Obesity

Overview

Obesity is widely regarded as a pandemic, with potentially disastrous consequences for human health. The current WHO classification states that the cut-off points for overweight and obesity are 25 and 30 kg/m2 respectively. Many patients will seek medical help for their obesity, others will present with one of the complications of obesity and increasing numbers are being identified during the health screening.

Signs and Symptoms

Increased BMI (more than 30kg/m2), High blood pressure, Eating habits: binging, nocturnal, increased frequency

Common Causes

The discrepancy between energy consumption and energy expenditure, Increased snacking and loss of regular meals, High fatty diet, Decreased physical exercise, Hypothyroidism, Cushing's syndrome, Insulinoma, Hypothalamic tumours, A tricyclic antidepressant, Sulphonylureas, Corticosteroids, Sodium valproate

Risk Factors

The discrepancy between energy consumption and energy expenditure, Increased snacking and loss of regular meals, High fatty diet, Decreased physical exercise, Hypothyroidism, Cushing's syndrome, Insulinoma, Hypothalamic tumours, a tricyclic antidepressant, sulphonylureas, Corticosteroids, Sodium valproate

Investigation Techniques

Physical examination, Fasting blood glucose, Oral glucose tolerance test, fasting lipid profile, Liver function test, Renal function test, Thyroid function test, 24 hr urine free cortisol

Treatment and Prevention

Lifestyle advise to achieve lower body weight and maintain, Dietary changes: take more low caloric food, low-fat diet, high protein and low carbohydrate diet, balanced diet according to the energy required per day, Increase physical activities, exercise Drugs to reduce weight: orlistat, sibutramine, fluoxetine, metformin Behavioral therapy: counseling, self-monitoring, stress management Bariatric surgery to reduce the size of the stomach

Psychological Issues

Depression, Stress, Anxiety, Food eating disorder