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Introduction

Obesity is an abnormal, unhealthy condition of having excessive body fat or weight than is necessary for a particular height. Obesity is a major cause of death as well as several serious health conditions including chronic heart disease, diabetes, and high blood pressure.

Causes and Risk Factors

Besides genetic and hormonal influences, obesity occurs from excessive intake of calories – more than what is required for the body. Your body converts calories into energy for the body to use and the excess calories are converted into fatty substances, triggering obesity. The most common causes of obesity include:

  • Sedentary and physically inactive lifestyle
  • Unhealthy diet and eating habits
  • Pregnancy
  • Lack of proper sleep Disease conditions such as Hypothyroidism and depression
  • Medications such as steroids, antidepressants, antiseizure and diabetic medications

Risk factors for obesity include advancing age, being female and a family history of obesity.

Signs and Symptoms

Becoming obese is a gradual process. The usual signs observed in patients with obesity include:

  • Feeling tightness or discomfort and needing large-sized clothes
  • Inability to use public transportation due to the size of the seats
  • Difficulty with day-to-day tasks, especially those that require movement
  • Feeling tired and short of breath frequently
  • Carrying extra fat and an increased circumference around the waist
  • Having a high body mass index (BMI) equal to or over 30
  • Having Low self-esteem

Complications

Obesity is one of the leading causes of preventable death and impaired quality of life. It is an important underlying cause for a number of serious and chronic disease conditions such as:

  • Heart problems
  • Diabetes
  • High blood pressure
  • Cancer

You may also have problems related to:

  • Breathing (e.g., sleep apnea)
  • Joints (e.g., arthritis)
  • Gastrointestinal tract (gallstones)
  • Psychology (e.g., depression)
  • Fertility and pregnancy

Diagnosis

Your physician diagnoses obesity based on a complete physical examination including your weight, waist circumference, medical history, and blood tests. Your doctor will also assess the amount of fat content in your body by calculating your Body Mass Index (BMI). Body mass index (BMI) is a calculation of weight-to-height that is commonly used to classify overweight and obesity in adults.

Treatment

The goal of treating obesity is to facilitate weight loss and help you achieve a healthy weight. Treatment is centered on balancing the intake of energy (in the form of food) and the expenditure of this energy (in the form of activity). Obesity treatment options include lifestyle modifications, weight loss medications, and weight loss surgery. Lifestyle modifications that help to reduce body weight include dietary changes, physical activity, and behavioral changes.

  • Dietary changes include eating healthy food rich in nutrients while avoiding high calorie, highly processed junk foods.
  • Being physically active helps you lose weight and maintain your weight.
  • Behavioral changes include adopting healthier habits to reduce your eating triggers (such as watching TV, listening to music or chatting with friends while eating); avoiding stress; and participating in a weight loss program Weight-loss medications or appetite suppressant medications may be prescribed when lifestyle modifications do not help promote weight loss. Medication can also be prescribed to manage underlying conditions causing obesity.

Weight-loss surgery, also known as bariatric surgery, is considered only in patients with extreme obesity. Weight loss surgery treats obesity either by limiting the amount of food stored in the stomach, limiting the absorption of food, or both. The available surgical options for weight-loss include:

Gastric bypass surgery, also called Roux-en-Y gastric bypass, involves creating a small pouch on top your stomach and bypassing the flow of food directly to the small intestine, thereby avoiding absorption from the remaining part of the stomach.

Laparoscopic adjustable gastric banding (LAGB) or lap band surgery involves separating your stomach into a small upper pouch and a larger lower pouch using an adjustable band. The food intake is restricted or limited by adjusting the band. This procedure is minimally invasive and offers slow and steady weight-loss.

Sleeve gastrectomy, also called tube gastrectomy, involves reducing the size of the stomach by stapling or by removing a large part of the stomach to reduce the absorption
of food. After this procedure, your stomach appears like a tube rather than a pouch.

Biliopancreatic diversion (BPD) with duodenal switch is a complex surgical procedure which involves removing a large portion of the stomach and bypassing the food flow away from the upper portion of the small intestine. This procedure offers significant weight loss, but can be associated with several complications

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