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Posted on Nov 26, 2015 | 1 comment



Obesity is abnormal accumulation of body fat, usually 20% or more over an individual’s ideal body weight. It is defined as Body Mass Index (BMI) equal or more than 30. BMI is calculated as the ratio of body weight in kg to square of height in meters. There are other ways of measuring obesity like fat thickness, waist circumference.

The incidence of obesity is increasing day to day.  “In every region of the world, obesity doubled between 1980 and 2008,” As per WHO’s The World health statistics 2012 report, Today one in six adults that is, half a billion people (12% of the world’s population) are considered obese.”  Though India is a developing country with malnourishment, now a days India is gaining weight. Obesity has reached epidemic proportions in India in the 21st century, with morbid obesity affecting 5% of the country’s population. It is more prevalent in urban population & females.

Studies show that in India, nearly 15 to 20% of children are overweight and 30% are in the risk of falling in this category. It is these statistics that ring major alarm bells. In India, many studies have shown that the prevalence of overweight among adolescents varies between 10% and 30%. Another important concern is that as high as 60 to 70% may continue to be overweight or obese in adulthood.


BMI classification:

Under weight <19
Ideal 19-25
Over weight 25-30
Obese >30
Severely obese >35
Morbid obese >40
Super obese >50


Causes of obesity:

  • Genetic
  • Acquired
  1. Hormonal disturbances
  2. Diet habits: Excess eating of high calorie food, Irregular eating habits
  3. Life style: sedentary habits
  4. Drugs


Effects of obesity & relation with Diabetes:

           Obesity has its deleterious effects on all systems such as Respiratory disease, Stroke, Cardiovascular problems, Gall stone disease, Gout, Osteoarthritis, Hormonal abnormalities, Diabetes & Cancer. Diabetes and obesity are mutually related. India is diabetes capital of the world. 40.9 million people are diabetic in India, this is expected to rise to 69.9 million by 2025.

Glucose maintenance in the body is a complex process. Whenever food enters the system glucose needs to be absorbed into cells by insulin. Secretion of insulin is helped by incretins which are the substances produced by hind gut that stimulate the Beta cells to produce insulin. Secretion of insulin inhibited by anti incretins secreted by fore gut. Poor sugar control is the major contribute for the development of Diabetes which is due to excessive calorie intake, poor secretion of insulin, insulin resistance. All these are strongly associated with obesity.


Associated co-morbidities:

  • Metabolic syndrome
  1. Type II Diabetes
  2. Hypertension
  3. Dyslipedemia
  • Obstructive sleep apnea
  • Venous & Lymphatic stasis
  • Chronic respiratory hypoventilation
  • Hypertrophic cardiomyopathy


Complications of Obesity:

  • Psychological -
  1. Eating disorders
  2. Poor self esteem
  3. Social isolation & stigmatism
  4. Depression
  • Greater the BMI – Early the premature death
  • Increased incidence of co-morbidities & cancers


Management of Obesity:

Obesity management is a multidisciplinary approach with several modalities like conservative, medical, non surgical, minimally invasive & major surgical approaches.

Conservative approach is the base line primary modality achieved through changing dietary habits, life style. This will certainly help in early phases of obesity but requires a lot of dedication, commitment.

Medical management mainly targets on inducing early satiety.

Non surgical methods are Gastric balloon which will be placed endoscopically. It is useful when BMI is 25-30.

Surgical approach is well known as Bariatric or Weight reduction surgery. Most people are not successful losing weight with diets. As someone becomes overweight, the risk of developing other serious diseases dramatically increases. Surgery has proven to be the most effective method to treat severe obesity. Surgery is of choice when both conservative & medical management fails.




MBBS; MS,FICS Bariatric surgeon Fellow In Laparoscopic surgeon

Senior consultant Laparoscopic & Bariatric surgeon

Surgical Gastroenterologist,

Apollo Health City, Hyderabad