a) Globally, there are more than 1 billion overweight adults, at least 300 million of them obese.
b) Obesity and overweight pose a major risk for chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer. Increased consumption of energy-dense, nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity, have led to high obesity rates. The health consequences range from increased risk of premature death, to serious chronic conditions that reduce the overall quality of life. Of special concern is the increasing incidence of child obesity.
"Alarmed by reports that India will become the global diabetes capital by 2050, the Health Ministry has reduced the diagnostic cut-offs for body mass index (BMI) to 23 kg/m2 and the standard waist circumference to fight the battle against obesity. India's new diagnostic cut-off for the body mass index is 23 kg/m2 as opposed to 25 kg/m2 globally. People with BMI of 25 kg/m2 are clinically termed obese (as opposed to 30 kg/m2 at the international level) and those with BMI of 32.5 kg/m2 will require bariatric surgery to eliminate excess flab. According to guidelines, cut-offs for waist circumstances will now be 90 cm for Indian men (as opposed to 102 cm globally) and 80 cm for Indian women (as opposed to 88 cm at the international level)."
While genes are important in determining a person's susceptibility to weight gain, energy balance is determined by calorie intake and physical activity. Societal changes and worldwide nutrition transition are driving the obesity epidemic. Economic growth, modernization, urbanization and globalization of food markets are just some of the forces thought to underlie the epidemic.
As incomes rise and populations become more urban, diets high in complex carbohydrates give way to more varied diets with a higher proportion of fats, saturated fats and sugars. At the same time, large shifts towards less physically demanding work have been observed worldwide. Moves towards less physical activity are also found in the increasing use of automated transport, technology in the home, and more passive leisure pursuits.
Obesity Vs Overweight
The prevalence of overweight and obesity is commonly assessed by using body mass index (BMI), defined as the weight in kilograms divided by the square of the height in metres (kg/m2 ). A BMI over 25 kg/m2 is defined as overweight, and a BMI of over 30 kg/m2 as obese. These markers provide common benchmarks for assessment, but the risks of disease in all populations can increase progressively from lower BMI levels.
BMI increases amongst middle-aged elderly people, who are at the greatest risk of health complications. India which is undergoing nutrition transition, overnutrition co-exists with undernutrition. People with a BMI below 18.5 kg/m2 tend to be underweight.
Recent studies show that people who were undernourished in early life and then become obese in adulthood, tend to develop conditions such as high blood pressure, heart disease and diabetes at an earlier age and in more severe form than those who were never undernourished.
The extent of the problem
Obesity accounts for 2-6% of total health care costs in several developed countries; some estimates put the figure as high as 7%. The true costs are undoubtedly much greater as not all obesity-related conditions are included in the calculations.
How does excess body fat impact health?
Overweight and obesity lead to adverse metabolic effects on blood pressure, cholesterol, triglycerides and insulin resistance. Some confusion of the consequences of obesity arise because researchers have used different BMI cut-offs, and because the presence of many medical conditions involved in the development of obesity may confuse the effects of obesity itself.
The non-fatal, but debilitating health problems associated with obesity include respiratory difficulties, chronic musculoskeletal problems, skin problems and infertility. The more life-threatening problems fall into four main areas: CVD problems; conditions associated with insulin resistance such as type 2 diabetes; certain types of cancers, especially the hormonally related and large-bowel cancers; and gallbladder disease.
The likelihood of developing Type 2 diabetes and hypertension rises steeply with increasing body fatness. Confined to older adults for most of the 20th century, this disease now affects obese children even before puberty. Approximately 85% of people with diabetes are type 2, and of these, 90% are obese or overweight.
Raised BMI also increases the risks of cancer of the breast, colon, prostate, kidney and gallbladder. Chronic overweight and obesity contribute significantly to osteoarthritis, a major cause of disability in adults. Although obesity should be considered a disease in its own right, it is also one of the key risk factors for other chronic diseases together with smoking, high blood pressure and high blood cholesterol. In the analysis carried out for World Health Report 2002, approximately 58% of diabetes and 21% of ischaemic heart disease and 8-42% of certain cancers globally were attributable to a BMI above 21 kg/m2.
What can we do about it?
Creating supportive population-based environments through public policies that promote the availability and accessibility of a variety of low-fat, high-fibre foods, and that provide opportunities for physical activity.
Promoting healthy behaviour to encourage, motivate and enable individuals to lose weight by:
a. eating more fruit and vegetables, as well as nuts and whole grains;
b. engaging in daily moderate physical activity for at least 30 minutes;
c. cutting the amount of fatty, sugary foods in the diet;
d. moving from saturated animal-based fats to unsaturated vegetable-oil based fats.
Mounting a clinical response to the existing burden of obesity and associated conditions through clinical programs and staff training to ensure effective support for those affected to lose weight or avoid further weight gain.
How can RxOcean Help?
Please visit our Diet and Nutrition Section
to understand how can our team of doctors and dietitians / dieticians help you achieve your weight loss goals. You can also talk to our dietitian / dietician to discuss as to how much weight loss is required in your case or what should be your ideal body weight. Also in Feedback section, we have listed feedback
of some of our existing clients. This feedback should help motivate you as people from different walks of life have done the same and achieved their weight loss targets so can you.