Obesity is a deposition of an excessive amount of fat in storage areas of the body. Alternatively, overweight is an excess of body weight relative to height. The normal body fat in adult males is 8% and is 18% in females. Obesity results from positive energy balance (energy input is more than energy expenditure). So, the body stores excess food in a form of fat, accompanied by the hormonal and metabolic adaptation that increases the body weight.
Types of obesity
Hypertrophic; it develops as a result of increased fat content per fat cells. There is no increase in the number of fat cells.
Hyperplastic; in this type, there is a large number of fat cells above normal count. Usually, it develops in childhood.
Hyperplastic-hypertrophic; both fat content, and the number of fat cells increases markedly.
Also, there is another classification depends on the anatomical distribution of adipose tissue as follows:
Android: it is a male type of fatty tissue distribution. It almost appears as an abdominal fat distribution.
Gynoid: a female type and characterized by fat distribution in hips and thighs. However, both sexes can display either Android or gynoid obesity.
Causes of obesity
Neurogenic and psychological factors
-First, overweight persons are insensitive to internal signals, like hunger and satiety, but they are extremely sensitive to external signals (smell and taste)
-Second, a lesion in the satiety center in Hypothalamus causes excessive eating. Also, disturbance in neurotransmitters (chemical compounds transmit signals between neurons) can disturb the control of eating.
1- thyroid hormones: the decrease in the Secretion of thyroxine hormone (hypothyroidism) causes deposition of myxematous tissue.
2- the pancreas: also, hyper-insulinism leads to obesity.
3- Brain Secretion level; having diets low in tryptophan substance decrease brain Serotonin level. The low Serotonin level, resulting in the stimulation of the appetite control center.
The setpoint theory
This theory states that each person has a set point for his own weight. The set point seems to be related to fat insulin sensitivity. This sensitivity can improve and the set point lowered by exercise and certain diet regimen. Increasing the sensitivity to insulin result in less insulin Secretion which is helpful in reducing weight.
Diagnosis of obesity
If waistline is measured and found to be 80 in male or 88cm in a female, that means there is an abnormality in body weight.
2-body mass index
It is the ratio between total body weight and a square of height.
Here is a classification of overweight and obesity based on body mass index
Body mass index Classification
18.5 – 24.9 Normal weight
25- 29.9 Overweight
30 – 34.9 Obesity class |
35 – 39.9 Obesity class||
40 – 49.9 Obesity class|||
50 and above Super obesity
Treatment of obesity
1- general treatment:
Firstly, any psychological disturbance should be treated immediately.
Second, family, the environment and social conditions should be considered.
Third, the treatment usually based on either reducing energy intake or increasing energy expenditure.
2- Diet control
Ninety percent of persons participating in all diet programs regain their weight they have lost within two years. Also dieting control is an instrumental part of maintaining weight loss after surgery.
Doctors give the patient a diet contains calories less than his requirements. The quality of food should be rich in protein, poor in fat, low in carbohydrate, rich in vitamins and minerals, and rich in dietary fibers to enhance blood sugar control and decrease insulin level.
This bulk diet distends the stomach and thereby partially suppresses hunger.
Change the dietary habits (never to eat before bedtime and in between meals, avoid excess fat and carbohydrate in the diet.
3 – Exercise:
It increases energy expenditure, but Its value alone is limited. So it should be accompanied by diet regimen. Obese People need to practice exercise at least 150 minutes a week of moderate-intensity physical activity. Also, This exercise prevents further weight gain and maintain the loss of an amount of fat.
a) Simply, Using the anorexogenic drugs which act by directly inhibiting the feeding centers in the brain (amphetamines), or by reducing food intake and increasing energy expenditure (sibutramine).
The danger in using these drugs is that they simultaneously overexcite the central nervous system, making the person nervous and elevating the blood pressure. Also, a person soon adapts to the drug
b) Some drugs work by altering lipid metabolism (orlistat, a lipase inhibitor) that reduces the intestinal digestion of fat. This causes a portion of the ingested fat to be lost in the feces and therefore reduces energy absorption.
5- Surgical procedures:
Firstly, there are many procedures such as gastric bypass surgery, gastric balloon, and gastric banding surgery. Although these surgical procedures generally produce weight loss in obese patients, they are major operations, and their long-term effects on health are still uncertain.
The UCSF Bariatric Surgery Center has started to perform surgical weight loss procedures since 1996.
Usually, many people who are obese and who have been unsuccessful in losing and keeping off the weight, opt for weight-loss surgery. However, The surgery involves only sealing off most of the stomach to reduce the quantity of food you can consume.
The most common overweight surgeries are “restrictive” procedures, and usually, they aim to reduce the size of the stomach and lower the calories you often consume too.
Furthermore, The overweight surgeries are preferred for people who weigh more than 100 pounds over their ideal or Have a body mass index (BMI) of 40 or higher.
In addition, to be considered for weight-loss surgery, you must be well-informed and motivated with acceptable operative risks. Also, understand clearly how your life may change after an operation and be able to participate in treatment.
6- Other treatments:
Additionally, there are many ways to Acupuncture, liposuction, restriction of water intake, massage, and other measures are of no medical basis and of no actual role.
Finally, the Complications of obesity:
– Flat feet and osteoarthritis of hip and knee
– Dyspnea (difficulty in breathing) with a little effort
– Type 2 diabetes and hypo-insulinism
– Arteriosclerosis, hypertension and Heart disease
– Liver cirrhosis and stones in gallbladder
– Less resistance to trauma of surgical operations and anesthesia
– Certain cancers (breast, colon, and endometrial)
– High cholesterol
– Sleep apnea and other breathing problems
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