Obesity and Heart Disease

There is a significant increase in prevalence of overweight (BMI>25—29kg/m²) and obese persons (>30kg/m²) in the world both in adults and children. It is associated with increased incidence of cardiovascular diseases resulting in shorter life span. Approximately 30% of US population overweight & 13% are obese

What is the relation of obesity to medical problem?

Obesity is diagnosed by calculating body mass index (BMI) which is related to body weight and height BMI=Wt. (in kg.)/Ht. (m²)

It results in increase Heart attacks and stroke which is due to increased prevalence of High BP, Diabetes, Insulin resistance (metabolic syndrome) and lipid disorder. Sleeping disorder (snoring or obstructive sleep apnea is also strongly associated with obesity). Obesity results in increased inflammation (Positive high sensitive CRP) of  blood vessel wall and also clotting factors. Sudden death in heart patient is also more common in obese patient.

Can weight loss offers health benefit!

Yes, even modest weight loss to the tune of 5-10% results in control of BP, glucose tolerance, Lipid profile & reduces insulin resistance. It also reduces sleep disorder (snoring) which is now found to be related to many cardiovascular and respiratory problems. Clinical research has shown that weight reduction has benefit on treatment of arthritis, osteoporosis & it reduces incidence of gall bladder disease & even colorectal & breast cancer.

What is the cause of obesity?

Most common cause is excess intake & less expenditure of energy. However in some patient genetic factors also play a role. They have increased levels of leptin. Certain endocrines diseases like Hypothyroidism, Cushing  syndrome are associated with obesity.

How to manage obesity?

There is little consensus in ideal approach to the management of obesity. Promoting life style changes though useful, has been universally disappointing. Effective treatment approach involves multifaceted approach including dietary counseling, behaviors modification, increased physical activity and psychosocial support. A diet deficient in 7500 calories will reduce 1 kg of weight, therefore eating 100 calories/day for 1 year, will reduce 5kg of weight.

For some resistant cases drug treatment therapy has been useful as adjunct Treatment. Drugs (Sibutramine, oristat, Rimonabant) are helpful. Surgery is recommended for morbid obese which is defined as wt. more by 45kg. or 100% above ideal wt. – which results in death by 12 times. Bariatric surgery is necessary and useful in these patient.

Message: An urgent attention to childhood obesity is important as it can result in significant health problems to nation. Life style changes starting from childhood education in school, healthy food habits and avoidance of junk & fast food along increased indulgence in outdoor activity rather than spending time in front of TV & Computers is necessary.