Non-Communicable Diseases

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Obesity

Overview:

Obesity is defined as an abnormal or excessive fat accumulation that presents a risk to the health. The main cause of weight gain and obesity is the imbalance between the amount of calories you take in and the calories you burn.

Body mass index (BMI):

It is one way of measuring whether a person's weight or body fat is higher than what is considered a healthy weight for a given height. This is measured by: calculating a person's weight in kilograms, then dividing that number by the person's height in meters squared (kg/m2). If the resulting ratio is high, then it can be an indicator of high body fat.

BMI levels: what do they refer to?

Weight status	Body Mass Index (BMI)
Underweight	Less than 18.5
Normal (healthy weight)	18.5-24.9
Overweight	25-29.9
Obese Class I (Moderately obese)	30-34.9
Obese Class II (Severely obese)	35-39.9
Obese Class III (Very severely obese)	40 and above

Causes of obesity:

Family history of obesity;
Unhealthy food habits followed by the individual or the family;
Inactivity or inadequate physical exercise;
Certain diseases (e.g. Cushing's syndrome, hypothyroidism, and Prader-Willi syndrome), and medical conditions (e.g. arthritis) can also lead to decreased activity, which may result in weight gain;
Certain medications: some medications can lead to weight gain. These include some antidepressants, anti-seizure medications, and diabetes medications, as well as certain types of contraceptives;
Changes in sleeping habits: not getting enough sleep or getting too much sleep can cause hormonal changes that can increase your appetite;
Aging;
Pregnancy.

Complications of obesity:

Fatigue and lack of energy
Shortness of breath
Difficulty sleeping
Back and joint pain
Type 2 diabetes
High levels of cholesterol or triglycerides
High blood pressure
Cardiovascular disease
Gout
Chronic kidney disease
Psychological problems: low self-esteem, lack of confidence, and feeling isolated, which may lead to depression
Cancers (e.g. colon, colorectal, breast, uterine, pancreatic, prostate, esophageal, liver, and kidney cancers)

Diagnosis:

Health history: the doctor may review your weight history, weight-loss efforts, exercise habits, eating patterns, what other conditions you've had, medications, stress levels and other issues about your health. The doctor may also review your family's health history.
Clinical examination: weight, height, heart rate, blood pressure and temperature.
BMI test
Measuring your waist circumference.
Blood tests: Tests may include a cholesterol test, liver function tests, a thyroid test and others. Your doctor may also recommend certain heart tests, such as: an electrocardiogram (ECG).

Treatment:

The goal of obesity treatment is to help obese individuals reach and stay at a healthy weight, limit their risks of developing other serious health issues, and improve their overall quality of life.

This may require the help of a team of health professionals, including a dietitian, to help patients suffering from obesity understand their situation and make the necessary changes in their eating and activity habits; start exercising and eating a healthy diet.

The doctor sets a goal weight for the patient and explains how it can be achieved. Initially, the goal may be to lose 5 to 10 percent of their body weight within six months.

The patient may start feeling better upon losing a small amount of weight, about 5 to 15 percent of their total weight. That is, if the patient weighs 91 kg and is obese by BMI standards, then this patient may need a lose between 4.5 to 13.6 kg for their health to begin to improve.

Other treatment alternatives:

There are several ways to treat obesity and help patients reach and stay at a healthy weight. Finding the appropriate treatment method suitable for each case depends on the patient's level of obesity and their overall health status, as well as their willingness to participate in a weight-loss plan and commit to it on a long-term basis in order to maintain a healthy weight. These treatment methods include:

Dietary changes.
Regular exercise and activity.
Behavior modification.
Prescription weight-loss medications.
Weight-loss surgery: for those with a BMI of 40 or higher.

Prevention

If you are at risk of becoming obese, currently overweight, or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems. The steps to prevent weight gain are the same as the steps to lose weight, and these include:

Daily exercise: according to the American College of Sports Medicine, you need to get 150 to 300 minutes of moderate-intensity activity a week to prevent weight gain. Moderately intense physical activities include: fast walking and swimming;
Maintaining a healthy well-balanced diet: this can be achieved by focusing on low-calorie, nutrient-dense foods, such as: fruits, vegetables, and whole grains, as well as avoiding saturated fat, sweets and alcohol. It is important to choose foods that promote a healthy weight and good health;
Closely monitoring what you eat or drink on a long-term basis.

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