Date post: | 08-Jul-2015 |
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Health & Medicine |
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Obesity is defined as an
abnormal growth of the
adipose tissue due to an
enlargement of fat cell
size(hypertrophic
obesity)or an increase in
fat cell
number(hyperplastic
obesity)or a
combination of both.
Central obesity is defined as waist
circumference ≥ 90 cm in males
and ≥ 80 cm in females.
+
Any two of the following
-Increased triglycerides ≥ 150
mg/dl (1.70 mmol/L)
-reduced HDL cholesterol <40
mg/dl in males and < 50 mg/dl in
females.
-raised blood pressure systolic bp ≥
130 mm Hg and diastolic bp ≥
85mm Hg.
-raised fasting plasma glucose ≥
100 mg/dl.
Or treatment for previously
diagnosed any of the above
condition.
Classification BMI
(kg/m2
)
Risk of Co-morbidities
Underweight <18.5 Low (Risks are increased in
other areas)
Desirable 18.5-
22.9
Average
Overweight 22.9-
29.9
Mildly Increased
Obese >30.0
Class 1
Obesity
30.0-
34.9
Moderate
Class 11
Obesity
35.0-
39.9
Severe
Class 111
(morbid
obesity)
>40.0 Very severe
Obesity is primarily
driven by individual
decisions, and the
way society
influences them
Human biology -
genetics plays a
part but does not
pre-destine us to
be obese
Culture/Individual
psychology - it is
difficult to break
habituated
unhealthy eating
patterns, especially
when common to
those around us
The food environment - there has
also been a huge increase in the
quantity of quick convenience
foods, which tend to be high in
saturated fat, salt and sugar.
The physical environment - our
lives have become increasingly
sedentary. For e.g. last two
decades have seen marked
reduction in school walking.
RELATIVE RISK OF HEALTH PROBLEMS
ASSOCIATED WITH OBESITY
Greatly increased
(relative risk >>3)
• Diabetes
• Gall bladder diseases
• Hypertension
• Dyslipidemia
• Insulin resistance
• Sleep apnea
• Breathlessness
Moderately increased
(relative risk 2-3)
• Coronary heart disease
• Osteoarthritis (knees)
• Hyperuricemia and gout
Slightly increased
(1-2)
• Cancer(breast cancer in postmenopausal women, endometrial cancer, colon cancer)
• Reproductive hormone abnormalities
• Polycystic ovarian syndrome
• Infertility
• Low back ache
• Increased anesthetic risk
• Foetal defect arising from maternal obesity.
• Moderate calorie restriction.(to achieve a 5-10% loss of body weight in 1st yr)
• Moderate increase in physical activity.
• Change in dietary composition.Primary intervention
• Drug therapy is required to treat the metabolic syndrome associated with obesity.
• There is a definite need for treatment that can modulate the underlying mechanism of metabolic syndrome as a whole and thereby reduce the impact of all the risk factors and the long term metabolic and cardiovascular consequences.
Secondary intervention
Cut down on salt
and sugar.
Do not skip meals
Do not eat while
reading, watching
TV, playing video
games.
Eat little at
dinner.
Walk after night
meals.
Avoid foods high
in saturated fat
and cholesterol.
Take fruits in
between meals for
snacking.
Take at least 7-10
glasses of water
every day.
Use skimmed milk
instead of full fat
milk.
AVOID
•Alcoholic drinks.
•Butter , margarine
•Cakes, pancakes, cookies, doughnuts, pastries etc.
•Candies, chocolates, cream, cheese.
•French fries, potato chips, pizza, pasta, burger, snacking food.
•Jams, jellies, sugar and syrup.
•Ice cream, ice milk, sherbets, soda drinks.
D
I
E
T
EARLY YEARS(UNDER 5S)
Preschool children should be physically
active at least for 180 minutes.
All under 5s should minimize the time
spend being sedentary for extended
periods except for sleeping.
CHILDREN AND ADOLESCENTS
All children and young people should engage in
moderate to vigorous intensity physical activity
for at least 60 minutes and up to several hours
every day.
-Vigorous intensity activities, including those that
strengthen muscle and bone should be
incorporated at least thrice a week.
-They should minimize the time spend being
sedentary for extended periods.
ADULTS AND OLD AGE
-Adults should aim to be active daily. Over a
week, activity should add up to at least 150
minutes
(2½ hours) of moderate intensity activity in bouts
of 10 minutes or more – one way to approach
this is to do 30 minutes on at least 5 days a week.
Alternatively, comparable benefits can be achieved
through 75 minutes of vigorous intensity
activity spread across the week or a combination of
moderate and vigorous intensity activity.
-Adults should also undertake physical activity to
improve muscle strength on at least two days
a week.
-All adults should minimize the amount of time
spend being sedentary for long.
Ammonium carb-
Fat patients with weak heart.
Women who are tired and weary and takes cold
easily.
Leads a sedentary lifestyle.
Dry coryza-stoppage of nose-at night-can only
breathe through mouth-danger of suffocation.
Sadness with disposition to
weep, timidity, disgust with
life, heedlessness, weakness of memory, great
absence of mind.
Chilly patient < wet stormy weather ; washing
> warmth.
Ammonium muriaticum-
Body is fat and legs are thin with large buttocks.
Full of grief but cannot weep. Irritability and
disposition to be angry.
Feets get very cold in the evening in bed.
Antium crudum-
Children and old people who have a tendency to grow
fat with coated white tongue.
Belching and great eructations of ingesta.bloating
after eating.
Cold and callous excrescenses.
Patient is aggravated from extremes of temperature.
Calcarea carbonicum-
Sweating on the forehead which wets the
pillow while sleeping.
Fair, fat, flabby are the red lined symptom.
Great sensitiveness to cold damp air.
Capsicum-
Person who are weak of lax fibre.the
digestion is poor and suffer from myalgia.
Have burning pains still doesn’t like cold.
Old people who have exhausted their vitality.
Home-sickness.
>from heat
Carlsbad-
Action on liver, treatment of obesity and
diabetes.
Self satisfied, very talkative, good humored.
Discouraged and anxious about domestic
duties. Absent minded, heedless, forgets
names.
Sensitive to cold air. sweats more easily.
> Motion and open air.
Calotropis gigantea-
Helps in reducing the obesity, without
reducing the weight i.e. flesh would
decrease but the muscle would become
more firm.
There is great heat in stomach.
Ferrum metallicum-
Obesity with anaemia, puffy face with pitting of
flesh. Delicate girls, fearfully constipated with low
spirits.< cold weather. > warm weather.
Great lassitude and weakness.
Graphitis-
Obesity in females with delayed
menstruation.
Fair, fat , chilly constipated people.
Kali carbonicum-
Older fat people characterized by sweat, backache
and weakness.
Dark haired person with lax fiber and inclined to be
fat.
Esculentine-
Great fat reducer. Can be alternated
with phytoline.
Should be given in mother tincture.Fucus vesiculosus-
Given when calcarea carb fails.
Indigestion, obstinate
constipation, flatulence.
To be given in tinctures.
Phytolacca berry-
One of the best remedies in weight
reduction and corpulence reduction
Phytoline-
Great fat reducer. Recommended
when the patient is having difficulty in
walking, sitting, palpitation, dyspnoea
on least
exertion, nausea, eructations.
Given in mother tincture.
Thyroidinum-
Excessive obesity. Acts best in
pale patients.
Is a powerful diuretic and helps in
myx-odema and various types of
oedema.