Obesity is defined as a condition of excessive body fat. It is a chronic condition where excessive fat deposition impairs health. Obesity is a growing concern in India, with a high prevalence of abdominal obesity. It has been estimated that more than 100 million people in India are struggling with obesity. A report published between 2019 and 2021 states that around 40% of women and 12% of men were found to be abdominally obese.
What is obesity?
Obesity occurs when there is excessive body fat. It is a chronic (long-term) and complex disease that can affect overall health and quality of life. Obesity can lead to serious medical conditions and impact self-esteem and mental health. It is a common disease affecting millions worldwide.
What causes obesity?
On a basic level, obesity occurs when calorie intake exceeds the body’s energy expenditure. Several factors may contribute to consuming more food than the body needs:
Certain medications: Some antidepressants, steroids, anti-seizure medications, diabetes medications, and beta-blockers can contribute to weight gain.
Disability: Adults and children with physical and learning disabilities are at higher risk for obesity.
Eating habits: Consuming more calories than needed, eating ultra-processed foods, sugary foods and drinks, and foods high in saturated fats can lead to weight gain.
Genetics: Some individuals carry specific obesity-related genes that affect appetite and metabolism.
Lack of physical activity: Excessive screen time, such as watching TV, playing video games, or prolonged mobile and laptop use, reduces physical activity levels.
Lack of sleep: Sleeping less than seven hours can disrupt hormones that regulate hunger, leading to increased appetite.
Stress: Chronic stress increases cortisol levels, which may trigger cravings for high-fat, high-sugar foods that contribute to weight gain.
Underlying health conditions: Disorders such as metabolic syndrome and polycystic ovary syndrome (PCOS) can cause weight gain. Mental health issues, such as anxiety and depression, may also lead to emotional eating and increased calorie intake.
Symptoms of obesity
Although obesity itself does not cause specific symptoms, healthcare providers diagnose it using the Body Mass Index (BMI) and other assessments.
What is BMI?
BMI (Body Mass Index) measures body weight in relation to height. Healthcare providers use BMI as a standard classification for obesity.
BMI Classifications
Obesity is classified into three general categories based on BMI:
• Class I obesity: BMI of 30 to less than 35 kg/m².
• Class II obesity: BMI of 35 to less than 40 kg/m².
• Class III obesity: BMI of 40+ kg/m².
Although BMI is widely used, it does not always accurately predict specific health risks, as body composition varies among individuals.
Complications of obesity
Metabolic changes: Excess calorie intake leads to lipid storage in fat cells. When fat cells enlarge, they release hormones and chemicals that cause inflammation.
Cardiovascular diseases: Obesity increases the risk of heart diseases, including coronary artery disease, heart failure, heart attack, and stroke.
Fatty liver disease: Excess fats in the blood accumulate in the liver, causing inflammation (hepatitis) and potential liver damage (cirrhosis).
Gallstones: High cholesterol levels may lead to gallstone formation and gallbladder diseases.
Kidney disease: Conditions such as high blood pressure, diabetes, and liver disease increase the risk of chronic kidney disease.
Type 2 diabetes: Obesity significantly raises the risk of developing Type 2 diabetes.
Other complications: Arthritis, asthma, back pain, and sleep apnea.
Risk factors associated with obesity
Certain cancers, including esophageal, pancreatic, colorectal, breast, uterine, and ovarian cancer.
Depression and mood disorders.
Female infertility and pregnancy complications.
Memory and cognitive issues, including an increased risk of Alzheimer’s disease and dementia.
Diagnosis of obesity Healthcare providers assess obesity through:
Medical history: Past conditions, treatments, medications, and family health history.
Weight history: Previous weight management attempts and patterns of weight gain.
Lifestyle factors: Eating habits, sleep patterns, and physical activity levels.
Mental well-being: Stress levels and psychological factors contributing to weight gain.
Treatment & Management of Obesity
Obesity management includes dietary changes, behavioral interventions, medications, and, if necessary, surgical procedures.
Dietary modifications: Individualized low-calorie diets should be monitored for regular weight loss. Restricting either carbohydrates or fats can help achieve a caloric deficit.
Behavioral interventions: Patients should receive counseling on healthy eating, physical activity, and lifestyle modifications.
Medications: Anti-obesity medications may be prescribed for individuals with a BMI ≥ 30.
Surgical interventions: Bariatric surgery is considered for individuals with a BMI ≥ 40 or a BMI ≥ 35 with severe comorbidities. Patients undergoing surgery must commit to long-term lifestyle changes and follow-up care.
Physiotherapy and Obesity
Physiotherapists play a key role in weight management by designing exercise programs that promote fat loss and improve overall fitness. Exercise not only reduces fat mass but also lowers the risk of metabolic diseases, cardiovascular conditions, and inflammation.
Exercise Recommendations
To maintain weight and improve overall health:
150 to 300 minutes of moderate-intensity aerobic exercise per week or 75 to 150 minutes of vigorous-intensity exercise per week is recommended.
For weight loss: At least 200 to 300 minutes of moderate to vigorous exercise per week is advised.
For beginners: Start with low-intensity activities and gradually increase intensity and duration.
Spread exercise sessions throughout the week rather than completing them all in one day. • Use appropriate sports gear and choose safe environments.
Modify exercises to reduce joint stress (e.g., using cycling or hydrotherapy instead of running for individuals with arthritis).
Strength training can be incorporated to build muscle mass, although it is less effective for direct weight loss.
Personalized Approach to Weight Loss -There is no one-size-fits-all approach to obesity management.
Physiotherapists must assess individuals’ responses to different exercises and adjust treatment plans accordingly.
Obesity is characterized by an excess of body fat and is a chronic, complex disease that can impact both health and quality of life. Physiotherapists are crucial in managing weight by creating exercise routines that encourage fat reduction and enhance overall fitness.
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