Obesity is a complex metabolic condition wherein a person gains excessive fat that predisposes him/her to develop other medical conditions. The U.S. Centers for Disease Control and Prevention (CDC) identifies obesity as person with a body mass index (BMI) or 30 or higher. BMI is calculated by determining the weight of an individual (in kilograms) and dividing it by the square of the height (in meters).
The problem of obesity has become a tremendous concern in the past decades because of its increasing incidence worldwide, affecting not only adults but also children. The World Health Organization even labeled it as the global epidemic that is most visible yet most neglected.
Obesity happens when the body gets an excess of calories or energy. We get calories from the food that we eat, and we burn calories as our body use it up to fuel the activities that we have. Excess calories are generally converted to fat, and deficiency in calories generally lead to burning of fats. In essence, the caloric status of our body is dependent upon the balance of our food intake (diet) and our physical activity (lifestyle). However, a third factor also contributes to the development of obesity: genetics. Obesity happens as a combination of three things:
- Diet: Excessive food intake of inappropriate types such as processed carbohydrates and glutin
- Lifestyle: Lack of physical activity
- Genetics: Genetic predisposition to obesity and baseline metabolism factors
The interplay of these three factors, especially genetics, can explain why some people eat a lot but don’t get fat and why some people keep on dieting but still get fat. These three factors determine whether an individual will become obese or not.
Complications of obesity
Obesity is more than just a cosmetic concern. Obesity is a true medical condition that brings with it several complications that are life threatening. These complications include:
- Dyslipidemia or high levels of lipids in the blood
- Heart disease
- Osteoarthritis and low back pain
- Sleep apnea
- Fatty liver
- Gall stones
- Infertility and irregular periods
- Complications during delivery
In addition to these medical conditions, obesity brings with it some psychological concerns with negative feelings such as guilt, lack of self-esteem, isolation, sexual dysfunction, and depression.
When to seek consult
Visit your doctor at any time that you feel concerned about your weight or if at any time you determine that you want to lose weight.
Your doctor will be able to diagnose if you are obese simply by getting your height and your weight. However, your doctor will also perform additional tests because obesity is associated with many other complications. Your doctor might take your blood pressure level and request for blood tests to determine your cholesterol and blood sugar levels. Other imaging studies might also be requested as deemed important by your doctor.
The treatment for obesity always starts with the things that are within your immediate control: diet and lifestyle.
- Diet - Your doctor might refer you to a dietitian who can create an individualized meal plan for you. Your new diet aims to provide you with the right amount of calories and the right blend of nutrients. Dieting is not just about reducing the quantity of what you eat; it also about eating the right types of food in the proper distribution.
- Lifestyle - Your doctor might also refer you to a physical trainer who can help you develop an individualized fitness plan. Your trainer can teach you some exercises that can help you burn the extra calories. The interesting thing about physical activity is that it not only burns your calories, it also keeps you strong, healthy, and invigorated. In addition, exercise can suppress appetite; so, it can help you with your dieting.
- Medications - Sometimes, dieting and lifestyle changes might not be enough to achieve your target weight. In this case, your doctor can give you medications that can help you lose weight. Your doctor will assess carefully if these medications are really needed for your case. These medications include orlistat, lorcaserin, phentermine, and others.
- Bariatric Surgery - When all else fails, your doctor might recommend you to undergo bariatric surgery. Bariatric surgery is a form of weight loss surgery that aims to limit the amount of food that your gut absorbs. This is done by performing alterations in your gut such as bypassing the stomach, putting a band in the stomach to constrict it, or removing a portion of the stomach so that it accommodates less food. Of course, bariatric surgeries are major surgeries that come with risks; therefore, bariatric surgery is only recommended only when conservative measures such as dieting and lifestyle modifications have failed.