The Bold Voice of J&K

Beyond weight: The public health challenge of Obesity

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Dr Lucky Gupta & Lovish Batra

It is a lesser-known fact that every year, fourth March is observed as World Obesity Day. The day dates its significance back to 2015 when it was first observed by World Obesity Federation and WHO to “lead and drive global efforts to reduce, prevent and treat obesity.”
Obesity is defined as an increase in Body mass index (BMI). For Asians, the accepted WHO cutoff level of BMI is ?27.5 kg/m2. BMI is calculated by dividing person’s weight in kilograms by the square of height in meters. Due to the lack of awareness and information regarding the subject, many people believe that obesity is just an abnormality of increased weight and that a few extra kilograms cannot hurt anybody. Obesity might feel harmless, but over the past few years, various studies have shown the negative impacts of obesity on the physical, mental, social, environmental and economic well-being of not only an individual but the community as a whole. Causes of obesity include unhealthy eating behaviors, lack of physical activity, poor sleep, surrounding environment, high amounts of stress, associated other health issues, medicines and genetic causes.
The magnitude of the problem
According to the National Family and Health Survey five, the prevalence of abdominal obesity in India was found to be around 40% in women and 12% in men. Studies also predict that by 2040, India will be in an epidemic-like situation with obesity.
Health, environmental and economic effects of obesity
In today’s time, obesity is a significant health challenge. In 2019, 50 lakh people died prematurely due to obesity, which makes it one of the foremost causes of death around the globe. Various researchers have found a relationship between obesity and an increased risk of cardiovascular disease, stroke, diabetes mellitus, gall bladder disease, arthritis, and sleep apnea, among other health issues.
The spectrum of problems is not limited to physical issues but also mental health issues. Multiple studies conducted around the globe show that the prevalence of psychiatric disorders in obese people is about 20% to 60% higher than in the general population. Within this spectrum lie a multitude of problems like depression, anxiety, eating disorders, poor self-image, social stigma, discrimination, physical abuse and even substance abuse.
The effects of obesity are not only limited to individuals suffering from it but the whole economy. According to a 2019 study, obesity-related costs are nearly 0.8% of the economy of India. Obese people are also reported to be less likely to be employed and promoted. The economic impacts are rooted in the increased medical costs, among various reasons.
Obesity also takes its toll on the environment. Obese people have 20% more emissions than normal-weight people due to increased food consumption, increased metabolism and raised fossil fuel usage for transportation.
Prevention and Treatment
Obesity is a lifestyle-related disorder and is easily preventable by subtle modifications in current lifestyles. Also, the preferred treatment of obesity is lifestyle modification with the primary goal of reducing excess weight, thereby decreasing the risk of related comorbidities.
Lifestyle Modifications-
The dietary modification makes up a significant chunk of the lifestyle modifications for obesity. These include taking a low-calorie diet rich in fibre, whole grains, fruits and vegetables along with reduced intake of fat and carbohydrates. Studies have found these low-calorie, low-fat, low-carbohydrate diets consistently related to weight loss.Use of unhealthy foods like refined grains and sweets, potatoes, processed meat, and sugary drinks should be limited.
Exercise is a crucial factor for weight loss and overall better health outcomes. WHO recommends that adults have about 150 minutes of moderate-intensity or 75 minutes of vigorous physical activity for better well-being.Evidence-based smartphone applications are easily accessible and have proven to be very beneficial in combating obesity.
Another important factor is limiting television time, screen time and other “sit time” to reduce the sedentary habits which contribute towards obesity.
Treatment-
The treatment part includes medications, surgery and therapy/ counselling, depending upon the circumstances. Treatment of Obesity is a months-long process, and emotional support from family and experts is pivotal for the successful completion.
Bariatric surgery (weight loss surgery) is preferred when all other methods fail to show the expected results. Surgical interventions are better than other methods in preventing the incidence and risk of other associated diseases.
In patients with eating disorders, cognitive behavioral therapy (CBT) has the best patient outcomes in addition to other treatments available.
As mentioned earlier, obesity is a rising matter of public health concern. Awareness, education, proper address and prevention can help us to limit the extent of not only obesity but also related disorders like heart disease and diabetes. Also, the importance of research and policy formation in preventing and managing obesity cannot be ignored.
In summary, even though initiatives like awareness campaigns, health education, lifestyle modifications including meditation, along with psychological assistance, initially appear like baby steps but are definitely the need of the hour and will be very impactful in the years to come.
(The writers Dr Lucky Gupta is Assistant Professor, Department of Pediatric Surgery, AIIMS, Vijaypur, and Lovish Batra a student of 2021 batch, AIIMS Jammu).

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