Obesity

Obesity is defined as having an excessive amount of body fat. It is different from being overweight, which means weighing too much. Obesity occurs over time when you eat more calories than you use. An obese person has accumulated so much body fat that it might have a negative effect on their health. It increases your risk of diseases and health problems such as heart disease, diabetes and high blood pressure. Obesity is nowadays measured using the BMI index. The BMI is a statistical measurement derived from your height and weight. Divide the person’s weight in kilograms by their height in meters squared. For example:

  • Weight 90 kilograms and
  • Height 1.9 meters.
  • So (1.9)2 = 3.61
  • 90 divided by 3.61 = BMI is 24.93

How to determine you are obese or not?

BMI less than 18.5 Underweight
BMI between 18.5 and 25 Healthy weight
BMI between 25 and 30 Overweight
BMI between 30 and 40 Obese
BMI over 40 Very obese (morbidly obese)

Causes:

  1. Consuming too many calories by unhealthy diet and eating habits: Having a diet that’s high in calories, eating fast food, skipping breakfast, eating most of your calories at night, drinking high-calorie beverages and eating oversized portions all contribute to weight gain.
  2. Leading a sedentary lifestyle: With the arrival of televisions, computers, video games, remote controls, washing machines, dish washers and other modern convenience devices, the majority of people are leading a much more sedentary lifestyle compared to their parents and grandparents.
  3. Not sleeping enough. Getting less than seven hours of sleep a night can cause changes in hormones that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
  4. Endocrine disruptors, such as some foods that interfere with lipid metabolism.
  5. Medications that make patients put on weight. Some medications can lead to weight gain if you don’t compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.

 Complications:

If you’re obese, you’re more likely to develop a number of potentially serious health problems, including:

  • High cholesterol and triglycerides
  • Type 2 diabetes
  • High blood pressure
  • Heart disease
  • Stroke
  • Gynecologic problems such as infertility and irregular periods
  • Erectile dysfunction and sexual health issues, due to deposits of fat blocking or narrowing the arteries to the genitals
  • Nonalcoholic fatty liver disease, a condition in which fat builds up in the liver and can cause inflammation or scarring
  • Osteoarthritis

Treatment or Management:

The goal of obesity treatment is to reach and stay at a healthy weight. Successful and permanent weight loss is best achieved as a result of increased physical activity, changing how and when you eat, and modifying your behavior. Some of the tips to be kept in mind by the obese people are:

  • Start making healthy changes in your diet, such as eating more fruits, vegetables and whole grains and reducing portion sizes. Eat breakfast.
  • Track how much you’re eating or drinking each day so that you get a sense of how many calories you’re taking in.
  • Begin increasing your activity level. Try to get up and move around your home more frequently. Start gradually if you aren’t in good shape or aren’t used to exercising. Even a 10-minute daily walk can help.

Other treatment tools include:

  • Prescription weight-loss medications
  • Weight-loss surgery: like Gastric bypass surgery. Laparoscopic adjustable gastric banding (LAGB). Gastric sleeve. Biliopancreatic diversion with duodenal switch.

Ayurvedic Perspective:

Ayurveda names obesity as Sthoulyam. Acharya Charaka, includes obese people among the eight most censured people in the society.


Nidanam (Causative factors)

  • Intake of excess quantity of food rich in fat and calories.
  • Day sleep as a routine
  • Loss of Physical and Mental activity.
  •  Genetic causes,which leads to endocrine dysfunctions


Samprapti (pathogenesis)

Due to the causes vitiated Kapha makes obstruction of all minute channels(srotus) and makes the development of deeper tissues(dhatus) improper. So the vatha gets blocked inside the stomach which makes the digestive fire blaze. Such increased appetite makes the person eat more and thus gaining more weight. Transformation of dhathus get obstructed at the level of medodhathu (body fat) and the further dhathus like asthi(bone) majja(bone marrow) and sukram(reproductive tissue). At the same time all the tissue structure and functions are in imbalance due to vitiated kapha and the malnourishment of dhatus caused by it. Generally the body and mind of the person become weak and fragile.


Lakshana (signs & symptoms)

  • Short life span
  • Restricted movements
  • Loss of libido
  • Fatigue
  • Bad odour of body
  • Excess sweating
  • Excess thirst
  • Excess appetite

Chikithsa (treatment)

The treatment of obesity is based on correcting digestive fire and absorption, considering the physical and mental strength of the patient. This includes those which clear the dushti of medas, vaatha and kapha. Mostly, food and medicines with qualities like Katu(pungent), thiktha(bitter) and rooksha(dry) are used for this purpose. As the appetite of the obese is always more than normal, the treatment protocol includes heavy diet but dry ones which will not make the body fat more. The procedures include udwarthana, choornapindasweda, swedana and sodhana therapies like mrduvirechana. As the strength of the obese person will be very poor, theekshnasodhana procedures are not recommended. But in some cases vamanam and vasti can be implemented under the supervision of an experienced vaidya.

Pathyaahara-vihaara (preferred diet & regimen)

To be practiced:

  • Yavam, wheat, honey, oats, buttermilk, carrot, bitter gourd etc
  • Timely intake of food.
  • Early sleeping and wake up.

To be avoided

  • Fried, oily & frozen foods, cheese, meat, egg, ghee, butter, curd, yoghurt, etc.
  • Day sleeping.
  • Skipping of meals.
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