Like other metros the midsized Nagpur and surrounding cities of Vidarbha have been witnessing large number of obese people across all ages, of late, thanks to the boon of technology and luxury leading to sedentary lives taking toll on the health.
Says Dr Prachi Mahajan, Consultant Bariatric and Laparoscopy Surgeon in Nagpur, “Being overweight has become more of a norm! Obesity is on the increase, bringing with it, a number of metabolic illnesses. Obesity is, in fact, a form of malnutrition.”
Dr Mahajan feels it’s high time the so called techno savvy people should sit back and delve deeper into sorting out the problem before it gets too late.
In an exclusive chat with Nagpur Today, Dr. Mahajan shared some important aspects on obesity and its impact on the health. In the first part of the series, she has detailed on various aspects of obesity for our readers.
Here’s the low down…
What lies in body shape?
Dr Mahajan said, “We all know the male and female body assumes the typical apple and pear shapes respectively, with increasing obesity. Men tend to put on weight around the trunk and abdomen whereas the typical female distribution of fat is around the lower body. Male type of fat deposition is more strongly associated with cardiovascular illness.”
BMI tells how obese you are
Dr Mahajan said the main criterion by which obesity is characterized is known as the Body Mass Index (BMI). BMI is a ratio of the weight in kg to the square of the height in meters.
BMI = weight (kg) / height2 (m2)
Thus, the acceptable weight of a taller person would be more than that of a shorter person. Normal BMI is considered to be between 19-30. If it is less than 19, it indicates undernourishment, whereas BMI > 30 kg/m2 is considered obese.
Grade 1 obesity : BMI 30-34.9 kg/m2
Grade 2 obesity : BMI 35-39.9 kg/m2
Grade 3 obesity : BMI 40 kg/m2 and above
Extremely obese individuals fall into the super-obese category. Those individuals who suffer from serious life-threatening problems due to obesity are known as morbidly obese.
Health risks with obesity
Obese people are more prone to suffering from Type 2 diabetes, i.e maturity onset or adult type diabetes. In addition to a hereditary predisposition to diabetes, weight gain itself causes reduced efficiency of insulin in glucose metabolism. Thus, the available insulin produced by the pancreas falls short of the heavier body’s requirement and a person has continuously elevated blood sugar levels.
The association of hypertension with obesity is another potentially dangerous one. There are various mechanisms by which this occurs. The demands of a heavier body on the heart far exceed what a normal heart can handle. The heart needs to pump at a higher pressure head in order to maintain adequate blood supply to the tissues.
– High blood cholestrol
Obese individuals more commonly have high blood cholesterol and unhealthy fatty acids that cause early narrowing of arteries. Thus the heart has to pump blood against resistance in stiff narrowed arteries, thus resulting in raised blood pressure. All these processes get worse over time and as age advances, the efficiency of the heart reduces, thus resulting in ischaemic heart disease.
Overweight individuals are more likely to have raised cholesterol and LDL levels and lower levels of good cholesterol in their blood. This predisposes to early atherosclerosis and narrowing of arteries leading to the heart.
– Respiratory disorders
An increased bulk over the trunk (abdominal fat) causes disturbance to the mechanics of respiration (breathing). The movements of the diaphragm are compromised, thus causing poor oxygenation of blood in the lungs. Sustained respiratory insufficiency may also result in cardiac failure in severe cases.
– Respiratory disorders
Obese individuals commonly have a short fat neck with poor musculature and are more prone to snoring. The tongue falls back during sleep, causing narrowing of the air passage. This, when severe, can cause near-total obstruction to the inhalation of air and is known as the Obstructive Sleep Apnoea Syndrome.
Since the weight of the body is continuously borne by the musculoskeletal system, the bones and joints come under constant attack by being overweight. Bones become brittle, osteoporosis sets in and osteoarthritis, i.e wear and tear of joints occurs rapidly. Thus, backache, knee and hip joint pains are very common in obese patients.
Psychsocial aspects of obesity
Overweight persons suffer from a lack of self confidence and often suffer from chronic depression, which often sets in the vicious cycle of overweight-overeating. Obese individuals often get laughed at and teased by their peers and this causes them to stay away from social gatherings. The societal norms make matrimonial alliances also difficult for overweight individuals, thus adding to their torment. Improvement in one’s body image is most often the only solution to these problems.
esity thus has far reaching implications in our daily lives. In the next section in this series, we will discuss ways to maintain a healthy lifestyle and how to maintain near-ideal body weight.
(Dr Prachi Mahajan is an MS, FRCS (United Kingdom), FMAS. She is Consultant Bariatric and Laparoscopy Surgeon in Nagpur. She has been practising as a surgeon with special interest in GI and Breast surgery in Nagpur since 10 years. She has attended to large series of breast cancer patients and also performed advanced laparoscopic and thoracoscopic procedures and bariatric surgical procedures. Dr Mahajan also shares to her credit presentation of papers and winning awards in various National and International Conferences)