Obesity The Silent Killer Disease
Obesity is the most common nutritional disorder in affluent societies ; it's significance requires constant emphasis because it is accociated with increased mortalily , predisposes to the development of important diseases and diminishes the efficiency and happiness of those effected.
Obesity is a condition in which there is an excessive amount of body fat. Body fat can be measured by the measurement of body weight. Excessive fat accumulates because there is imbalance between energy intake and expenditure. This can arise in different ways leading to the clinical sign ' Obesity '.
A famous chinese proverb states that : " Whatsoever was the father of a disease , obesity or an ill-diet was definately the mother ". Wrong eating habbits in childhood lead to adult obesity. Over eating as a child causes the number of the fat cells in the body to increase permenantly and the more fat cells you have in your body the more prone you are to obesity.
Obesity is one of the most common diseases of modern age. People 7 - 10 kilos over weight have 10 % higher than normal death rate. Among the several possible causes of obesity we can name :
1. Age : more prevalent in middle age ; obesity in childhood and adolescence is likely to be followed by obesity in adult life.
2. Social Economic Status : it is seen in the prosperous elite in developing contries on the contrary it is also seen in the lower socio-economic groups in affluent countries.
3. Heredity : patterns of eating and activity are influenced by social , cultural , economic and genetic factors.
4. Endocrine Factors : e.g. hypothyrodism , hypogonadism , hypopituitarism & Cushing's syndrome.
5. Energy Balance : a small excess of calories if habitual can eventually lead to large accumulation of fat.
6. Social Factors : business lunches can contribute to over eating.
7. Metabolic Defects : can cause reduced energy expenditure.
8. Others : some people over eat because they are unhappy , stress binging ( in times of psychological stressful conditions ).
9. Drugs : use of steroids , oral contraceptives , insulin and phenothiazines are followed by obesity due to their ability to stimulate appetite.
Complications of Obesity include :
• Psychological depression : sexual problems , emotional depression.
• Mechanical disabilities : e.g. osteoarthrosis of knees , hips and spine , respiratory infections , varicose vains , diaphragmatic hernias etc.
• Metabolic disorders : non-insulin dependent diabetes mellitus , gallstones , hyperlipidaemia etc.
• Cardiovascular disorders : hypertension , ischaemic heart disease etc.
• Life expectancy : causes increased rate of mortality at all ages.
Cancer death rate from cancer of Colon and Prostate in males and cancer of Ovaries , Uterus and Breast in females is 10 % higher in the obese than among the normal people because FAT IS METABOLICALLY ACTIVE.
Management
The immediate cause of obesity is energy imbalance hence weight reduction can be achieved by reducing energy intake or by increasing energy output or by a combination of the two. This involves a change in the individual's lifestyle ; thus the treatment is difficult and the patient needs motivation. Rewards must be seen ahead , psychological understanding and behavioural advise are essential weapons.