Obesity is a medical condition in which excess body fat accumulates to an extent that it may have an adverse effect on health, leading to reduced life expectancy and / or increased health problems. An increase of 20% or more above the 'ideal body weight' is the point at which excess weight becomes a health risk. India is now facing an epidemic of obesity with about 5% of its population having morbid obesity (NFHS 2007). Indians are genetically susceptible to obesity especially around the waist.
What causes obesity?
Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity and genetic susceptibility although a few cases are caused primarily due to hereditary causes, endocrine disorders, medications or psychiatric disorders.
Morbid obesity is a complex multifactorial, chronic disease where weight and symptoms build up slowly over time. Obesity becomes 'morbid' when it reaches the point where it has an adverse effect on health, particularly causing heart disease, type 2 diabetes, obstructive sleep apnoea, certain types of cancer and osteoarthritis. Class II and class III obesity is considered morbid obesity.
Body Mass Index (BMI)
Body mass index is a tool to measure the extent of obesity, where weight and height are used in a formula.
BMI = Weight in kg / Height in m2
Classification of obesity
- Overweight (preobese) if BMI is between 25 and 29.9
- Class I obesity if BMI is between 30 and 34.9
- Class II obesity if BMI is between 35 and 39.9
- Class III obesity if BMI is =/>40
Overweight and class I obesity can usually be treated with diet modification, exercise and behavioural changes and do not require surgery. Class II and III require bariatric surgery.
Consequences of morbid obesity
- Cardiac disease
- Renal failure
- Type-II diabetes mellitus
- Drowsiness (day time)
- Sleep apnoea
- Barrett's oesophagus
- Stress urinary incontinence
- Accelerated arthritis of spine
- Degenerative arthritis of the hip, knees
- Venous stasis in legs
- Pseudo tumour cerebri
- Polycystic ovarian syndrome
- Gastroesophageal reflux disease (GERD)
- Pregnancy complications