Obesity is a disease characterized by excessive storage of fat in the body that may affect health. It is a chronic problem with high prevalence in developed countries, and constitutes a risk factor for the onset, development, and aggravation of other diseases. Labeled by World Health Organization as the epidemic of the 21st century, obesity kills more than hunger and infectious diseases.

If a person’s bodyweight is at least 20% higher than it should be, he or she is considered obese. When a one’s Body Mass Index (BMI) is between 25 and 29.9, the person is considered overweight. A BMI rating is 30 or over s considered obese. The formula to calculate obesity is:  BMI = Weight (kg) / [Height (m) x Height (m)]

Obesity causes

Excess body fat results from consuming more calories than those who are expended. But being overweight does not necessarily mean that the person is eating in excess.

Obesity depends on a number of factors, which can be genetic (genetic predisposition, sex and age), environmental or behavioral (absence of a balanced diet, physical inactivity), and metabolic and hormonal (less than 5% of obesity cases). In addition, women during the periods of pregnancy, and menopause are also facing risk factors.

 

Obesity consequences

Obesity is associated with numerous health complications, such debilitating and progressive diseases and chronic conditions with high mortality rates. In addition to physical and psychological discomfort, obesity can lead to health problems like cardiovascular illness (hypertension, atherosclerosis and heart problems), metabolic complications (dyslipidemias, type 2 diabetes and gout), or problems with the pulmonary system (dyspnea and fatigue, obese respiratory distress syndrome, apnea and pulmonary embolism).

Gastrointestinal complications, like Hepatic steatosis ( fatty liver ), gallstones (the formation of sand or small stones in the gallbladder), and colon cancer are also attributed to obesity, as well as urinary and reproductive problems, such as infertility, amenorrhea (abnormal absence of menstruation), urinary incontinence, some cancers (endometrial, breast, and prostate), hypogenitalism (ovarian or testicular failure), and hirsutism.

An obese person can also experience psychological and social changes, reflected in social isolation, depression, anxiety, and loss of self-esteem.

Obesity prevention, treatment and research

Obesity prevention is based on a balanced diet, regular physical activity, and healthy lifestyle. The first stage of treatment relies on the combination of a low calorie diet, behavior modification, increased physical activity, and understanding of possible psychological causes of obesity.

When changing habits is not enough, anti-obesity drugs can be prescribed, such as anorexigens (to suppress appetite via neurotransmitters), thermogenics (to accelerate metabolism), and other drugs that act on the intestine (for delayed gastric emptying or inhibiting intestinal absorption).

In the case of patients with severe obesity, bariatric surgery can be performed.  The procedure may be restrictive, with reduced capacity and gastric emptying capacity, or poorly absorptive, with the exclusion of large segments of the small intestine to prevent the absorption of food.

Currently, there are three main types of bariatric surgery: gastric bypass, sleeve gastrectomy, and gastric banding.

Gastric Bypass

Gastric bypass was the first form of bariatric surgery developed and performed. The original experiments with the procedure were conducted in the 1970s, when researchers hypothesized that by stapling off a portion of the stomach, reducing its capacity to hold food, it would give obese patients a sense of feeling full sooner and restrict caloric intake. The procedure is still performed, and the underlying idea forms the basis of all bariatric procedures.

Sleeve Gastrectomy

Sleeve gastrectomy is a variation on the original gastric bypass operation. Rather than stapling off a portion of the stomach, surgeons instead reshape the stomach’s shape into that of a long, narrower sleeve. By reducing the size and changing the shape of the stomach, it offers patients good permanent, long-term results, according to recent research. However, complications associated with sleeve gastrectomy can be serious, particularly if the seam from the surgery does not heal and the stomach begins to leak. This leakage can cause sepsis, organ failure, and death.

Gastric Banding

Gastric banding is a novel weight loss surgery procedure in that is utilizes a medical device to reduce the capability of the stomach to hold food. A “gastric band” is a simple, thin silicone band that is inserted into the body through a very small laproscopic incision and wrapped around the stomach. The band also has a small tube that runs up to and sit just under the skin, which acts as a port for injecting saline into the band. This feature gives the gastric band the ability to be made tighter or looser, which gives doctors control over how much food and/or caloric restriction a patient receives.

The gastric band has been proven to be both safe and effective for weight loss, and it can be removed. However, patients must also adapt to new eating and lifestyle habits to accompany installation of the band in order to avoid uncomfortable side effects. However, complications with the gastric band have shown to be not as serious as with sleeve gastrectomy.

There are currently two FDA-approved gastric band choices — the Lap-Band and the Realize Gastric Band.

Recent investigations at Texas-based research institutions have been improving science’s understanding of the disease. For instance, a study by University of Texas Health Science Center and Harvard Medical School indicates that artificial sweeteners in diet soda are linked to health issues like obesity. In addition, findings from the University of Texas MD Anderson Cancer Center reveal that obesity has been linked to several types of cancer.

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