WHAT IS OBESITY ?

I would be somewhat disingenuous to say we haven’t heard or used the term “obese” or ‘’obesity “ in the past one way or the other. So what is obesity anyways ?

Obesity is a medical condition brought about by an excessive accumulation of body fat that can impair one’s health. Typically it is  defined using the Body Mass Index (BMI), a measure that uses height and weight to calculate body fat. Generally, a BMI of 30 or higher is considered obese for the average adult.

DIABETES AND OBESITY

Another term we seemingly cannot get out the way of these days is “Diabetes” .  Well,  diabetes is a chronic medical condition characterized by elevated blood glucose (sugar) levels. It occurs when the body either can’t produce enough insulin or can’t effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar levels, so the ability and the extent to which it acts directly affects a person’s proneness to becoming diabetic.

Now, what does diabetes have to do with obesity ? Well, obesity and diabetes, particularly type 2 diabetes, are closely linked due to several interconnected biological mechanisms.

A more detailed explanation:

1. Insulin resistance: Excess body fat, especially those situated around the abdomen, release hormones and inflammatory substances that interfere with insulin signaling. This leads to insulin resistance, where cells become less responsive to insulin’s effects. As a result, the body needs to produce more insulin to maintain normal blood sugar levels.
2. Beta cell dysfunction: In obese individuals, the pancreas initially compensates for insulin resistance by producing more insulin. Over time, this increased demand can lead to beta cell exhaustion and dysfunction. Eventually, the pancreas may fail to produce enough insulin, leading to diabetes.
3. Lipo-toxicity: Excess fat can lead to increased free fatty acids in the bloodstream. These fatty acids can accumulate in non-fat tissues like the liver and muscles, further contributing to insulin resistance.
4. Chronic inflammation: Obesity is associated with a state of low-grade, chronic inflammation. This inflammation can interfere with insulin signaling and contribute to insulin resistance.
5. Adipokines: Fat tissue produces various hormones and signaling molecules called adipokines. In obesity, there’s often an imbalance in these adipokines, which can affect insulin sensitivity and glucose metabolism.
6. Genetic factors: Some genetic variants increase the risk of both obesity and diabetes, suggesting shared genetic susceptibility.
7. Lifestyle factors: Both conditions are influenced by similar lifestyle factors such as poor diet and lack of physical activity. These behaviors contribute to weight gain and can directly impact glucose metabolism.

This close relationships explain why weight loss and lifestyle changes are effective in preventing or managing type 2 diabetes in overweight or obese individuals. However, it’s important to note that even though obesity significantly increases the risk of type 2 diabetes, every obese individual develops diabetes, and not all people with diabetes are obese, indicating the complexity of these conditions.

SIGNS AND SYMPTOMS OF OBESITY

The signs of obesity can vary from person to person, but here are some common indicators:

1. Visual appearance: Excess body fat, especially around the waist Visible increase in body size
2. Body Mass Index (BMI):BMI of 30 or higher for adults
3. Physical symptoms: Shortness of breath, especially during physical activity Excessive sweating Snoring or sleep apnea Joint pain, especially in weight-bearing joints like knees and hips Fatigue or difficulty with physical tasks
4. Skin issues: Darkened skin in body folds (acanthosis nigricans) Stretch marks and Skin tags
5. Metabolic signs: High blood pressure Elevated blood sugar levels Abnormal cholesterol levels
6. Psychological signs: Low self-esteem or poor body image Depression or anxiety related to weight
7. Lifestyle indicators: Difficulty fitting into clothes Avoidance of physical activities Eating large portions or frequent snacking
8. Medical history: Weight-related health issues like type 2 diabetes, heart disease, or fatty liver disease

RISK FACTORS FOR OBESITY

The risk factors for obesity are varied and often interconnected. Here’s a comprehensive list of the main risk factors:

1. Diet: A high-calorie diet, especially from processed foods usually leads to obesity at some point. Usually it comprises of frequent consumption of sugary drinks, large serving sizes and Irregular eating patterns, to name a few.
2. Lifestyle: Lifestyle habits like Sedentary behavior, lack of physical activity, poor sleep habits and high stress levels are among a few that could precipitate obesity in an individual.
3. Genetics: A significant family history of obesity can predispose a person to Obesity. Also certain genetic conditions (e.g., Prader-Willi syndrome)
4. Age: The risk increases with age due to reduced metabolism and decreased muscle mass
5. Gender: Generally women are more prone to obesity, partly due to hormonal factors
6. Socioeconomic factors::lower income and education levels are associated with higher obesity rates. Additionally, limited access to healthy foods or safe areas for physical activity further promote obesity.
7. Medical conditions: pre existing conditions like Hypothyroidism, Polycystic ovary syndrome (PCOS) and Cushing’s syndrome predispose a person to being obese.
8. Medications: Certain antidepressants, antipsychotics, diabetes medications and some corticosteroids predispose a person to being obese.
9. Psychological factors: Depression, anxiety and eating disorders usually would  steer an individual towards potential obesity
10. Pregnancy: Childbearing brings about a series of changes to the female body, most notably weight gain. Weight gain during pregnancy that isn’t lost after childbirth could accelerate the onset of obesity in the person involved.

It’s important to note that having one or more of these risk factors doesn’t necessarily mean a person will become obese. Obesity usually results from a complex interplay of  two or more of these above listed factors. Understanding these risk factors can help in developing strategies for prevention and management.

MANAGEMENT

The management of diabetes is crucial for maintaining good health and preventing complications. It isn’t  a singular process when it comes to it’s management. It involves a mix of pharmaceutical and lifestyle interventions to get preferred results. Here’s an overview of the key aspects of diabetes management:

1. Blood glucose monitoring: Regular checking of blood sugar levels Use of home glucose meters or continuous glucose monitors
2. Medication: For Type 1 diabetes: Insulin therapy (injections or insulin pump) For Type 2 diabetes: Oral medications (e.g., metformin) and/or insulin as needed
3. Diet: Balanced, nutritious meals Carbohydrate counting Portion control Limiting sugar and refined carbohydrates Increasing fiber intake
4. Physical activity: Regular exercise (aim for at least 150 minutes per week) Both aerobic exercises and strength training
5. Weight management: Maintaining a healthy weight or losing weight if overweight
6. Stress management: Stress reduction techniques (e.g., meditation, yoga) Adequate sleep
7. Regular medical check-ups:HbA1c tests (every 3-6 months) Annual eye exams Regular foot exams Kidney function tests
8. Cardiovascular health: Blood pressure control Cholesterol management Smoking cessation if applicable
9. Education: Diabetes self-management education Nutritional counseling
10. Complication prevention: Proper foot care Dental hygiene Vaccinations (e.g., flu shot)
11. Alcohol consumption: Moderation, if any, and with food
12. Self-care: Regular self-monitoring for signs of hyper- or hypoglycemia Proper sick-day management
13. Support: Joining support groups Family involvement in care
14. Technology: Use of diabetes management apps Consideration of insulin pumps or continuous glucose monitors for some patients

CONCLUSION

Obesity is a complex chronic condition characterized by excessive body fat accumulation. It’s safe to say  that it can significantly impact health negatively in more ways than one.

It is associated with increased risks of various health problems, including heart disease, type 2 diabetes, and certain cancers. The management of obesity involves a multifaceted approach. This includes lifestyle modifications such as adopting a balanced, calorie-controlled diet and increasing physical activity. Behavioral therapy to address eating habits and psychological factors is often beneficial.

In some cases, healthcare providers may recommend medications to aid weight loss or, for severe obesity, bariatric surgery. The goal of obesity management is not just weight loss, but overall health improvement and the prevention of obesity-related complications.

Successful management often requires long-term commitment and support from healthcare professionals, family, and community resources.

Source Kelvin Imosemi MD.