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Yoga Asanas

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Obesity

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Obesity

What is obesity?

Obesity is defined as having a body mass index (BMI) of 30 or more.BMI is a calculation that takes a person’s weight and height into account. However, BMI does have some limitations.
According to the CDC, “Factors such as age, sex, ethnicity, and muscle mass can influence the relationship between BMI and body fat. Also, BMI doesn’t distinguish between excess fat, muscle, or bone mass,nor does it provide any indication of the distribution of fat among individuals.”
Despite these limitations,BMI continues to be widely used as an indicator of excess weight.

What causes obesity?

Eating more calories than you burn in daily activity and exercise (on a long-term basis) causes obesity. Over time,these extra calories add up and cause you to gain weight.

Common specific causes of obesity include:

eating a poor diet of foods high in fats and calories
having a sedentary (inactive) lifestyle
not sleeping enough, which can lead to hormonal changes that make you feel hungrier and crave certain high-calorie foods
genetics, which can affect how your body processes food into energy and how fat is stored
growing older, which can lead to less muscle mass and a slower metabolic rate, making it easier to gain weight
pregnancy (weight gained during pregnancy can be difficult to lose and may eventually lead to obesity)

Certain medical conditions may also lead to weight gain. These include:

polycystic ovary syndrome (PCOS): a condition that causes an imbalance of female reproductive hormones
Prader-Willi syndrome: a rare condition that an individual is born with which causes excessive hunger
Cushing syndrome: a condition caused by having an excessive amount of the hormone cortisol in your system
hypothyroidism (underactive thyroid): a condition in which the thyroid gland doesn’t produce enough of certain important hormones
osteoarthritis (and other conditions that cause pain that may lead to inactivity)

Who is at risk for obesity?

A complex mix of genetic, environmental, and psychological factors can increase a person’s risk for obesity.

Genetics
Some people possess genetic factors that make it difficult for them to lose weight.

Environment and community
Your environment at home, at school, and in your community, can all influence how and what you eat and how active you are. Maybe you haven’t learned to cook healthy meals or don’t think you can afford healthier foods. If your neighbourhood is unsafe, maybe you haven’t found a good place to play, walk, or run.

Psychological and other factors
Depression can sometimes lead to weight gain, as people turn to food for emotional comfort. Certain antidepressants can also increase risk of weight gain.

It’s a good thing to quit smoking, but quitting can also lead to weight gain. For that reason, it’s important to focus on diet and exercise while you’re quitting.

Medications such as steroids or birth control pills can also put you at greater risk for weight gain.

How is obesity diagnosed?

Obesity is defined as having a BMI of 30 or more. Body mass index is a rough calculation of a person’s weight in relation to their height.

Other more accurate measures of body fat and body fat distribution include skinfold thickness, waist-to-hip comparisons, and screening tests such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) scans.

Your doctor may also order certain tests to help diagnose obesity as well as obesity-related health risks. These may include blood tests to examine cholesterol and glucose levels, liver function tests, diabetes screen, thyroid tests, and heart tests, such as an electrocardiogram.

A measurement of the fat around your waist is also a good predictor of risk for obesity-related diseases

What are complications of obesity?

type 2 diabetes
heart disease
high blood pressure
certain cancers (breast, colon, and endometrial)
stroke
gallbladder disease
fatty liver disease
high cholesterol
sleep apnea and other breathing problems
arthritis
infertility
How is obesity treated?

Lifestyle and behavior changes

Your healthcare team can educate you on better food choices and help develop a healthy eating plan that works for you. A structured exercise program and increased daily activity — up to 300 minutes a week — will help build up your strength, endurance, and metabolism.
Counseling or support groups may also identify unhealthy triggers and help you cope with any anxiety, depression, or emotional eating issues.

Medical weight loss

Your doctor may also prescribe certain prescription weight loss medications in addition to healthy eating and exercise plans. Medications are usually prescribed only if other methods of weight loss haven’t worked and if you have a BMI of 27 or more in addition to obesity-related health issues.
Prescription weight loss medications either prevent the absorption of fat or suppress appetite. These drugs can have unpleasant side effects. For example, the drug orlistat (Xenical) can lead to oily and frequent bowel movements, bowel urgency, and gas. Your doctor will monitor you closely while you’re taking these medications.

Weight loss surgery

Weight loss surgery (commonly called “bariatric surgery”) requires a commitment from patients that they will change their lifestyle.
These types of surgery work by limiting how much food you can comfortably eat or by preventing your body from absorbing food and calories. Sometimes they do both.
Weight loss surgery isn’t a quick fix. It’s a major surgery and can have serious risks. After surgery, patients will need to change how they eat and how much they eat or risk getting sick.
Candidates for weight loss surgery will have a BMI of 40 or more, or have a BMI of 35 to 39.9 along with serious obesity-related health problems.
Patients will often have to lose weight prior to undergoing surgery. Additionally, they will normally undergo counseling to ensure that they’re both emotionally prepared for this surgery and willing to make the necessary lifestyle changes that it will require.
Surgical options include:
gastric bypass surgery, which creates a small pouch at the top of your stomach that connects directly to your small intestine. Food and liquids go through the pouch and into the intestine, bypassing most of the stomach.
laparoscopic adjustable gastric banding (LAGB), which separates your stomach into two pouches using a band
gastric sleeve, which removes part of your stomach
biliopancreatic diversion with duodenal switch, which removes most of your stomach

How can you prevent obesity?

Help prevent weight gain by making good lifestyle choices. Aim for moderate exercise (walking, swimming, biking) for 20 to 30 minutes every day.
Eat well by choosing nutritious foods like fruits, vegetables, whole grains, and lean protein. Eat high-fat, high-calorie foods in moderation.

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Obesity and Metabolic Syndrome

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'Metabolic' are the biochemical processes that are involved in the normal functioning of your body. Risk factors are common traits, habits or conditions that raise your risk of developing a disease. Metabolic syndrome is the term used for a group of factors that increase your risk of developing the cardiac diseases and other health issues, like stroke and diabetes. Metabolic syndrome is becoming a prevalent disorder due to a sharp rise in the rate of obesity among adults. Metabolic syndrome may soon overtake smoking as the dominant risk factor responsible for heart disorders.

The following are some of the dominant symptoms of metabolic syndrome:

-Abdominal obesity
-A high level of Triglyceride( 150 and higher)
-A lowered level of HDL (good cholesterol)
-Blood pressure of 130/85 and above
-Increased level of blood sugar (fasting) of 110 or more

It is not impossible to prevent the onset of metabolic syndrome. Slight lifestyle alterations can help to delay the onset of the disorder. In order to control metabolic syndrome effectively, you need to require long term dedication towards your health.

The following are some tips that may help you to control your metabolic syndrome:

-Lead an active life: Studies suggest that if you lead an active life, you run a lower risk of developing metabolic syndrome. If you exercise on a regular basis and participate in physical activities, it will help you to reduce your blood pressure level. Active lifestyle is also known to improve your insulin sensitivity, which will help you to control your metabolic syndrome effectively.

-Healthy diet: A healthy and balanced diet that comprises of fresh leafy vegetables, seasonal fruits and whole grains carbohydrates is good for your overall health and helps to prevent or slow down the onset of metabolic syndrome.

-Drink in moderation: A glass of wine on a daily basis is beneficial for your health. -According to recent studies, moderate intake of wine may lower a person's risk of developing metabolic syndrome. It must be kept in mind that wine is only helpful when consumed in moderation. In fact, over indulgence in wine is actually injurious to health.

-Maintain an ideal body weight: Obese people are more prone to suffer from high blood pressure and increased blood sugar level; all of which fuel the risk of developing metabolic syndrome. Reduce your excessive body fat to achieve an ideal body weight to lead a healthy life.

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Obesity - A Leading Cause Of Death Worldwide!

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Obesity is a medical condition in which excess accumulation of body fat creates an adverse effect on health. Obesity is a leading preventable cause of death worldwide, with increasing rates in adults and children. In 2015, 600 million adults and 100 million children were obese. Obesity is more common in women than men.It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist-hip ratio (WHR) and total cardiovascular risk factors. Body mass index is closely related to both percentage body fat and total body fat.

It is defined as the subject's weight divided by the square of their height and is calculated as follows:

BMI = m/h2(Where m and h are the subject's weight and height, respectively)Waist-hip ratio is the dimensionless ratio of the circumference of the waist to that of the hips. This ratio is calculated as waist measurement divided by hip measurement (W ÷ H)The WHR has been used as an indicator or measure of health and the risk of developing serious health conditions.

Causes-

Diet: Excessive food energy intake
Sedentary lifestyle
Genetics

-Other illnesses: Hypothyroidism, Cushing's syndrome, growth hormone deficiency, and eating disorders

-Certain medications: Insulin, sulfonylureas, thiazolidinediones, atypical antipsychotics, antidepressants, steroids, certain anticonvulsants, pizotifen, and some forms of hormonal contraception

Gut bacteria Health risks associated with obesity
Bone and cartilage degeneration (osteoarthritis)
Coronary heart disease
Gallbladder disease (gall stone)
High blood pressure (hypertension)
High total cholesterol and high levels of triglycerides (dyslipidemia)
Respiratory problems
Several cancers
Sleep apnea
Stroke
Type 2 diabetes mellitus
Management of obesity
Conservative management

-Diet: Limit energy intake from total fats and sugars and increase consumption of fruits, vegetables, legumes, whole grains, and nuts.

-Eat consistently: Resist the urge to overeat. Your food intake should follow a regular routine. Overeating not only upsets your routine but also impacts your metabolism.

-Breakfast: Never miss your breakfast. Breakfast is a crucial meal; it also helps stave off hunger later on in the day, which often leads to overeating and snacking.

-Monitor yourself: Keep a close check on what you eat and regularly weigh yourself.

-Physical activity: Perform at least 200 minutes of moderate-intensity exercise each week. This schedule should be spread out over at least 3 days.

-Watching TV: Limit watching TV to no more than 10 hours each week.
Surgical management

The surgical management of obesity involves the following two procedures:

-Restrictive procedures
-Malabsorptive procedures

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Dr. Deepali Ladkat
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