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Lối sống lành mạnh : Glossary
Obesity
[2007-09-18 09:37] (1,220)

Definition

 

Definition of obesity: The term obesity is used to describe the excessive storage of fat in the tissues of the body. Everyone has a standard body weight. A person is considered obese if his body weight is at least 120% greater than the standard body weight. Anyone with a BMI exceeding 30 is described as obese. The terms obese and overweight are used to describe the same condition and are interchangeable. However, strictly speaking, these terms have different meanings. The term “overweight” describes the weight of our whole body, including all tissues, bones, and fatty tissues. Bodybuilders may be classified as overweight due to overly massive muscles, but they are not considered obese. However, in most overweight cases, the fat in the tissues is excessively increased. In these cases, both terms are interchangeable.

 

Symptoms

 

People with obesity have a higher chance of acquiring a disease, and has a lower life expectancy. The belief that obesity causes short life has been existent since Ancient Greece, as written by the Greek physician Hippocrates. He said that ‘sudden death comes more commonly to the fat than the skinny.’ Here are a list of diseases that is usually found in cases of obesity:

  • Diabetes
  • High blood pressure
  • Hyperlipidemia
  • Heart failures
  • Cancer
  • Disease of the gall bladder and gallstone
  • Arthritis
  • Gout
  • Lung disease
  • Increased cases of sleep apnea syndrome

Other than these conditions, obesity can cause pain and distress both mentally and socially. Generally, people with obesity are stereotyped to be lazy, unattractive, late in processing work, and being slow. In people with obesity, these stereotypes may cause the lack of confidence, the feeling of shame, and discontentment with their body. These may lead to depression and may prevent the obese patients inform having a normal social life.

Causes, conditions, and physiologies

 

The cause of obesity is not completely explained yet. It is not logical to assume that obesity is caused only by the desire for food or laziness. Recent research and clinical studies show that obesity is not caused by a few simple factors but rather by a variety of factors. Obesity is also classified as a chronic disease.

  1. Genetic factor: Obesity can be hereditary. If the parents are obese, the children have a higher chance to become obese. 60-80% of obese children have one or two parents who are obese. Also, judging from the fact that obesity is focused on certain families and through non-identical twin researches, genetics has been determined as one of the factors causing obesity. In support of this, there are cases of obesity resulting from genetic abnormalities. However, family members may have different dietary habits and there are cases where the parents are obese but the children are not. Therefore, obesity cannot be fully explained by genetics alone.
  2. Dietary habits: Dietary habits and everyday habits play an important role in obesity. People who prefer high-fat food are more likely to be obese. Food such as hamburgers, french-fries, and ice-cream are tasty but have high levels of fat. The calorie levels per unit are too high, which can cause obesity. Judging from the fact that there are almost no cases of obesity among vegetarians, we can see the effect of diet in obesity.
  3. People who spend most of the day sitting down have a higher risk of obesity. When there is less activity, there is less use of the body’s energy. 20-30 minutes of daily exercise can prevent obesity.
  4. Unbalanced energy metabolism: We ingest food, digest the food, and form the energy we need in our everyday lives. If we ingest more food than necessary to produce the energy we need, the extra food causes obesity. This mathematical approach is only a theory, but in reality, the left over food is stored in the fat tissues. Our body consumes energy until we die. If a person has a low metabolism rate for the basic energies needed for breathing and maintaining body temperature or if a person has a low fat-oxidation rate, he/she has a higher chance of getting obesity. These factors may be related to genetics, and therefore uncontrollable. However, exercising and increasing the amount of muscles increases the energy consumption during activities.
  5. Psychological factors: Some people tend to overeat when stressed or depressed. These eating habits are considered a part of eating disorders. 30-40% of patients with obesity have such habits of overeating. These psychological factors can lead to an increase in food intake as well as a decrease in physical activities. This causes an unbalanced energy metabolism which can lead to obesity.

Diagnoses

 

Obesity is the accumulation of fat tissues, and can be diagnosed by measuring the body fat levels to determine the BMI. However, it is difficult to measure the body fat level, which is why we use the following indirect measurements.

  1. Body mass index, BMI: It can be calculated through a simple equation. It is relatively accurate in estimating the amount of body fat, and it is the most commonly used measurement. The BMI is your body weight (kg) divided by the square of your height (m). For example, if you are 150 cm tall and have a body weight of 50 kg, your BMI is your body weight, 50, divided by the square of your height, 2.25 (1.5x1.5), which equals 22.2 kg/m2. A person is described as overweight if the BMI is between 25 and 29.9 and obese if the BMI exceeds 30. However, using BMI to define the terms “obese” and “overweight” would depend on the age, sex, and race of the person, so you would need to take these factors into consideration (refer to the table on the relationship between BMI and BMI of Koreans). The standard weight is also known as the ideal standard weight. The equation for the standard weight is [height (cm) ? 100] x 100. Anyone who exceeds 120% of the standard weight is termed obese.
  2. Waist size. Even if the waist size is similar, the physical shape and risk for geriatric disease differs depending on the amount of accumulated fat. Obesity with higher concentrations of fat in the stomach area is called the middle-centered, male type, or apple type obesity. Obesity with higher concentration of fat in the hips and the thighs is called peripheral, women type, or western bear type obesity. The risk for high blood pressure and arteriosclerosis is higher for the middle-centered obesity. For this reason, the waist size is important, and it is measured from above the navel to the shortest way to the waist. The hip size is measured by finding the longest length of the hip area. If the waist - hip measurement ratio exceeds 1.0 for men, and 0.9 for women, the risk for geriatric diseases is higher.
  3. You can use instruments for ultrasonic tests, bioelectric resistance tests, and tomographic tests to measure the body fat. It has a good correlation with the BMI.

Progress, Prognosis

 

Obesity shortens the lifespan of a person. Based on a 30-year research study, people with higher BMI have lower life expectancy. As the BMI increases, the health risk percentage increases as well. Therefore, people with obesity develop various complications and have higher mortality rates. Even if the effects of obesity on mortality rate are not immediately visible, you should not overlook the symptoms and think that obesity has no associated short-term risks.


Complications

  1. Obesity influences fat metabolism increasing the amount of cholesterol and triglycerides in the blood leading to hyperlipidemia. In turn, hyperlipidemia causes arteriosclerosis.
  2. Obesity causes high blood pressure, sternocardia, and myocardial infarction or heart attack.
  3. Obesity influences glucose metabolism and causes diabetes by increasing the blood sugar.
  4. Cholelithiasis. Obese patients have increased levels of cholesterol in the blood which leads to cholelithiasis. Cholelithiasis, in turn, may cause bile duct inflammation (cholecystitis). Also, there is a higher risk of surgical complications for surgery performed in the stomach area.
  5. Cancer rates are also increased in obese patients, with a high incidence of cancers in the digestive systems.
  6. Lung disorders. In severe obesity, too much fat are stored in the chest wall and diaphragm area. This limits the expansion of the lungs, which causes breathing difficulties. Eventually, the oxygen supply in the blood decreases while the carbon dioxide level increases leading to symptoms of fatigue and listlessness. Obese patients also develop sleep apnea syndrome, a condition where breathing stops for a period of time during sleep.
  7. Fractures and arthritis. Due to the extreme weight, excessive pressure is applied to the knees and the vertebral joints, leading to degenerative arthritis.
  8. Sexual disorders. In cases of severe obesity, the metabolism of testosterones and estrogens are affected, causing a decrease in sexual functions including a decrease in the tendency to be attracted to someone else. Also, the effects of obesity on the sex hormones, influences the satisfaction achieved during sex.

Treatment

 

There are several treatment methods for obesity, including dietary plans, exercise, activity therapy, medications, and surgery. It takes a lot of effort to lose weight and maintain the new weight. Most of the time, the result is not as satisfactory as the efforts. Do not plan a short-term weight loss program. The chance of success is higher if you plan to lose 5-10 % of the weight over a long term. Also, the main point of treating obesity is to decrease the amount of calorie intake and increase calorie expenditure.

  1. Dietary methods. Limit the calorie intake and expend the fat stored in the body for weight loss. There are low-calorie meals for obese patients that supply 800 calories per day and extra-low calorie meals that supply 600-800 calories daily. But in practice, the lowest calorie meal prescribed is 1500 calories for men and 1200 calories for women. The average calorie consumption in Korea is around 1800-2000 calories. 0.45 kg of fat tissues is estimated to be equivalent to 3500 calories, so in order to lose 0.5 kg in a week, you need to expend 500 calories a day. To lose 1kg in a week, you have to ingest 1000 calories less from your normal intake levels.
  2. Exercise. Exercise increases the rate of calorie usage to bring forth weight loss. If you exercise, your body oxidizes and expends the fat stored in tissues increasing the muscles and other non-fat tissues and causing weight loss. Also, the appropriate amount of exercise is known to decrease the appetite. Exercise as a means of weight loss works best when accompanied with dietary plans. In general exercise techniques, the recommendations are: to use 50-60% of your maximum exercise capability and to exercise for 30-60 minutes daily for 3-5 times a week. For obese patients, the duration of exercise needs to be increased to 60 minutes for 6-7 times a day to decrease body fat and body weight. To lose 1kg of body fat in a week, you need to consume 400 calories in exercise. This corresponds to 90 minutes of walking, 60 minutes of power walking, 30 minutes of jogging. Walking should consist of 110 steps per minute, power-walking consists of 140 paces per minute, and jogging consists of walking 180 paces per minute.
  3. Behavioral therapy. Behavioral therapy is needed because the person following the dietary plans and the exercise plans for obesity treatment is the patient himself. The patient needs to examine his habits and change his lifestyle by strengthening the good habits, etc. Behavioral therapy helps in checking the self-observation methods.
  4. Medication treatment. Various medicines are used for weight loss. However, no medicine has yet been developed that has an outstanding effect on weight loss. In recent years, a few medicines have been approved. The obesity medication approved by the FDA is designed to be a component of the weight loss program and should be taken while on a dietary plan and exercise program. If your BMI exceeds 30 or if it is over 27 but you have obesity-related risk factors or diseases, you are a candidate for medical therapy. The most commonly used medication is the appetite-repressor. This brings weight loss in the first months, but loses effect after 3-6 months. Patients on continuous medical treatment have less weight gain than patients not using medications. Recently, a research study showed that life-long use of obesity medications is effective.  
  5. Surgery. Patients with severe obesity are occasionally advised to undergo surgery for weight loss. The most commonly used method involves removing a portion of the small intestines, but it causes several complications and side effects after surgery. A number of people undergo liposuction, but it is questionable as to how much weight loss can be achieved by partial removal of fat in obese patients.

Preventions

 

Everyone knows that eating the right amount of food and exercising are the most important ways to prevent obesity. However, it is hard to execute this treatment. Continuous effort is required to maintain the ideal weight. Various weight loss programs are available and have higher chances of succeeding than working alone. However, you will not succeed if you are blinded by the advertisements that suggest a quick, fast way of losing weight while eating all you want. Take note of your dietary habits including the type of food you eat and the amount of food you consume as well as the exercise you have done and write them in a diary. Reflect on your habits and errors and show determination to try your best.

 

Consult a doctor in the following cases:  

  • If you show complications due to severe obesity
  • If you plan to lose weight by starving or eating extra-low calorie meals
  • If you want to use medications for obesity
  • If you’re obese and wish to start exercising
  • If you have difficulty maintaining your new weight
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