What is Obesity?

• OBESITY is defined as a state of excess accumulation of body fat.
• It can result from increased energy intake, decreased energy expenditure or a combination of both.
• Although often viewed as equivalent to increased body weight, this need not be the case - lean but very muscular individual may be overweight by arbitrary standards without having increased adiposity.
• Obesity itself can be considered as disease as well as underlying cause of many diseases.

Measurement of Obesity

Body Mass Index (BMI) is the most widely method to gauge obesity. It can be calculated as (Weight in Kg)/ (Height in Meter)².

Waist Circumference > 40 inches in men and > 35 inches in women is a risk factor.

Waist/hip ratio > 1.0 in men and > 0.9 in women is also a risk factor.

• Causes & Complications of Obesity

  MODIFIABLE	MODIFIABLE	NON-MODIFIABLE
  LIFE STYLE	MEDICAL
  Unhealthy Life style problems Inappropriate diet a) Food Fadism b) Food Cultism c) High Carbohydrate diet d) High Fat diet e) Low Protein Diet Lack of Exercise Sedentary Life style Addictions STRESS SLEEP DISTURBANCES Others	Hormonal Causes a) Hypothyroidism b) Diabetes Mellitus - II c) Insulin Resistance d) Cushing's Syndrome e) Insulinoma f) PCOD g) Low Growth hormone h) Low Testosterone i) Hyperestrogenemia j) Hypogonadism Hypothalamic or Central Nervous System Lesions Bulimia Drug Induced Others	Idiopathic (No known cause) Genetic Hereditary Ethnicity Others

• Complications of Obesity
  • Diabetes Mellitus-II
  • Insulin Resistance
  • Metabolic syndrome
  • Hypertension
  • Heart diseases
  • Snoring/Obstructive sleep apnea
  • Osteoarthritis
  • Acid Reflux disease
  • Cataract.
  • Respiratory diseases
  • Gall stones
  • PCOD
  • Menstrual Irregularities
  • Impotence
  • Infertility
  • Depression
  • Skin problems like pigmentation, acne, hirsutism etc.
  • Cancers (Breast, Cervix, Uterus, Colon, Rectum, Pancreas etc)
  • Endocrinopathies and hormonal imbalances.
  • Others
• Management of Obesity at DTHC
  • Education and Counselling
  • Identify the risk factors
  • Identify the Modifiable Cause
  • Identify the Complications
  • Treat the Modifiable Causes
  • Manage the Complications
  • Prevent further Complications
  • Avoidance of risk factors
  • Dietary Management
  • Life Style Management (Exercise, Stress reduction)
  • Sleep Management
  • Medical Management of Obesity and it's Complications (Medical Bariatrics)
  • Surgical Management Of Obesity (Bariatric Surgery)
  • Post Bariatric Surgery life style modification
  • Psychosocial Counselling and management
  • Occupational Management

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