I recently managed a patient with obesity hypoventilation syndrome (Pickwickian syndrome). She had had asthma-like symptoms and signs since 2015. Part of management was about controlling the weight through ensuring a low-fat-low-calories diet and graded physical activities. It reminded me of the fact that much as we are fighting immunizable diseases through vaccinations, the burden of non-communicable diseases is ever increasing and there should be a deliberate strategy to curb this threat, obesity inclusive.
Women, in particular, suffer the most deleterious effects of obesity, especially when it comes to pregnancy and childbirth. You can prevent obesity – better still, control it. Let’s get into it.
Obesity is an increased percentage of total body fat compared with the normal. Overweight, on the other hand, means increased body weight relative height. Both can have catastrophic effects on your health.
Clinicians can assess overweight using Body Mass Index (BMI), which is calculated as; [weight in Kgs]/[Height in meters]2. Women aged 19 to 35 years old should have a BMI of 19 to 25, and those above 35, of 21 to 27.
A woman is overweight if her BMI is higher than 25; obese if this is higher than 30 and severely or morbidly obese if this is higher than 40.
Clinicians use the skinfolds measurements to determine relative obesity. They can also assess the distribution of body fat using the waist and hip size. A lady with body fat content higher than 33% is obese. It is worth noting that an increased waist-to-hip ratio is a risk factor for heart disease and diabetes.
Obesity is caused by consuming too many calories for the physical activities performed. There’s a group of people whose reasons for gaining weight are unknown. Genetics, psychological reasons, culture, and society may all play an important role as far as obesity is concerned.
Being overweight increases your probability of having catastrophic health problems like high blood pressure, diabetes, coronary artery disease, joint diseases. Easy tiredness, shortness of breath are common symptoms of obesity complications. Morbid obesity predisposes you to have difficulties breathing while asleep.
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Clinicians diagnose obesity through medical history and physical examinations. They carry out a few measurements to determine the amount of body fat. They can also order for blood and urine tests to rule out medical ailments that are known to cause excess weight.
Treating obesity requires a multidisciplinary approach that involves physicians and dieticians as well as physiotherapists and psychologists. It, however, requires the utmost level of consistency, persistence, endurance and most importantly being patient.
Diet, exercise, medicines, and surgery are all used. The clinicians can help you plan a decent low-fat, low-calorie diet. Exercising is very rewarding, and an individualized, supervised program helps prevent complications.
A few drugs are available for weight loss, but they don’t go without side effects. They include amphetamines, orlistat, lorcaserin, phentermine, diethylpropion, and a combination of naltrexone and bupropion.
It is on this ground that you should only use them after diet and exercise have failed and under the direct supervision of a clinician.
Women who are morbidly obese and had had no success with the above methods may consider surgery, such as gastric bypass, lap band, or vertical band gastroplasty (stomach stapling).
DOs and DON’Ts in Managing Obesity;
- DO tell your clinician about other medical problems.
- DO tell your clinician about all your drugs, and call if you have side effects from medicines.
- DO tell your clinician if you’re pregnant or nursing.
- DO consider joining a support group.
- DO some daily exercises.
- DO learn your current weight, body mass index, and body fat content.
- DO call your clinician if you gain weight on a regular diet and exercise.
- DO let your clinician know if you have severe diarrhoea or low blood sugar after surgery.
- DON’T try fad diets.
- DON’T try to lose weight too quickly.
- DON’T drink a lot of soft drinks or eat fast food.
- DON’T smoke to control body weight.
- DON’T become discouraged if weight loss stops for a while.