Obesity is a complex disease characterized by an excessive amount of body fat. It is a medical problem that largely increases risk of other health problems such as heart disease, diabetes, hypertension, sleep apnea and certain cancers. To remain healthy and lower the risks of these chronic diseases, weight control is highly recommended in obese or overweight people. Show Get to know obesityObesity is a chronic disease characterized by the excessive accumulation and storage of fat in the body. Obesity was traditionally defined as an increase in body fat which is greater than 20 percent of an ideal body weight in men or 30 percent of an ideal body weight in women. Fat accumulation in obese people might present as the deposit of subcutaneous fat under the skin or an excess of visceral fat, known as central obesity in which the abdomen protrudes excessively. There are several methods to measure fat and define obesity. The most commonly used on is Body mass index (BMI). BMI is a measure of body fat based on height and weight that applies to adult men and women. The formula is BMI = kg/m2 where kg is a person’s weight in kilograms and m2 is height in meters squared.
Obesity and metabolic syndromeMetabolic syndrome is a cluster of conditions that occur together, resulting in increased risk of heart disease, stroke and type 2 diabetes. These conditions include increased blood pressure, high blood sugar, abnormal cholesterol or triglyceride levels and obesity. Obesity substantially contributes to a number of adverse health consequences including development of insulin resistance, high blood lipids and elevated levels C-reactive protein (CRP) –an independent risk factor for cardiovascular disease. Overweight people, without weight reduction, are more likely to develop central obesity up to 25%. Assessing central obesityCentral obesity is an excess accumulation of fat in the abdominal area, particularly due to excess visceral fat. Since visceral fat is supplied by the portal blood system, excess fat in this area can lead to the release of fatty deposits into the bloodstream, causing health-related problems. Waist circumference has been shown to be one of the most accurate indicators of abdominal fat assessment. However, abdominal obesity measurement guidelines and cutoffs vary among different ethnic groups. In combination with the measurement of waist circumference, central obesity can be defined if at least 2 of these criteria present:
Measurement of waist circumferenceTo correctly measure waist circumference, measurement should be conducted in the morning before having breakfast. Steps for measurement involve:
Waist circumference is strongly associated with BMI. Both indicators have been clinically used to predict health problems potentially caused by obesity. Cut points to define central obesity among different ethnical groups are:
Contributing factors to central obesityStatistical data reviews that approximately 30% of Thai populations aged over 35 have developed central obesity. Compared to neighboring countries in ASEAN, 32.2% of Thai populations have BMI ≥ 25 which ranks as the second highest number in the region. The prevalence of central obesity has been continuously rising during recent decades. Contributing factors primarily include:
Health-related problems caused by central obesityCentral obesity is associated with a statistically higher risk of developing a wide range of diseases, including: cardiovascular diseases, neurological diseases e.g. stroke, diabetes, hypertension, fatty liver, gallstones, gout, osteoarthritis, sleep apnea, skin disorder e.g. fungal infection, varicose veins and certain cancers. More importantly, people with raised waist circumference, every 5 cm. are 3-5 times as likely to have diagnosed diabetes. To minimize the risks of developing these diseases, weight control and lifestyle changes are viral, especially in younger age. Treatment of central obesityThe desired goal to treat central obesity is to lower the risks of health-related conditions induced by an excessive fat. To achieve the treatment goal, body weight must be reduced at least 5% from the baseline. Treatments include: 1. Regular exercise: To reduce weight, it is highly recommended to have regular exercise at least 30 minutes per day, 5 days each week. For office workers, activities that encourage movement are suggested. 2. Intensive lifestyle modification in diets:
3. Weight reduction pills: Certain drugs used to control weight might be prescribed if BMI is greater than 30 or 27 with diagnosed diseases induced by obesity. 4. Bariatric surgery: Bariatric surgery is highly recommended in patients who have BMI greater than 40 or 35 with diagnosed diseases or comorbidity caused by obesity. Procedures include:
On the occasion of World Obesity Day, to be aware of the health-related problems caused by obesity remains important to everyone. Not only to stay in shape, but weight control and lifestyle changes also help to minimize chances of chronic diseases associated with obesity.
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