Definition

Obesity is characterized by an excessive accumulation of adipose tissue and is associated with an elevated susceptibility to various health conditions. Beyond aesthetic concerns and diminished self-esteem, obesity can considerably impair an individual's health by precipitating a range of complications, including but not limited to cardiovascular disease, cancer, diabetes, and high blood pressure.

The assessment of obesity can be accomplished through the utilization of the Body Mass Index (BMI). The body mass index is a metric utilized to categorize adults as overweight or obese. BMI is calculated by dividing an individual's body weight in kilograms by the square of their height in meters. As per the World Health Organization (WHO), obesity is defined as a body mass index (BMI) value of 30 or higher. Additionally, the thickness of the epidermis on the arms, shoulder blades, or over the pelvic bones can be used to determine obesity.

According to the World Health Organization, the prevalence of obesity among adults worldwide exceeded 650 million in 2016. It is estimated that the global prevalence of obesity has nearly tripled since 1975. Then, in 2017, four million individuals per year lost their lives due to being overweight or obese. At present, obesity is not solely a concern in affluent nations; in low and middle-income countries, as well, the incidence of this condition is on the rise.

Causes

Obesity is a multifaceted disorder that has the potential to impact both infants and adults. Weight gain can occur when an individual's daily energy expenditure exceeds the amount of energy consumed through food. The caloric expenditure significantly exceeds the energy expended on routine tasks. Fat is the bodily storage of excess calories.

Obesity is a multifactorial disease resulting from the interaction of dietary patterns and daily physical activity with environmental, cultural, and socioeconomic factors, in addition to genetic predisposition. There are numerous causes for weight loss difficulties, which include:

• Nutrition and exercise

Unhealthy dietary habits, such as consuming fast food that is heavy in calories and sugar, can lead to weight gain and obesity. These particular meals can induce rapid hunger, prompting individuals to resume eating. Lack of regular exercise or physical activity, along with the eating of high-calorie foods, might lead to weight gain. Insufficient sleep can also impact body weight.

• Social determinants of health

Conditions of employment, study, or residence are considered social determinants of health. The absence of environmental and social determinants that facilitate adequate physical activity and access to nutritious food can lead to nutrition-related issues, including obesity.

• Genetic

Numerous genes have been identified in association with the accumulation of adipose tissue and weight gain. Certain variants of these genes have been associated with an increased susceptibility to obesity.

• Certain diseases and medications

Certain conditions, including Cushing's disease, have the potential to induce obesity or weight gain. Additionally, certain classes of antidepressants have the potential to induce weight gain.

Risk factor

The following are obesity risk factors:

• Sedentary lifestyle
• Inadequate dietary habits.
• Inadequate sleep patterns, such as sleep deprivation or insomnia,
• Stress or anxiety.
• Specific medical conditions.
• Hereditary predisposition to obesity.
• Historical background of specific medications.

Symptoms

Additional symptoms of obesity, aside from having a body mass index of 30 or more, include:

• Multiple cutaneous creases and dermatological infections within the cutaneous creases.
• Insomnia and excessive daytime sleepiness.
• Chronic pain in the back and/or joints.
• Hyperhidrosis.
• Not capable of withstanding high temperatures.
• Severe fatigue.
• A psychological condition characterized by persistent feelings of sadness, hopelessness, and a lack of interest in or pleasure in activities.
• Experience of respiratory distress (dyspnea).

Diagnosis

The doctor can determine the diagnosis of obesity through medical interviews, physical examinations, and additional tests.

During patient interviews, the doctor will inquire about the patient's symptoms, dietary habits, level of physical activity, and daily sleep patterns. In addition, it is also important to inquire about the patient's past medical records, familial medical history, and the environmental factors surrounding their house.

Following that, the physician will perform a comprehensive physical assessment, which entails evaluating the patient's vital signs and overall well-being. At the beginning, the patient's body weight and height are often assessed to compute their body mass index. The physician will also assess for indications of comorbidities involving other organs as a consequence of obesity.

Subsequently, the doctor may recommend additional diagnostic procedures, including blood analyses such as comprehensive blood tests, cholesterol testing, and, if deemed essential, urine tests.

Management

The treatment of obesity necessitates a multifaceted therapeutic strategy due to the intricate nature of this ailment. Reducing body weight by 5–10 percent can have a substantial positive impact on overall health and enhance the quality of life.

Increase your physical activity by exercising 3–4 times a week for 30 minutes. Swimming, walking, and brisk walking are aerobic activities. Maintaining a diet requires limiting high-fat foods, increasing fiber-rich veggies, and reducing carbohydrate intake. Additionally, stress management helps preserve metabolism.

Concurrently, medication may be administered if obesity is accompanied by comorbidities. For instance, people with diabetes, hypertension, and dyslipidemia (elevated levels of body fat) do not see improvement despite adopting lifestyle modifications.

Doctors must supervise pharmaceutical use, which cannot be self-purchased. Doctors may also recommend bariatric surgery for obese patients with comorbidities. Before doing bariatric surgery, the doctor will evaluate age, mental health, and BMI.

Complications

Multiple conditions can result from obesity, including:

• High blood pressure (hypertension)
• Dyslipidemia is a condition with high LDL and triglycerides and low HDL.
• Diabetes.
• Cardiovascular disease.
• Neurological disorders, including stroke.
• Gallbladder disease.
• Joint inflammation, such as osteoarthritis.
• Airway problems and sleep disorders.
• Mental health disorders, including anxiety and depression.
• Physical pain and poor living quality.
• Malignancy or cancer

Prevention

Preventing obesity requires the adoption of a healthy lifestyle, such as following a healthy diet by avoiding foods that are high in sugar and saturated fat, like fried foods. In addition to this, it is imperative to establish regular mealtimes to sustain body weight by the ideal body mass index. In addition to increasing protein and vegetable consumption, reducing carbohydrate intake is advised to prevent obesity.

Additionally, it is recommended that you engage in daily physical activity, such as walking or exercising. You will be able to prevent a sedentary way of life. Consistently maintaining a positive mindset and avoiding stress, abstaining from smoking and alcohol consumption, ensuring adequate sleep, and actively participating in and congregating with communities that promote a healthy lifestyle are additional measures that can be taken to prevent obesity.

When to see a doctor?

If you have a history of obesity in your family, have acquired a lot of weight quickly, or have trouble managing your appetite, you should see a doctor right away. If your primary care doctors suspect that you may be suffering from a condition like diabetes or hypertension, they will likely refer you to an internal medicine expert.

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