OBESITY – Blog Post by Hasan Jamal(ii)

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Obesity & Health

There are many reasons why obesity is a health hazard. Annual death rate for obese people between ages of 20-64 is 50 % more than the people with close to normal weight. This statistical difference is primarily due to increased risk that the obese persons are at risk to suffer from. The possible hazards are:

Physiological

• Diabetes
• Digestive Problems
• Disorders of circulatory system – mainly heart
• Stroke
• Poor surgical risk
• Diagnosis and treatment become difficult in this group

Psychological

• Obesity has usually damaging psychological consequences.
• Obese children tend to lead isolated life as they are rejected by their peers
• Self-pity
• Such people avoid and escape from competitive situation.

Why People Put on Weight

• Imbalance between caloric intake and caloric expenditure as energy.
• Less physical activity- unspent calories are converted into fat and are deposited in the body.
• Hereditary factors- parental weight:

• Parent with normal weight- 10% chance of children getting overweight.
• If one of the parents is obese- 50% chance of children getting obese.
• If both are obese- 80% chance of children getting overweight.

• Absence of appropriate exercise pattern.
• Defective metabolic process.
• In childhood parents insist on their children to eat which results in weight gain and then becomes difficult to give up eating habits, thus to reduce weight when children grow up.

Losing Weight

Obesity is a condition that most of the people would like to avoid. Not putting on extra pounds seems to be easier than shedding them off. Anyone weighing 20% or more over the normal limit of his age and body build should be helped to slim down.

The ultimate key to successful weight reduction is proper eating combined with regular physical activity. Intake of fat and calories should be reduced and of fiber increased. If one does not succeed in losing weight still, then one needs a professional help from a qualified dietician and physician for advice combined with medication to correct metabolic abnormality.

Treatment of Obesity

Usually drugs like Amphetamines (Methylphenidate – A Piperidine derivative of amphetamine – Ritalin from Novartis), Dextro-Amphetamine and Methamphetamines and some chemically unrelated to the amphetamines like Methylphenidate and Phenmetrazine are used to curb the appetite of people on dieting for weight reduction. These drugs may give some results initially, but they are not without serious untoward effects, as they can result in:

• High blood pressure and palpitation.
• May result in drug tolerance and as such psychological dependence may develop quickly.

In certain cases, thyroid pills are taken assuming that obesity could be due to glandular problems which means underactive thyroid. Hypothyroidism is not usually responsible for weight gain.  These drugs should never be taken unless the under activity of thyroid is proven by specific laboratory tests.

In recent years the U.S. Food and Drug Administration (FDA) have approved five prescription weight loss pills for long-term use and they work, Dr. Kahan says. ‘These medications remain underutilized and underappreciated,’ he says. ‘If diet and exercise are not working for you, ask your doctor about weight loss medications,’ he says. ‘These are very well studied and effective. However, none of these weight loss pills are magic bullets, and all work best in conjunction with lifestyle changes including a healthy diet and regular exercise.

NOTE:  I AM PURPOSELY NOT MENTIONING THE NAME OF THESE DRUGS AS ETHICALLY AND MORALLY I AM IN NO POSITION TO RECOMMEND OR TEMPT SOMEONE TO USE THESE PRODUCTS WITHOUT PROPER PROFESSIONAL CARE AND SUPERVISION.

Lately world over, natural products or nutraceuticals treatment is gaining acceptability due to their better safety and efficacy profile. This could be an effective, safe and well-balanced solution to obesity. However, the information in this field of medication is still not sufficient, but the available data so far, shows encouraging results.

CONCLUSION:

Pakistan is currently suffering from an emerging Epidemic of Obesity. The rising burden of obesity is widespread among adults (man and women) and children. The burden of obesity is higher among females in all age groups as compare to males. Effective interventions are required at population level to create awareness about the hazards of this trend, prevention and control this emerging public health issue. People need to be on their guard, keep the weight under control by changing the trajectory of life style to healthy eating and physical exercise.

References:

1. Manual of Medical Therapeutics – Department of Medicine, Washington University, School of Medicine St. Louis, Missouri. Editors:  Metthew J. Orland, M.D and Robert J. Saltman, M.D.
2. New Complete Medical and Health Encyclopedia. Editors: Richard J. Wagman M.D; FACP Assistant Professor, Downstate Medical Center, NY.
3. J Ayub Med Coll Abbottabad. 2016 Jul-Sep;28(3):597-600. Obesity, an Emerging Epidemic in Pakistan-A Review of Evidence
4. APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan.
5. Department of Community Health Sciences, Aga Khan University Hospital, Karachi, Pakistan.