Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduce life expectancy or increased health problems. Body Mass Index (BMI), a measurement which compares weight & height, defines people as overweight, if their BMI is between 25 and 30 kg/m2 and obese when it is greater than 30 kg/m2 .
Formula for BMI:
BMI (kg/m2) = Weight (kg)/Height (m2)
CLASSIFICATION BASED ON BODY MASS INDEX
Obesity increases the likelihood of various diseases, particularly-
- Heart disease
- Type 2 Diabetes
- Obstructive Sleep Apnea (OSA)
- Certain types of Cancer
CAUSES OF OBESITY
- Lack of physical exercise
- Diet therapy
- Physical exercise
- Stress management
- Weight loss surgery
PRINCIPLES OF DIET
Low calorie, low CHO, normal protein, low fat, normal vitamins & minerals liberal fluid, high fiber diet
ENERGY: About 20 kcal per kg ideal body weight is prescribed for a sedentary worker and 25 kcal for moderately active worker.
CARBOHYDRATE: To produce a feeling of satiety, and for regular bowel movements, bulk producing carbohydrates like green vegetables and fruits are liberally prescribed. Starches with high carbohydrate content, like potatoes and rice, are restricted.
PROTEINS: are necessary for tissue repair and have a high specific dynamic action. About 0.8- 1g of protein per kg body weight is adequate.
FAT: Since fats are concentrated source of energy, they should be restricted. It is best to supply the quota as vegetables oils (except coconut & palm), so that enough essential fatty acids are supplied for proper nutrition.
VITAMINS: With prolonged restriction of fats, there is likely to be a restriction of fat soluble vitamins A, D, E & K which may be supplemented.
MINERALS: Restriction of sodium as common salt is helpful in weight reducing diet as excess sodium predisposes to retention of fluid. Research suggests that a calcium rich diet especially one that includes dairy sources (with limit in total calories) not only helps young women keep weight in check but may reduce overall levels of body fat. Calcium may depress certain hormone which consequently improves the body’s ability to break down fat in cells and slow fat production.
FLUID: can be taken liberally as extra fluids are excreted by healthy kidneys. Also a glass of water before meals helps to cut down food intake.
FIBER: High fiber low calorie foods like green leafy vegetables, fruits, vegetable salads, whole grain cereals and pulses can be included in the diet. Inclusion of high fiber foods in the diet for obese has many advantage. They are-
Ø Low in calorie density
Ø Foods like greens provide many vitamin & mineral.
Ø Give satiety
Ø Helps in regulating bowel movement
Ø Reduce blood cholesterol
Higher intake of fiber automatically cut down fat and calorie.
All carbohydrate sources are classified into three general categories:
- High glycemic index foods (GI 70 or above) that induce an immediate rise in blood sugar.
- Intermediate glycemic index foods (GI 55-69) that induce an average rise in blood sugar.
- Low glycemic index foods (GI 55 or below), that cause a relatively gradual rise in blood sugar.
Low GI foods, by virtue of their slow digestion & absorption, produce gradual rise in blood sugar & insulin levels. As these foods control blood sugar levels, they regulate hunger pangs and eating habits. Consumption of low GI foods also helps to prevent unnecessary snacking and excess calorie consumption. This in turn can help avoid serious condition like obesity and cardiovascular diseases.
Most obese patients lead sedentary lives. A low calorie diet accompanied by moderate exercise will be effective in causing weight loss. Aerobic exercise directly increases the daily energy expenditure and is particularly useful for long term weight maintenance.
Stress is a major reason for overeating. Patients can reduce stress- related overeating by learning how to implement methods other than eating to deal with or reduce stress. Some e.g. include meditation, yoga and physical activity.
SURGERY It is advised in patients with a BMI ≥ 40. Gastric bypass surgery is the preferred method for most obesity surgeons.
|Early morning||lemon water||1 cup|
|Break fast||Roti||2 piece|
|Bed time||skimmed milk||1 glass|
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