Obesity/ Overweight

What is it:

Overweight refers to a weight above the "normal" range. The metric used to determine this is BMI (Body Mass Index), defined as the weight in kilograms divided by height in meters squared. Overweight is defined as a BMI of 25 to 29.9 kg/m2; obesity is defined as a BMI of ≥30 kg/m2. In Asians, a BMI of ≥23 kg/m2 is considered to be overweight, given the stronger genetic predisposition to weight-related lifestyle diseases.

How to know if you are obese:

As per American Diabetes Association 2017 guidelines, here are the obesity categories and their corresponding BMI ranges for Asians:

Causes:

• Unbalanced lifestyle

• Excess intake of carbohydrate and fats

• Lack of physical activity

Complications:

Obesity is a health concern.  If not managed, it can lead to serious health problems, such as:

• increase blood cholesterol and triglyceride level

• lower "good" HDL cholesterol. Low HDL cholesterol tends to raise heart attack risk

• increase blood pressure

• induce diabetes. In some people, diabetes makes other risk factors much worse. The danger of heart attack is especially high for these people

• lead to sleep apnea (when you periodically stop breathing during sleep)

• cause joint diseases such as osteoarthritis

How to manage:

You have heard often that reducing weight means overhauling your lifestyle. You may have tried it umpteenth number of times and felt like it’s too tough to do. The reality is that most of us fail at overhauling our lifestyle because we set ourselves up for big milestones. So start small.  Losing just 10% of your body weight can make a difference in your health.

Management of obesity requires extensive focus on your diet (what you eat and when you eat it), physical activity and behavior therapy. A diet low in carbohydrates and fat, and rich in protein and fiber is recommended. The American Diabetes Association recommends moderate physical activity of at least 150 min/week to reduce the risk of Type 2 Diabetes. Behavior modification including group counseling, diet diaries, and changes in eating patterns should also be initiated.

References:

1. American Diabetes Association Standards of Medical Care in Diabetes. Obesity management for the treatment of type 2 diabetes. Diabetes Care 2017; 40 (Suppl. 1): S57-S63
2. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults,