WHY DO WE NEED TO WATCH OUR WEIGHT?

Health hazards of obesity include:

Cardiovascular - Essential hypertension, coronary artery disease, left ventricular hypertrophy, cor pulmonale, obesity-associated cardiomyopathy, accelerated atherosclerosis, pulmonary hypertension of obesity
Central nervous system - Stroke, idiopathic intracranial hypertension, meralgia, paresthetica
Gastrointestinal - Gall bladder disease (cholecystitis, cholelithiasis), nonalcoholic steatohepatitis (NASH), fatty liver infiltration, gastroesophageal reflux disease
Respiratory tract - Obstructive sleep apnea, obesity hypoventilation syndrome (Pickwickian syndrome), increased predisposition to respiratory infections, increased incidence of bronchial asthma
Malignancies - Association with endometrial, prostate, gall bladder, breast, colon, and, possibly, lung cancer
Psychologic - Social stigmatization, depression, dementia, job accidents
Orthopedic - Osteoarthritis, coxa vera, slipped capital femoral epiphyses, Blount disease and Legg-Calvé-Perthes disease, chronic lumbago
Metabolic - Insulin resistance, hyperinsulinemia, type 2 diabetes mellitus, dyslipidemia (characterized by high total cholesterol, high triglycerides, normal or elevated low-density lipoprotein, and low high-density lipoprotein), decreased life expectancy
Reproductive - Anovulation, early puberty, infertility, hyperandrogenism and polycystic ovaries in women, hypogonadotrophic hypogonadism in men
Obstetric and perinatal - Pregnancy-related hypertension, fetal macrosomia, pelvic dystocia
Increased surgical risk and postoperative complications including wound infection, deep venous thrombosis, pulmonary embolism, and postoperative pneumonia
Pelvic problems - Stress incontinence
Cutaneous - Intertrigo (bacterial and/or fungal), acanthosis nigricans, hirsutism, increased risk for cellulites and carbuncles
Extremities - Venous varicosities, lower extremity venous and/or lymphatic edema
Miscellaneous - Reduced mobility, difficulty maintaining personal hygiene

Benefits from a 10Kg weight loss include:

Mortality - >20% reduction in total mortality
Mortality - >30% reduction in diabetes-related deaths
Mortality - >40% reduction in obesity-related cancer deaths
Blood Pressure - 10 mmHg reduction in systolic blood pressure
Blood Pressure - 20 mmHg reduction in diastolic blood pressure
Diabetes - 50% reduction in fasting glucose
Lipids - 10% reduction in total cholesterol
Lipids - 15% reduction in LDL (low density lipoprotein)
Lipids - 30% reduction in triglycerides
Lipids - 8% increase in HDL (high density lipoprotein)

Lifestyle intervention should continue for a minimum of 3 to 6 months, this should include: Improved diet – watch what you eat, quit smoking, stop alcohol consumption, increased activity - Sedentary form of lifestyle increases chance of being overweight or obese.

The recommendation by the American College of Sports Medicine for the minimum weekly exercise for the purposes of reducing body weight is 1,000kcal/week

Aerobic isotonic exercise is of the greatest value for subjects who are obese, ultimate goal is to achieve 30 – 60 min of continuous aerobic exercise 5 – 7 times a week

Some ideas: Walk last few blocks home from work, Walk briskly round your house everyday, ride bicycle, join TV exercise class, go to the gym, use music to do housework faster (Popmobile), go up and down the staircase several times.

Combine diet with exercise to sustain weight loss.

Health benefits: improved lipid levels, increased insulin sensitivity, reduced risk for progression of cardiovascular disease, reduced risk for the onset of type 2 diabetes.

LetsKeepWalking to avoid the problems of obesity and reap the benefits of fitness

REFERENCES:

Obesity: 2008 WACP REVISION COURSE: Part I: Internal Medicine by AA Fasanmade
SURGICAL APPROACH TO MORBID OBESITY by YAKUB, S

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Contributed by: Dr John Esin (UBTH)