Overweight and Obesity

Overweight and Obesity

It is one of the most important root cause of the health problem, which society has purchased involuntarily, due to their lifestyle. Obesity increases the likelihood of various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, osteoarthritis, and depression [ʘʘ]. This is the height of paradox, that nonscientific dieting is one of the important cause of overweight and obesity. According to WHO, the fact sheet is placed below.

•Key facts

•Worldwide obesity has nearly tripled since 1975. Overweight is the 6^th most important risk factor contributing to the overall burden of disease worldwide. 1.1 bn Adults and 10% of children are now classified as overweight or obese. [ʘ]

•In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese.

•39% of adults aged 18 years and over were overweight in 2016, and 13% were obese.

•Most of the world's population live in countries where overweight and obesity kills more people than underweight.

•41 million children under the age of 5 were overweight or obese in 2016.

•Over 340 million children and adolescents aged 5-19 were overweight or obese in 2016.

•Obesity is preventable.

Fig 1: The current Global condition of Obesity

Definition 

It is defined as “the physiology of weight regulation, the pathophysiology that leads to unwanted weight gain and maintenance of the obese state even when reasonable attempts in lifestyle improvement are made, and the adverse health consequences of generalized and central obesity.”

Or simply, it may be defined as “it is a medical condition in which excess body fat has accumulated to an extent that it may have a negative effect on health.” 

Causes:

The prominent and easily understood cause is excess input and lower output resulted in the accumulation of surplus and is depicted in the figure given below. 

Fig. 2: Depicting a Gross relation between Food intake and Obesity 

Diet 
As per review, the excess food as the primary factor [ʘ] for this as per capita food consumption varies markedly between different regions and countries, over the time [ʘ]. Excess diet is one of the important cause of overweight and obesity, but more unpleasant is imbalance diet. A low or imbalanced diet equally promotes the gain in weight. Therefore, it is advised by the medical fraternity to have a balanced diet. I wish to write a separate topic on it due to its significance, maybe the next topic. However, a quick outline regarding this is given in the picture, below:

Fig. 3: Basics of Balance Diet

Obese people consistently under-report their food consumption as compared to people of normal weight. This is supported both by tests of people carried out in a calorimeter room and by direct observation.

Sedentary Lifestyle

A sedentary lifestyle plays a significant role in obesity by decreasing physical work, visible worldwide [ʘ]. Consistency in the decrease in physical exercise is reported by the various researches [ʘ].  This reduces the consumption of food intake and therefore promotes the deposition of surplus food.

Genetics
Genetic setup is one of the important cause, people become pry of obesity without much effort. Besides, other medical conditions, obesity is also the result of an interplay between genetic and environmental factors [ʘ]. Polymorphisms in various genes controlling appetite and metabolism predispose to obesity when sufficient food energy is present. 

People with two copies of the FTO gene (fat mass and obesity-associated gene) have been found on average 1.67-fold greater risk of obesity compared with those without the risk allele [ʘ]. The differences in BMI between people that are due to genetics varies depending on the population examined from 6% to 85% [ʘ].

Other Illnesses

Certain physical and mental illnesses and the pharmaceutical substances used to treat them can increase the risk of obesity. Medical illnesses that increase obesity risk include [ʘ] :

1. genetic syndromes
1. Prader–Willi syndrome, 
2. Bardet–Biedl syndrome, 
3. Cohen syndrome, and 
4. MOMO syndrome
2. some congenital or acquired conditions:
1. hypothyroidism, 
2. Cushing's syndrome, 
3. growth hormone deficiency and 
4. eating disorders: [ʘ]
1. binge eating disorder and 
2. night eating syndrome

Gut bacteria: Infectobesity [ʘ]

Good amount of researches is going on to correlates the gut fermentation and indicated that it is responsible for the production of SCFA (short chain fatty acids) and its investment in energy production. Therefore, adds the additional energy value to food intake. 

Other Factors

Many other factors add the obes as reflected in various researches includes:[ʘ]

1. The short duration of Sleep [ʘ ʘ]. 
2. Neuroticism, 
3. Impulsivity, and 
4. Sensitivity  

So, What should be Done?

The overall target to reduce the weight should be confined to reduce BMI, if not suffering from any problem, mentioned above. Consider the figure (2), and note the account of input and output food, so that one can determine their own strategy for reduction in weight. Accordingly, the strategy for weight reduction and treatment of obesity has been divided into following heads:

1-Dietary Modulation 
Increase in fibers and decrease in caloric food shall be helpful in weight modulation. However, going for traditional food is safest and well tested over a long period of time. Nevertheless, consuming fast food directly concerned with weight gain, as they are high caloric stuff.

2-Physical Activity

As mentioned above, physical exercise is reducing due to the easy lifestyle, which is resulted in weight gain. Some simple change can bring very courageous results, like walking briskly, swimming, using the stairs instead of the elevator etc. The CDC suggest doing 60–90 minutes of moderately intense activity most days of the week.

3. Weight-loss medications

Sometimes medication is prescribed by the doctors if above 2 measures become ineffective. 

4-Surgery 
Sometimes surgery is also prescribed and done if a body mass index of 40 or above, or lower than 40 if they have other health issues, as below:

1. Gastric sleeve or gastric band
2. Gastric bypass
3. Surgeons often do bariatric surgery as a laparoscopic, or keyhole procedure.

5-Hormonal Treatment

Hormonal treatment might one day help people with obesity. Research in 2014 unfolds that part of the success of bariatric surgery might be the impact on gut hormones. Binding these hormones could lead to novel, non-surgical options.

6. Browning white fat cells

Humans and other mammals contain two types of fat cell:

• Brown-fat cells burn calories and produce heat.
• White-fat cells store calories.

Scientists have been looking for ways to reprogram white-fat cells so that they behave more like brown fat cells. They call these "beiging" fat cells.

• "Conclusively, going back to nature shall be free of cost treatment for all unwanted weight"
• Keep in mind that "Avoiding food is no solution for Overweight or Obesity" instead, taking balance food is best the remediation.
• And also, taking fat in required quantity is also essential. Fat is NOT untouchable.