Obesity: Causes, diagnosis, and treatment

What is obesity?

As per The World Health Organization, obesity is an excessive accumulation of fat in the body that poses a health risk. Anyone with a BMI greater than 30 is considered obese according to the agreed criteria for measuring obesity.

Obesity classification

Obesity is divided according to the degree of its measurement into three categories: overweight, obesity, and morbid obesity, each of which is estimated according to the value of the Body Mass Index (BMI).

Childhood obesity definition

Childhood obesity is defined as when a child is above the healthy weight of his/her age and height.

What is morbid obesity?

People with BMI above 40 are included in Morbid Obesity.

Obesity is the biggest health problem and the greatest risk of causing health complications and other diseases.

Obese patients must lose weight by undergoing one of the agreed-upon treatment programs offered in ILAJAK Medical in consultation with a doctor or nutritionist, otherwise, they risk exposure to a wide range of diseases and illnesses.

What causes obesity?

Obesity has many causes, ranging from nutritional causes, unhealthy habits, pathological causes, and genetic causes, and it can also be attributed to more than one cause of obesity at the same time according to the case studied. It is well established that the cause of obesity is an imbalance between energy intake and its consumption in the body.

Factors predisposing to obesity include:

Genetics

Many obese people have a genetic predisposition to obesity as a result of genetic factors that they have. It is more likely for a person with one or both of his parents to be obese to become obese as well.

The genes you inherit from your parents affect the amount of fat your body stores. Genes affect the function of lipid-regulating hormones in the body. An example of this is a deficiency of leptin, a hormone produced by adipocytes and the placenta of a pregnant woman. Leptin regulates weight by instructing the brain to reduce appetite for food when fat stores are full. If the body, for any reason, is unable to produce enough leptin, the body will lose the ability to control weight, and obesity will occur.

Growing older

While growing older the lipid turnover in adipose tissue (where the body stores fat) decreases, meaning the removal of fat from fat cells slows down, contributing to weight gain.

Pregnancy

Most pregnant women gain around 10kg to 12.5kg.

Most of the extra weight is because your baby is growing, but your body will also be storing fat, ready to make breast milk after your baby is born.

Not sleeping enough

When you are sleep-deprived, you have less of a hormone called Leptin.

More Ghrelin plus less Leptin equals weight gain.

This results in eating more and a slower metabolism which ultimately leads to weight gain.

Certain health conditions

In some cases, obesity may result from diseases that affect a person and cause him to gain weight. These diseases vary in type and mechanism of causing obesity, and the most important diseases associated with weight gain are:

• Hypothyroidism,
• Prader-Willi syndrome,
• Cushing's syndrome,
• Insulin resistance (Diabetes Mellitus),
• Polycystic ovary syndrome.

Risk factors

Obesity and overweight may be caused by a group of factors and triggers:

Unhealthy food

Unhealthy eating and living habits are the most common causes of obesity.

The diet is high in calories, with a lack of vegetables and fruits, and excessive eating of fast food. It is better to avoid these habits in the prevention of obesity.

Also, the daily liquid calories intake on a routine basis without feeling full from, such as drinking juices, soft and sweetened drinks.

The lack of physical activity increases the problem, causing the body to consume less of the fats stored in it, and with an adequate amount of calories entering the body daily, it exceeds the consumption, which leads to weight gain.

Psychological factors

Using food to cope with life is a mechanism used by many people and probably people with such a way of thinking will stay the same until they find another way to cope with life.

Some medications

Medicines that may cause weight gain include:

• Medicines for diabetes: such as insulin, thiazolidinediones, and sulfonylureas.
• Antipsychotic medicines: such as haloperidol, clozapine, risperidone, olanzapine, quetiapine, and lithium.
• MAOI: MAOI stands for monoamine oxidase inhibitor.
• Corticosteroids: Oral corticosteroids treat a range of conditions from asthma and arthritis to back pain and lupus.
• Beta-Blockers.

Obesity Diagnosis

For diagnosing obesity patient must undergo several tests includes measuring your height; checking vital signs, such as heart rate, blood pressure, and temperature; listening to your heart and lungs; and examining your abdomen.

Then calculating your Body mass index, 30.0 BMI or higher are considered obese below will elaborate this.

BMI calculation

Weight in kilograms divided by square of height in meter:

• BMI less than 18.5, falls within the underweight range.
• BMI 18.5 to <25, falls within the healthy weight range.
• BMI 25.0 to <30, falls within the overweight range.
• BMI 30.0 or higher, falls within the obesity range
• BMI 40.0 or higher, falls within the morbid obesity range

Skinfold thickness tests

This test is performed by measuring the thickness of a skin fold by a device called skinfold calipers which measures the body fat, it is usually done on seven main areas: Tricep, Bicep, Subscap, Supraspinale, Abdominal, Thigh, and Calf.

Below is a chart to help you recognize the result of your skinfold test result:

Waist-to-hip comparisons

The waist-to-hip ratio is one of the measurements doctors use to check risks that may cause by excess weight, it is measured by comparing the size of your waist to the size of your hips in inches as per the chart below:

Health risk	Women	Men
Low	0.80 or lower	0.95 or lower
Moderate	0.81-0.85	0.96-1.0
High	0.86 or higher	1.0 or higher

Blood tests to examine cholesterol and glucose levels

A lipid profile is taken to measure the amount of good and bad cholesterol and triglycerides in the blood.

Also, a blood sugar test called A1C test is performed to measure the glucose level in your blood for the last 3 months.

Liver function tests

Liver function tests are blood tests that measure different enzymes, proteins, and other substances made by the liver which includes:

• ALT AST: measure enzymes that liver releases in response to damage and disease.
• Serum albumin test: Measures how well the liver is creating albumin
• ALP test: Evaluation of the bile duct system of the liver.
• Bilirubin test: Measurement of the bilirubin disposal

Complications of Obesity

Obese patients are exposed to complications, and the common problems of obesity are:

Type 2 diabetes

There is a close association between obesity and type 2 diabetes, there is a seven times greater risk of diabetes in obese people compared the healthy weight.

Heart disease

Obesity increases the risk of the development of cardiovascular diseases.

Obese people require more blood to supply oxygen and nutrients to their bodies which requires more effort from the heart.

High blood pressure

We explained above how obesity contributes to heart diseases by pumping more blood and putting more pressure on the heart this increased volume of blood is opposed by the arteries and resists this flow of blood, causing your blood pressure to rise.

Certain cancers (breast, colon, and endometrial)

Study shows that excess body fat increases the risk of several cancers, including colorectal post-menopausal breast, uterine, esophageal, kidney, and pancreatic cancers.

Stroke

High cholesterol, high triglycerides, and high blood sugar, these conditions harm the blood vessels of the brain and the heart and increase the risk of blood clot formation and traveling to the brain.

How is obesity treated?

There are many ways for treating obesity, and they range from simple non-surgical ways, including lifestyle changes and diet modification, to surgical treatment for severe obesity, through medication and other methods.

Lifestyle and behavioral changes

Treatment of obesity via lifestyle and behavioral changes, and mainly includes two steps:

• Diet: Follow a diet low in calories and rich in proteins, with an increase in the proportion of vegetables and fruits, and a decrease in the intake of bread, starches, and whole grains.
• Physical activity: exercising regularly and according to a schedule, increasing activities, and walking.
• Avoid smoking.

Medications for weight loss

When diet and exercise are not effective in losing weight, medications called lipid-lowering drugs can be used to reduce the amount of fat absorbed by the body during digestion.

Weight loss surgery

It is possible to choose the treatment of obesity by surgery when hope is lost from the effectiveness of other methods. Obesity can be treated with several types of surgeries, including sleeve gastrectomy, gastric bypass, gastric balloon, and others. By choosing ILAJAK Medical, be sure that you have made the right choice regarding your partner in obesity treatment. Contact us to find out about the latest types of obesity treatment in Turkey and to determine the best options that suit you.

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