Obesity - Causes , Risks and Weight Loss Solutions

We are fat not because we suffer from some exotic genetic illness, but because, we choose to be so! Surprised, in the real sense obesity is a state of mind. The faster we accept this fact the thinner we get. The thinner we get - the healthier we are, the longer we live and perhaps in today’s context, the more fashionable we can be.

Defining Flab

Simply put, flab is the excessive accumulation of fat on the body, leading to disease from it in any form, often culminating in a reduced life expectancy. Central obesity (tummy, spare tyre) will deflate your health in the long run.

Body Mass Index (BMI) and Obesity

BMI or Body Mass Index is calculated by dividing your weight in Kilograms by the square of your height in meters. Based on BMI obesity is further classified as follows:-
< 18.5 Underweight
18.5–24.9 Normal weight
25.0–29.9 Overweight
30.0–34.9 Class I obesity
35.0–39.9 Class II obesity
= 40.0 Class III obesity

Waist to Hip Ratio
It is defined as the ratio of the circumference of the waist to that of the hips. It is calculated by measuring the smaller circumference of the natural waist, usually just above the belly button, and dividing by the hip circumference the widest part of the buttocks or hips. Targets are 0.7 for women and 0.9 for men. In common parlance this is the science for having either a desirable ‘pear shaped’ or an unhealthy ‘apple shaped’ figure.

What makes us Fat: Causes Of Obesity

There are various causes of obesity. Some of them are Diet, Sedentary lifestyle, Genetics, Sociology, Endocrine disorders and Drugs.

Diet and Sedentary lifestyle

It is our brain that has made us champions of technology, easing our lifestyle, caressing our every need. We feed on snack based junk foods and commute across continents without lifting so much as a finger. This has tipped the scales of intake and output in favor of bursting waistlines.

Genetics

Don’t worry about these genetic jargons. They rarely afflict only a few. These are Prader-Willi syndrome, Bardet-Biedl syndrome, Cohen syndrome etc. Instead worry about this fact - 80% of the offspring of two obese parents are likely to be obese, in contrast to less than 10% of the offspring of two parents who are of normal weight.

Sociology

Obesity ponders around the ‘middle’, the center of the body and the center of the social strata – ‘the middle class’. This is because poverty ensures that the lower class is too hungry and too tired to be fat, while wealth, on the other hand, dictates a high society physique by affording a nutritious meal and plenty of opportunity for trained physical activity.

Endocrine disorders and Drugs

Hypothyroidism and Cushing’s syndrome are endocrine disorders predisposing to obesity. The following drugs can cause weight gain - sulfonylureas, thiazolidinediones, atypical antipsychotics, antidepressants, phenytoin, valproate and depot progesterones.

Obesity Risks and Complications – Effect of Obesity On Health

The metabolic syndrome is a group of obesity-related risk factors for coronary heart disease and diabetes. A person has the metabolic syndrome if he or she has three or more of the following risk factors: A large waistline, High triglycerides, high blood pressure or high fasting blood glucose (sugar). These individuals have nearly twice the risk for coronary heart disease and five times the risk for type 2 diabetes. It is estimated that 27 percent of American adults have the metabolic syndrome.
Effects of Increased Body Mass includes osteoarthritis, obstructive sleep apnea syndrome and social ostracism.
Effects of Increased Fat Deposition includes diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease and most importantly in women the polycystic ovaries. Increased fat also creates a pro inflammatory and pro thrombotic state (increased tendency to blood clotting).

Weight Loss Solutions – Here’s How

‘Rule your mind or it will rule you’ is an axiom that reliably makes ‘the tough get going when the going is tough’.

Weight Management: Weight Control by Diet and Lifestyle modifications

The best way to achieve weight loss is to either self start or enroll into a weight loss program. This entails finding low calorie food substitutes that you can use as per your eating preferences and local availability.
Partial starvation (diet weight loss) and forced exercise is the secret. Food substitution, balanced diets and avoidance of crash diets (fast weight loss) all combined with realistic simple and enjoyable exercise plans will succeed in keeping the weight down long term. This is called as healthy weight loss.

Medical Weight Loss Solutions

Medicine has provided us two types of solutions- weight loss pills like Xenical and surgery. The pros and cons of both these medical solutions for weight loss are explained below.

Drugs – Weight Loss Pills

 

SSRI’s and SSNRI’s

These hover around mollifying the satiety center of the brain. Located in the hypothalamus, this center is activated by neuro hormones ‘Noradrenaline’ and ‘Serotonin’. Fenfluramine and Sibutramine are examples of this controversial group of anorectic agents. These tranquillize the brain into reducing food seeking behavior as well as food consumption.
Minor side effects include dry mouth, constipation, insomnia, mood swings, lethargy, drowsiness and reduced libido. Major problems that have caused the safety of these agents to be placed under the scanner (and even bans in some countries) include – valvular heart defects, hypertension, angina and heart failure. These drugs must be used with the greatest of caution and need expert supervision. Moreover it must be known that benefits may reverse on discontinuation.

Lipase Inhibitors - Weight Loss Pill Xenical

The problems with the above agents have led to the development of a new molecule – Orlistat (XENICAL).

How Xenical Works

This wonder drug inhibits pancreatic and gastric lipases thereby preventing fat breakdown and making it difficult to absorb.

How Effective Is Xenical/ Does Xenical Work?

XENICAL is recommended for long term use in severe obesity to prevent morbid complications. It is cheap, readily available online and safer than SSNRI’s. Since it prevents fat absorption, long term use may be associated with side effects. Therefore patients must adapt to the hard fact that they can’t depend on Xenical forever.
What they can rely on and what would give them results is shifting over to healthy eating and exercising regularly. This must be maintained even after Xenical weight loss therapy is over.

How Fast Does Xenical Work

This depends on the degree of obesity and the lifestyle modifications that one can make during therapy. Usually for moderate to severe obesity the duration varies from 6months to 2 years.
However during the therapy period the patient must learn to motivate himself or herself to exercise regularly, avoid junk foods and eat according to calorie requirements for his or her constitution.

Side Effects Of Xenical

Like any other drug XENICAL too has its share of side effects which include – Nausea, flatulence, steatorrhoea, fluid motions, gripes and malabsorption especially of fat soluble vitamins like A, D, E and K.

Obesity Weight Loss Surgery - Gastric Bypass Surgery And Gastroplasty

Weight loss surgery is usually reserved for the morbidly obese (BMI> 40 or > 35) with heart problems. Gastric By Pass results in more weight loss than Gastroplasty, but both are good for sustained weight loss.
Dumping and vitamin deficiency result from them. XENICAL is a good alternative in cases unfit for surgery.

Weight Loss Solutions - Concluding Remarks

Convincing the mind to reduce and maintain a proper figure is the cornerstone to successfully beating the battle of the bulge in cosmetic or moderate obesity. On the other hand SSNRI’s have paved the way for XENICAL, a safer alternative to aid in morbid obesity therapy.
All said and done it is better to ‘eat to live rather than live to eat’ and while doing so, remember never to ‘waste the waste around your waist’!