What is Obesity?


OBESITY is defined as a state of excess accumulation of body fat. It can result from increased energy intake, decreased energy expenditure or a combination of both. Although often viewed as equivalent to increased body weight, this need not be the case - lean but very muscular individual may be overweight by arbitrary standards without having increased adiposity. Obesity itself can be considered as disease as well as underlying cause of many diseases.



Measurement of Obesity


Body Mass Index (BMI) is the most widely method to gauge obesity. It can be calculated as (Weight in Kg)/ (Height in Meter)2.


  BMI(kg/m2) Obesity Class Risk Of Complication
Healthy weight 18.5 - 24.9 -- --
Overweight 25 - 29.9 -- Increased
Obesity 30.0 - 34.9 | High
Obesity 35.0 - 39.9 || Very High
Extreme Obesity ≥ 40 ||| Extremely high

Causes of obesity


The various causes of obesity are:
1) Hormone Disorders:
Thyroid Disorder: Primary and secondary Hypothyroidism
Pituitary Disorder: Pan-hypopituitarism
Growth hormone deficiency
Cushing's disease
Leptin Deficiency: is a important cause of obesity
Adrenal disorder: Cushing's syndrome
Ovarian disorder: Polycystic ovarian syndrome
Chromosomal Syndrome: Turner's syndrome
Testicular disorder: Hypogonadism, klienfelter's syndrome, noonan's syndrome
2) Hyerinsulinemia
3) Insulin Resistance syndrome
4) Idiopathic obesity
5) Drug Induced : Sulphonylurea, Insulin, Oestrogen, Contraceptive pill, Corticosteroid, Cyproheptadine, Sodium valproate, Nonselective beta adrenergic blockade, Phenothiazines, Psychotropic Drugs & many more drugs when taken for sufficient period of time.
6) Increased Fat Forming Tendency:
7) Chronic Alcohol Use
8) Lifestyle Disorders


Investigations & Diagnosis


We take detail history & examine the patient first and after that only relevant test are done to find out the cause for obesity. For this we do following tests: Hormone test: as Thyroid (Free T4, Free T3, TSH), Insulin, Cortisol (am & pm), Growth hormones, FSH, LH, Testosterone, Estradiol, IGF-1, IGFBP-3, genital hormones , Lipid profile etc.

Treatment: Once the cause of overweight is found then it can be treated effectively. Various drugs are available which decreases fat formation in body & also promotes more & more decrease of fat, leading to gradual reduction of body weight.

1) Drug treatment: various treatments are
Antiobesity drugs: There are four types of medicines are available for obesity.There are many drugs which prevent absorption of fat & glucose from intestine into body so that some of these fats in food passes in stool. There are many other drugs which are non-absorbable food which give fullness of tummy but does not have caloric value. There are certain other drugs which helps in burning of body fat in producing calories, so that patient loses weight fast. These drugs have no side effects as widely thought, so that these can be used safely. These drugs are as follows:

a) Sibutramin hydroclhloride: This is one of the very effective drug for obesity. This medicine decrease fat formation in the body, decreases appetite as well as enhances helps in burning of preexisting fat. In various scientific studies it has been found to be free of any significant side effect. But because it is a new drug thus it should be used under medical supervision. We have treated thousands of patients with very good response. The beauty of this drug is weight lost remains there even after stopping drug.

b) Orlistat: This is a new class of drug for obesity. This medicine decreases absorption of fat & other weight increasing substances from intestine into blood. Thus even if person eats fatty food his weight does not increase. In various scientific studies it has been found to be free of any significant side effect. But because it is a new drug thus it should be used under medical supervision. We have treated thousands of patients with very good response. The beauty of this drug is weight lost remains there even after stopping drug.

c) Newer Medicines for Weight Loss: There are two very new therspies for weight loss has been invented. These are: *beta 3 adrenergic receptor agonists & RecLeptin
*Recombinant Leptin suplimentation in various studies has shown dramatic loss of weight.

d) Phendimetrazine,
e) Diethylpropion,
f) Phentermine,
g) Phentermin hcl
h) Metformin
i) Benzphetamines,
k) Tablets which decrease fat forming tendencies
l) Tablets which increases fat burning tendencies
n) Fenfluramine

2) Behavioral therapy:
Along with medicines we do behavior modification therapy by which patient starts avoiding fatty & sweet foods & healthy eating habit is encouraged.
3) Exercise
4) Special food supplements
5) Food pyramid

6) Surgery for obesity:
When obesity become too much with many complications then one of the treatment options can be surgery. These surgical treatment are very effective for permanent cure of obesity. We have certain experts which are specialized in obesity surgery.

Gastric Banding
Laproscopic surgery
Gastric bypass surgery
Vertically banded gastroplasty
Scopinaro bypass