Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist–hip ratio and total cardiovascular risk factors.
People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a person’s weight by the square of the person’s height, is over 30 kg/m2, the range 25–30 kg/m2 is defined as overweight.
Some East Asian countries use lower values. Obesity increases the likelihood of various diseases and conditions, particularly  cardiovascular diseases, obstructive sleep apnea, certain types of cancer, osteoarthritis, depression.
Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity, genetic susceptibility. A few cases are caused primarily by genes, endocrine disorders, medications, mental disorder. The view that obese people eat little yet gain weight due to a slow metabolism is not medically supported. On average, obese people have a greater energy expenditure than their normal counterparts due to the energy required to maintain an increased body mass.
Obesity is mostly preventable through a combination of social changes and personal choices. Changes to diet and exercising are the main treatments.Diet quality can be improved by reducing the consumption of energy-dense foods, such as those high in fat or sugars, and by increasing the intake of dietary fiber.
Medications can be used, along with a suitable diet, to reduce appetite or decrease fat absorption.
If diet, exercise, and medication are not effective, a gastric balloon or surgery may be performed to reduce stomach volume or length of the intestines, leading to feeling full earlier or a reduced ability to absorb nutrients from food.
|30.0||35.0||class I obesity|
|35.0||40.0||class II obesity|
|40.0||class III obesity|
BMI= m /h2
Where m and h are the subject’s weight and height respectively.
BMI is usually expressed in kilograms of weight per meter squared of height.
To convert from pounds per inch squared multiply by 703(kg/m2) /(lbs. /sq. inch).
WORLD HEALTH ORGANISATION CLASSIFICATION OF OBESITY
- Any BMI 35 or 40 kg/m2 is severe obesity.
- A BMI of ≥ 35 kg/m2 and experiencing obesity-related health conditions or ≥40–44.9 kg/m2 is morbid obesity.
- A BMI of ≥ 45 or 50 kg/m2 is super obesity.
COMPLICATIONS OF OBESITY:-Excessive body is associated with various diseases and conditions, particularly cardiovascular diseases, diabetes mellitus type 2, obstructive sleep apnea, certain types of cancer, osteoarthritis, and asthma. As a result, obesity has been found to reduce life expectancy.
Health consequences fall into two broad categories: those attributable to the effects of increased
fat mass (such as osteoarthritis, obstructive sleep apnea, social stigmatization) and those due to the
increased number of cardiovascular diseaseو non-alcoholic
fatty liver disease). Increases in body fat alter the
body’s response to insulin, potentially leading to insulin
resistance. Increased fat also creates a pro-inflammatory state and aro- thrombotic state.
The main treatment for obesity consists of weight loss, dieting and physical exercise. Dieting, as part of a lifestyle change, produces sustained weight loss, despite slow weight regain over time. Intensive behavioural interventions combining both dietary changes and exercise are recommended.
Several diets are effective. In the short-term low carbohydrate diets appear better than low fat diets for weight loss. In the long term, however, all types of low-carbohydrate and low-fat diets appear equally beneficial.
Five medications have evidence for long-term use:-
3. ROLE OF BARIATRIC SURGERY
Bariatric surgical procedures provide consistent, long-term weight-lossو severely obese patients. In addition, such procedures especially bypass operations, provide a high rate of cure from type 2 diabetes and prevent the progression to diabetes in high-risk population