Obesity

Obesity refers to an excess amount of fat in the body which can lead to significant health problems such as diabetes, high blood pressure and heart disease. How healthy your weight is, is measured through the body mass index (BMI). This is your weight in kilograms divided by your height in meters squared. In adults a normal BMI is 18.5 to 25, someone is considered overweight with a value between 25 to 30, obesity is defined as a BMI value of 30 to 40, while extreme obesity is a value of greater than 40. People with high muscle mass do not fit into these categories as muscle is more dense thus weighs more leading to higher BMIs.

In general obesity is the joined result of inactivity combined with an unhealthy excess (high calorie) diet leading to a higher intake of calories than those burned during daily activities and exercise. Factors that can contribute to obesity include:

• increasing age due to reduced muscle bulk and need for calories
• a disturbed sleeping pattern of too much or too little sleep leading to body hormonal changes
• medical conditions that may lead to reduced activity such as arthritis,
• some genetic predispositions in the metabolism of fat
• rare medical conditions such as underactive thyroid or Cushing’s disease
• certain medication such as anti-depressants, steroids and diabetes medications

Complications

Obesity increases your risk of developing significant health problems. The higher level of cholesterol in the blood can lead to high blood pressure, heart disease, strokes, formation of gallstones and a fatty inflamed liver. Fat accumulation also impairs the metabolism of sugar in the blood leading to diabetes, reduced fertility and irregular periods in women and sexual dysfunction. The deposition of fat also leads to breathing problems while the increased weight strains the bones and joints causing osteoarthritis and may cause disability. Furthermore, obesity can increase your risk of developing a number of cancers such as cancer of
Importantly the weight gain may affect your quality of life as you may not be able to participate in pleasant activities. This can make you feel isolated and affect your mood making you depressed.

Diagnosis

A history of your general health will be taken in order to exclude any rare medical factors as the cause for your weight gain. A discussion will also take place of your expectations, previous attempts to loose weight, your motivation, exercise and eating habits as well as your lifestyle and potential stress. Investigations may be required to exclude any medical factors contributing to your weight gain or to check for any of the possible complications of excess weight.

Treatment options

The aim of obesity treatment is to improve your health by reducing the risk of complications and potentially reverse some of those that may have already developed. This is achieved by loosing weight and maintaining this weight loss. A number of non surgical ways exist to assist with that. This includes improvement of the type of foods you eat, your dietary habits as well as increasing your exercise. If the above fail or you are now suffering from complications from your increased weight then bariatric (weight loss) surgery is an option. The common bariatric procedures are gastric balloon, gastric band, gastric sleeve and gastric bypass. The most appropriate treatment and the rationale behind it will be discussed with you at an individualised basis. All types of weight loss surgery come with specific complication risks that will need to be balanced against the impact of obesity in your life.

Importantly, you have to remember that weight loss surgery on itself does not guarantee that you will loose all of your excess weight or maintain it. The best results are obtained when you commit to lifelong changes in your eating and exercise habits.