Prevention and management of obesity

Introduction

The scourge of the obesity has eaten deep into the society and it’s has been a major problem plaguing the populace. Obesity means having excess body fat. Obesity can also be defined as a body mass indene of higher then 30. The New York Times, (2006) the world is the grips of an affliction that threaten to overwhelm entire nations health and shorten the life span of future generations. The cause is obesity. This insidious creeping pandemic of obesity is now engulfing the entire world. “It’s as big a threat as global warming and bird flu” said Zimmer, an Australian expert on diabetes. Other experts said that the cost of treating health problems related to being obese was immeasurable on global scale, but was estimated as a billion of dollars a year in countries like Australia, Britain and the United States.

We are not dealing with a scientific or medical problem, we are dealing with an enormous economic problems that, it is already accepted, is going to overwhelm every medical system in the world “said Philip James,” He also said that government had been forced to confront rising obesity rates because of the expense of treating related health issues. Among the most worrying problems are skyrocketing rates of obesity among children, which make them prone to chronic disease as they grow older and could share years of their lives.

Kate Steinbeck said that children in this generation could be the first in history to die before their parent because of health problems related to obesity. According to the national institutes of health, obesity is an increase problem, where 60% of American adults, 35% are considered obese. An increasing sedentary life style, in which many people work at computer and sit down to watch television, for relaxation is at least partially responsible. However people who are genetically predisposed toward obesity can often make life style choice that prevent or control the problem.

Obesity is difficult to treat and has a high relapse rate. Even though medication and diets can helps, the treatment of obesity cannot be a short term “fix” but has to be a life-long commitment to proper diet habit increase physical activity, and regular exercise.

Conceptual framework

Obesity is a condition that is a serious medical problem. Obesity is evaluated by calculating body mass index (BM1). Several definitions of obesity are available though they all contained the same thing. Obesity, in its simple’s term, is the accumulation of too much fat in the   body. Obesity is defined by the world health organization (WHO) as an abnormal or excessive fat accumulation that present a risk to an individual health.

According to the Wikipedia encyclopedia defines obesity thus “obesity is a medical condition in which excess body fat has accumulated to extent that it may here an adverse effect on health leading to reduced life expectancy or increasing health problems. Over 20 years, obesity has become the most prevalent nutritional problem in the world eclipsing. It is a key risk factor for many chronic and non communicable diseases.

According to the most recent estimate (2004) Canadian community health survey 59% of the adult population is obese highlight a pressing public health problem that shows no signs of improving on the near future. Obesity rate has drastically increased among boys and girls. This increase is cause for concern. Obesity should no longer be viewed as cosmetic or body image issue. The cause of obesity is complex and multifactorial. The rapid increase in the prevalence of obesity as a result of environmental and cultural influences rather than genetic factor.

International Council of Nurses (2012) encourages nurses to create public awareness of multiple and changing determinants of health that affect becoming obese. And also to help the public understand that obesity is predominantly a social environmental disease. The world economic forum (2013) said that obesity has grown to epic proportions, tackling this issue has proven to be extensively more complicated as there is not one direct answer to solving it. They also estimate that 47 trillion of output might be lost in the next 20years due to non communicable disease and mental health problems, with obesity to blame for 44percent of the diabetes burden and 23 percent of heart disease.

Connor Schratz (2013) illustrated that an obese individual is indeed baldy nourished, only with an excess of nutrients. The world is now facing a double burden of obesity “says Mr. Brance” children are already obese on the track to become obese adolescents and adults and develop chronic diseases. According to the world health organization (WHO) which says that the solution to this problem is better educated parents and adult who can over see a child’s nutritional intake and ensure that they are getting the right amount of vitamin, mineral, carbohydrate and protein, without excess.

Signs and symptoms of obesity

According to the national health, lung and blood institute, the signs symptoms of obesity are as follows.

  • Clothes feeling tight and needing a large size.
  • Having extra fat around the waist.
  • Heavy sweating and a feeding of always being hot.
  • Difficulty sleeping.
  • Lack of energy and constantly feeling tired.
  • Various vain.
  • Type 2 diabetes.

Causes of obesity

According to Gayle. M. Galletta, he says that obesity occurs when you eat more calories than your body uses up. If the foods you eat provide more calories than your body needs excess is covered to fat initially, fat cells increase in size. When they can no longer expand, they increase in number. If you lose weight, the size of fat cells decrease, but the number of cells does not. But there are other factors that also play a role in obesity. These include.

  • Medication: Certain drugs such as steroids and some antidepressants may cause excessive weight gain.
  • Psychological factor: Psychological factors also influence eating habit and obesity. Many people eat in response to negative emotions such as sadness or anger.
  • Illness: Although not as common as many believe, there are some illnesses that can cause obesity. These include hormone problems such as hypothyroidism (poorly acting thyroid slows metabolism, depression and some vary disease of the brain that can lead to overeating.
  • Environmental factors: Although genes are an important factor in many cases of obesity, a person environmental factor include life style behaviors such as what a person eat and how active he or she is.
  • Genetics: Obesity tends to run in families. In a study of adults who were adopted as children, researcher found that participating adult weights were closer to their biological parent’s weight then their adoptive parents.
  • The environment provided by the adoptive family apparently had less influence on the development of obesity that the person’s genetic makeup.

Most recent studies Indicates that if one parent is obese the like hood of having an obese child is three times higher. If both parents are obese, the like hood is 10 times higher (Merch, 2012). According to Harvard School of Public Health which says that genes influence every aspect of human physiology, development and adaptation. Obesity is not an exception.

Diagnoses of obesity

According to Ricker Polsdorfer (2013) obesity is an abnormally high proportion of body fat. The doctor can often determine if you are obese by looking at your body and assessing the percentage of body fat. Methods of assessing body fat are discussed below.

Measuring your weight in proportion to your height is the traditional way of determining whether you are overweight, obese or at an appropriate weight, doctor can often determine if you are overweight or obese by calculating your body mass index (BMI), which is derived by dividing your weight in kilogram by your height on meters squared. Doctor may also estimate whether you have too much body fat by measuring your weight to help ratio. There are others tested that can estimate your percentage of body fat.

Accuracy of these tests varies and some are so expensive that you are not likely to have them at the doctor’s office. When combined with your visual appearance and weight circumference or weight to help ratio your BML can usually provide a valid estimate of whether you are overweight or obese.

Test to diagnose obesity includes

Body mass index (BMI)-A BMI of 25 to 29.9 is considered overweight and 30 0r higher is considered obese.

According to world health organization (2002), Body mass index (BMI) classification of obesity is divided into three.

Classification BMI (kg/m2)
Obese class I 30.oo-34.9
Obese class II 35.00-39.9
Obese class III > 40.00

 

  • Waist circumference, saggital diameter and waist to help ratio: Simple measurement that estimates the amount of fat deposited in the skin and inside the abdominal cavity. Waist to help ratio greater than 1 in men or 0.85 in women is considered obese. Waist circumferences that exceed 102 centimeters (40 inches) men or exceed 88 centimeters (35 inches) in women are associated with an increased risk of heart disease.
  • Skinfold caliper: Most fat is deposited beneath the skin. This test measures fat just beneath the skin, but cannot measure fat accumulated inside the abdomen.
  • Water displacement tests: Fat floats; the rest of your body sink. Determining how well you float provides an estimate ratio of fat to body mass.
  • Electrical measurements: A couple of test calculates your percentage of body fat by measuring the difference between the electrical characteristics of fat and often tissues in your body.
  • Blood test: To rules out other medical conditions that may cause excess body weight, such as a thyroid disorder.

Types of obesity

There are several standardized types of obesity that have been classified by the world health organization (WHO). The types of obesity are:

  • Class I
  • Class II
  • Class III

But have been subdivided by other organization into categories such as “mild obesity”   and “super obesity” the types of obesity set by the world health organization (WHO) were classified based on the true body mass index (BMI). Class1 is the first and lowest types of obesity. Individuals with a BMI between 30 and 34.99 would fall into this category. Class 11 include body mass index of 35 to 39.99. Classes 111 are those with body mass index over 40, include the sub-categories of several, morbid and super obesity in order of measuring severity.

Complication of obesity

According to Stanford Hospital and Clinics (2013) obesity has far ranging negative effects on health. The health effects associated with obesity include.

High blood pressure: Additional fat tissue in the body needs oxygen and nutrients in order to live, which requires the blood vessels to circulate more blood to the fat tissue. This increases the workload of the heart because it must pump more blood through additional blood vessels. More circulating blood also means more pressure on the artery walls. Higher pressures on the artery walls increase the blood pressure. In addition, extra weight can raise the heart rate and reduce the body’s ability to transport blood through the vessels.

Diabetes: Obesity is the major cause of type 2 diabetes. This type of diabetes usually begins with adulthood but is now actually occurring in children. Obesity can cause resistance to insulin; the hormone that regulates blood sugar becomes elevated. Even moderate obesity dramatically increases the risk of diabetes.

Heart disease: Atherosclerosis (hardening of the arteries) is present 10 times more often in obese people compared to those who are not obese. Coronary artery disease is also more prevalent because fatty deposits build up in arteries that supply the heart. Narrowed arteries and reduced blood flow to the heart can cause chest (angina) or a heart attack. Blood clots can also form in narrowed arteries and cause a stroke.

Joint problems, including osteoarthritis: Obesity can affect the knees and hips because of the stress placed on the joints by extra weight. Joint replacement surgery, while commonly performed on damaged joints, may not be an advisable option for an obese person because the artificial joint has a higher risk of loosening and causing further damage.

Sleep apnea and respiratory problems: Sleep apnea, which causes people to stop breathing for brief periods, interrupts sleep throughout the night and causes sleepiness during the day. It also causes heavy snoring. Respiratory problems associated with obesity, occur when added weight of the chest wall squeezes the lungs and causes restricted breathing.

Cancer: In women, being obese contributes to an increased risk for a variety of cancers including breast, colon, gall bladder and uterus. Men who are obese have a higher risk of colon and prostate cancers.

Metabolic syndrome: The National Cholesterol Education Program has identified metabolic syndrome as a complex risk factor for cardiovascular disease, metabolic syndrome consist of six major components: abdominal obesity, elevated blood cholesterol, elevated blood pressure, insulin resistance with or without glucose intolerance, elevation of certain blood components that indicate inflammation, and elevation of certain clotting factors in the blood.

Gynaecological problems (abnormal menses, infertility).

Prevention and management of obesity

According to Mayo Clinic (2013) the following ways are used in preventing and to manage obesity.

  • Monitor your weight regularly: People who weigh themselves at least once a week are more successful in keeping of excess pounds. Monitoring your weight can tell you whether your efforts are working and can help you detect small weight gain before they become big problems.
  • Know and avoid the food traps that cause you to eat: Identify situations that trigger you out of control eating. Try to keep a journal and write down what you eat, how much you eat, when you ear, how you are feeling and how hungry you are. And develop strategies for handling these types of situation and stay in control of your eating behavior.
  • Exercise regularly: According to the American college of sports medicine, you need to get 150 to 250 minutes of moderate intensity activity a week to prevent weight gain. Moderately intense physical activities include fast walking and swimming.
  • Eat healthy meals and snacks: Focus on low calories, nutrient-dense foods such as fruits, vegetables and whole grain. Avoid saturated fat and limit sweet and alcohol. Ensure that you choose food that promotes healthy weight gain and good health more often than you choose food that don’t.
  • Consistent: Stick to your healthy weight plan during the week.

Dietary guidelines for obesity

According to Medical Journal of Australia (2004) the dietary guidelines are as follows:

  • Reduce energy intake
  • Reduce portion size
  • Select food with lower fat content and low glycemic index
  • Increase vegetables and fruit intake
  • Reduce high sugar foods and drinks
  • Use the water as the main beverage
  • Eat more of whole grain product such as fish, poultry and nut
  • Reduce intake of red meat
  • Avoid junk foods.
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