Obesity is a disease, whereby the body accumulates an excess amount of fat. There are primarily two types of fat: subcutaneous and visceral. Obesity can be attributed to stress and the lack of physical exercise.
The incidence of obesity is highest in developed countries, the number sometimes exceeding 30%. In developing countries the number is slightly lower with 20-25% of population being diagnosed with this condition.
Obesity is more a physiological, rather than a pathological process. A person starts to deposit fat when he/she eats more than necessary. As a result, the body stores excess food energy in fat.
There are many factors that affect a person’s body fat mass. The main ones are:
Dietary habits. The more a person eats, the more he or she gains weight.
The rate of the primary metabolism is the amount of energy that a person is losing when he/she is resting. The higher the rate of metabolism, the lower the body weight index.
Factors that influence the rate of metabolism are:
Physical activity. The more a person works out, the lower the body fat index.
Digestion. A good digestive system is able to absorb more nutrients from the food. Some diseases affect digestion and trigger weight loss (chronic pancreatitis with exocrine pancreatic insufficiency). Digestive system can in some cases become more efficient if a person starves for a certain period of time, and digestion adjusts to take more nutrients from a small amount of food.
Primary obesity can be caused by chronic overeating, combined with low physical activity (90%). Secondary obesity is most commonly caused by diseases of the endocrine and central nervous system. Such diseases can drastically change metabolic processes (hypothyroidism, hypercortisolism, insulinoma) or contribute to an increased appetite (mental disorders, central nervous system tumours).
Obesity is always seen visually. The fat is deposited in different parts of the human body. The most common places are the belly, thighs, buttocks, chest and face. The fat can be stored on the limbs too.
Diagnosis of obesity is based on body mass index (BMI).
BMI = body weight (kg) / height2 (m)
Abdominal obesity poses a great risk to the health of a person. It is usually diagnosed by measuring waist circumference. The ratio of the waist circumference to hip circumference (ON / OF) is also calculated.
The criteria for diagnosis of men:
The criteria for diagnosis of women:
A more accurate diagnosis can be done by a lean body mass test. This test can be be performed only in well-equipped specialised clinics, since it requires special equipment
Obesity is not just a cosmetic defect. It is also serious medical health problem. A high body fat index can be a cause of many diseases. Among them are:
A risk for developing dozens of other diseases increases in people who suffer from obesity. A high body fat index significantly decreases the duration of life and its quality.
Obesity treatment is chosen individually, as it depends on a number of factors. Treatment can be conservative or surgical. Surgeries are performed with cosmetic or medical purposes in mind.
During the first two stages of obesity, conservative treatment may be used. The third stage required bariatric surgeries. Some clinical cases require surgical treatment of obesity as early as stage 2.
Conservative treatment includes:
Diet. The amount of fat and simple carbohydrates is significantly reduced in the diet. The aim of the diet is to reduce the calorie intake.
Exercise. Work outs are used to slow down or stop weight gain by expending energy and burning fat. Your muscles use a lot of energy even after exercising, that`s why exercise is a great way to lose weight, because even after you’ve exercised, your muscles are still burning up the fat.
Behavioural therapy. Psychotherapeutic interventions aim to correct the eating behaviour. This is a vital part of treatment, which ensures that one does not relapse into unhealthy patterns after treatment is finished.
Drugs. The most common medications, which help the patient lose weight are:
Other medications are used if necessary, depending on a specific case. For instance, if a person suffers from hypothyroidism (low thyroid hormone) thyroxine replacement therapy is prescribed. If hyperphagia takes place ("seizing" stress) then psychotropic drugs are recommended etc.
Plastic surgery aims to improve the appearance of a person, but it doesn’t improve the long-term prognosis of obesity. Plastic surgery usually targets the abdominal area.
Patient will look a lot better after the surgery is performed as his/her body weight is reduced considerably. Nonetheless, the amount of visceral fat, which surrounds internal organs, remains the same, so plastic surgery can be performed only for cosmetic and not medical reasons.
Bariatric surgery aims to:
Both surgeries are performed for medical reasons and are indicated in the third or second stages of obesity. They are recommended for patients with abdominal obesity, accompanying somatic pathology and for patients who did not benefit from conservative therapy.
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