Obesity is the new global pandemic, or rather, an old one, which only came to light after the wake-up call on health and disease by COVID-19 when more and more people started struggling with obesity due to the passive confinement in the comfort of our homes during the lockdown.

On a superficial glance at what obesity might mean, being well over the desired weight is an understanding that comes to mind. However, it is more than just being morbidly overweight. Obesity is a condition that produces fertile ground for a number of other diseases to grow and take root. Let’s take a closer look at this condition.

What is obesity?

Obesity, as defined by medical science, is a state of excessive fat accumulation in the body that is detrimental to health. Usually, a body mass index of more than 30 is taken as being obese. Obesity is a complex condition with effects in every sphere of health, ranging from cardiovascular health to fertility. In Indians, obesity and its ill effects, like diabetes, start at a still lower BMI range due to our genetic makeup. Obesity is often an outcome of a poor lifestyle. 

What causes obesity?
Obesity can arise as a result of a number of conditions that have roots in a number of social, psychological, economic, genetic, and cultural factors.
1. Low levels of physical activity due to sedentary jobs, the choice of TV, mobiles, mobiles, and gaming for entertainment, and a basic increase in screen time can lead to a lower number of calories burned rather than consumed, leading to obesity.
2. Eating a diet rich in fat, sugar, and other processed ingredients, such as fast food, packaged foods, and sweets, also leads to a surplus calorie intake.
3. Poor sleep quality can affect the hunger hormone ghrelin and cause an increased urge to eat food, as well as not being able to recognize being full.
4. High levels of the cortisol hormone, which is produced by the body due to increased stress, can also lead to an increase in the desire to eat, as well as the tendency of the body to store fat.
5. Metabolic syndrome, PCOS, and hypothyroidism-like conditions can also lead to weight gain in the affected person.
6. Genetics, too, has a big role to play in increasing obesity rates. People who have obesity in their families are much more likely to become obese.
7. Overtime intake of medications such as antidepressants, birth control pills, antipsychotics, steroids, and beta blockers for high blood pressure can all cause obesity and weight gain as a side effect.
8. The environment around us can also influence weight gain and obesity, as people living in open areas with walkways and parks are less likely to gain weight as compared to people living in areas with no dedicated space for walking and with fast food centers in the surroundings.

Why is obesity causing other diseases?
Obesity is a state of overnutrition, and the bulk of the body, due to increased fat mass, can produce an excess strain on the body physically as well. Excessive cholesterol and sugars circulating in the blood of an obese individual often overwhelm the metabolic and functional capacity of all the body organs. Deposition of excess cholesterol in the arteries can block important vessels, leading to cardiovascular accidents. Excessive fat can disrupt the hormonal balance, leading to diseases like PCOS, insulin resistance, and even diabetes. Excess glucose can lead to the formation of glycated proteins, which are proteins laden with excess glucose that can cause organ damage or disrupt organ functioning. Overall, obesity puts a great metabolic strain on the body, which leads to a large number of metabolites that can harm the body and even promote the growth of cancer.

What are the diseases that can be brought on by obesity?
Obesity can cause a diverse group of diseases, and it can also exaggerate the impact of already existing diseases. Some of the diseases that occur in close association with obesity are as follows:
1. Insulin resistance and type 2 diabetes.
2. Faster onset of osteoarthritis of the knees.
3. Gallstones and gallstone-related diseases like cholecystitis.
4. Sleep apnea due to increased deposition of fat in the neck region.
5. High blood pressure because of the increased surface area of the body.
6. Coronary artery disease due to fat accumulation in the vessels.
7. Increased incidence of stroke and venous thrombosis.
8. Deranged lipid profile leads to an increase in bad cholesterol LDL and triacyl glycerides and lowered levels of HDL, or good cholesterol.
9. Increased risk of a number of cancers such as breast cancer, stomach cancer, gallbladder cancer, esophageal cancer, ovarian cancer, and liver cancer.
10. Poor quality of life due to increased strain in doing normal activities and constant body aches and pains.
11. The increased incidence of mental illness in obese individuals is also a frequent finding.

How is obesity treated?
Obesity is a tough battle to fight for the world as well as the individuals affected by it, but with small steps in the right direction, we can hope to eliminate it in the coming future. The following are some of the treatment strategies adopted to treat obesity in today’s day and age:
1. Dietary modifications in the form of lowering calorie intake, eating increased portions of vegetables, proteins, and fruits to increase satiety, and reducing intake of sweet and packaged foods can all help transition into healthy eating habits, which not only cause weight loss but also weight maintenance.
2. Doing at least 150 minutes of exercise every week in the beginning and improving it to, say, 45 minutes of workout every 5 days a week to build strength and endurance.
3. Try to get in as many steps as you can through the day, even while doing daily activity, to burn calories through non-exercise thermogenesis.
4. Take counseling to overcome any emotional issues that may be underlying, such as an eating disorder or a defective coping mechanism, so that you don’t fall into the same pattern.
5. Become a part of a support group for weight loss to know that you are not alone in this journey and have other people to motivate you on days that you are not.
6. Sometimes doctors may prescribe weight-loss medications such as Orlistat, Liraglutide, Semaglutide, Penteramine-Topiramate, and Bupropion, all of which enable weight-loss through different mechanisms.
7. For patients who are morbidly obese but motivated, surgeries may be done to lose weight. Weight loss surgeries are known as bariatric surgery and are of the following types:
a. gastric bypass surgery or a Roux-en-Y gastric bypass in which the stomach and intestine are cut and placed such that most of the ingested food goes into the intestine directly.
b.Sleeve gastrectomy, in which a part of the stomach is removed to create a smaller pouch for food so that one can experience increased fullness with a smaller quantity of food.
c.Gastric banding, in which a band is applied to the stomach, and is tightened like a belt to create a narrow path between the two parts. It is a permanent method to decrease stomach capacity.
d.There are also new endoscopic procedures for weight loss, such as endoscopic sleeve gastrectomy, in which stitches are placed inside the stomach to reduce the size of the gastric cavity and reduce the capacity for food. A balloon called the intragastric balloon may also be inflated and placed inside the cavity to increase feelings of fullness. Intragastric balloons can stay in place for 6 months.
8. Other treatments include hydrogels, which are edible capsules in which tiny capsules absorb water and swell up. Vagal nerve blockade implants a vagal nerve-blocking device under the skin to tell the brain when the stomach feels full. Sometimes, a tube is placed into the stomach, and the contents of the stomach are removed.

Final thoughts 
Obesity is a disease that is both physical and mental. Overcoming obesity is a real challenge where one has to take steps to lose not just body fat but also the lifestyle that got them there in the first place. Of course, for some individuals, obesity is genetic and not a result of their lifestyle habits. Still, everyone can benefit from weight control and has to show the same motivation to reclaim their lives. Having freedom of movement, better energy levels, a stronger body, and a healthy body image can be life-changing. There should be no hesitation in taking professional health care if you need to do that. You can understand the process of weight loss and also do it safely.

We should be wary of fad diets and diet pills, as, for the moment, they can cause weight loss, but in the long run, they can be detrimental to the body. A sustainable approach to losing weight while boosting overall health can help change your body at a pace acceptable to it and make it long-lasting. Focus on your why and get started on the journey for your health.

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