Obesity is one of the many lifestyle diseases plaguing the general populace. Obesity means having too much fat in the body. It is different from being overweight, which means weighing too much; the weight may come from muscle, bone, fat and/or body water. Both terms mean that a person’s weight is greater than what is considered healthy for his or her height.

Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might tip the balance include your genetic makeup, overeating, eating high-fat foods and physical inactivity.

The Indian Scenario
Throughout the world, because of increasing affluence and urbanisation, people are eating more and leading sedentary lives. As a consequence, obesity is increasing worldwide. The trend is being observed in the developing nations too and India is no exception. While in India a significant proportion of the population, particularly from the rural areas is malnourished, the other part includes people who are obese. The latter are mainly affluent urban folks. At the same time, studies done in urban slums show a significant increase in obesity in this segment of the population too.

It is estimated that about 5 per cent of the Indian population is obese and the curve on the graph is fast rising. What is most worrying is that obesity amongst children is rampant and it is particularly so in north India. A recent Delhi-based study targeting school children aged between 14 and18 years found nearly 25 per cent of them to be overweight. A significant proportion of these obese children will progress to become obese adults too.

Health Issues When Obese
Being obese increases your risk of diabetes, heart disease, stroke, arthritis and some forms of cancers. It also makes breathing difficult and may cause fatty liver that predispose you to cirrhosis of the liver. Of late is also the realisation about obesity’s ill effects on the kidneys.

Your weight is the result of many factors. They include environment, family history and genetics, metabolism, behaviour or habits, and more. You can’t change factors such as family history, but you can help yourself by addressing your lifestyle and habits with preventive steps. Follow a healthy eating plan, engage in regular physical activity and try to avoid inactivity. Weight-loss medicines and surgery also are options for people in whom lifestyle changes fail to bring the desired results.

Body Mass Index (BMI) Calculation
BMI In Adults is calculated as (Weight in Kg)/ (Height in mtr)2

  • Normal weight – when between 18.5 and 24.9
  • Overweight – when between 25.0– 29.9
  • Obesity – when between 30.0–39.9
  • Extreme obesity – when 40.0 and above

BMI in Children & Teenagers is referred to as BMI-for-age percentile

  • Overweight is defined differently for children and teenagers from what it is for adults. Children are still growing and boys and girls mature at different rates.
  • BMIs for children and teenagers compare their heights and weights against growth charts that take age and sex into account. This is called BMI-for-age percentile.
  • A child or teenager’s BMI-for-age percentile shows how his or her BMI compares with other boys and girls of the same age.

How to Measure Obesity?
BMI: The most common way to find out whether you are overweight or obese is to figure out your body mass index (BMI). BMI is an estimate of body fat, and it’s a good gauge of your risk for diseases that occur with more body fat. The higher your BMI, the higher is your risk of disease. BMI is calculated from your height and weight.

Waist Circumference: It is the other commonly used method for assessing obesity. It helps in screening the possible health risks linked to overweight and obesity in adults. If one has abdominal obesity – most of the fat is around your waist rather than at your hips – you’re at increased risk for coronary heart disease and type 2 diabetes. This risk goes up with a waist size that’s greater than 35 inches for women and greater than 40 inches for men. To measure your waist size correctly, stand and place a tape around your belly, just above your hipbones. Measure your waist just after you breathe out

Obesity’s Hit On Kidneys

  • Of late it is being realized that obesity can predispose you to renal disease and if you are already a patient of renal disease, obesity can hasten your progression to renal failure. Losing even 5 to 10 percent of your weight can cut down the risk. It is also very important to break the unholy nexus between diabetes and obesity to lessen the number of patients ending up in severe renal failure and dialysis.
  • Obesity causes damage to the kidneys particularly in those who are genetically predisposed. The most well-known is proteinuria. It develops as a consequence of the metabolic syndrome where there is abdominal obesity and insulin resistance. It is suspected that the high level of insulin seen in the blood under this condition puts the patient at risk of damage to the glomerulus of the kidneys. There is protein leakage into the urine leading to kidney damage. The high levels of serum triglycerides may also play a part in hastening damage to the kidneys in this situation.
  • The second condition related to obesity is a glomerular abnormality called Focal and Segmental Glomerulosclerosis (FSGS). It also causes protein up early in dialysis as compared to leakage in the urine and if those individuals who have normal body weight is not controlled, the condition may lead to permanent kidney damage.
  • In persons with Chronic Kidney Disease (CKD), that is, those with irreversible kidney damage, obesity hastens the rate of decline of renal functions. In other words, obese patients are likely to go into severe renal failure much quicker than non obese patients. The possible explanation is that the remaining nephrons are made to work beyond their capacity and fail early.
  • There is some evidence to suggest that obese patients develop renal cancers more frequently as compared to normal individuals.
  • With the present day epidemic of diabetes leading to kidney disease, a significant number of these patients are obese too. It is the reason why they are ending up early in dialysis as compared to those individuals who have normal body weight.

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