6 months, you can then be prescribed a weight loss diet. Talk to us if you need help.

How much should I exercise?

For optimal health, you need to exercise for at least 45 minutes a day, 5 days a week. Exercise should be of moderate intensity. A good way of measuring intensity is that you should be gasping a little for air, but should be able to talk. And, yes, the 45 minutes does not include breaks.

Is there a shortcut?

Unfortunately no. Most of the short term fad diets help you lose weight quickly, but the fat also comes back quickly. Therefore regular healthy diet and exercise is the long term answer to good health.

Are there alternative therapies of weight loss?

Yes. Acupuncture helps you lose weight faster. However it is no shortcut to looking good. Studies have shown that people who take up acupuncture along with diet and exercise, lose weight twice as fast as those who only diet and exercise. So acupuncture can help you lose weight quickly if you are willing to stick to your diet and exercise plan! But is it a magic cure, not at all!

Are there drugs available for obesity?

Yes. Prescription drugs are available for certain category of patients. When diet and exercise fails in patients with a BMI greater than 30 or a BMI greater than 28 with co morbid health factors.

Why can't everyone take the drugs?

One group of drugs prevents the absorption of fats from the diet and the other group of drugs suppresses the appetite. Both groups DO NOT cause your weight to melt away, but cause weight loss by inducing starvation of some kind. Both of the above can be done with a certain level of discipline. Both groups of drugs have a lot of side effects, the most common being kidney damage.

What about surgery?

In extreme cases, bariatric surgery can be performed on patients. Bariatric surgery is usually performed in people with a BMI of greater than 40 or greater than 35 with co morbid health conditions. However, even after surgery, your doctor will advise you to undertake a good diet and a healthy exercise regime to prevent regain of weight. Therefore there is no short cut to diet and exercise.

What does bariatric surgery involve?

Bariatric surgery involves reducing the absorption of food from the diet and involves reducing the size of the stomach, among other forms.

QUOTES

America's health care system is in crisis precisely because we systematically neglect wellness and prevention.

- Tom Harkin

The ability to be in the present moment is a major component of mental wellness.

- Abraham Maslow

There are six components of wellness: proper weight and diet, proper exercise, breaking the smoking habit, control of alcohol, stress management and periodic exams.

- Kenneth H. Cooper

Water is a only drink for a wise man

- Henry David

Your stomach is not a waste basket

- Anonymous

The ground work of all happiness is good health

– Leigh Hunt

"To insure good health: Eat lightly, breathe deeply, live moderately, cultivate cheerfulness, and maintain an interest in life

– William Londen

Improved diet and physical activity are more effective than medication in reducing the occurrence of Type 2 diabetes.

- New England Journal of Medicine