Obesity is classified as a medical disease, which has gained epidemic proportions worldwide. It has increased drastically in magnitude across almost countries in the world.
Additionally, it causes health complications that touch upon almost all organs and systems in the body. These effects can become serious and cause death.
Obesity is now the second most common cause of preventable death in the world and is soon slated to overcome smoking, which ranks at the number one position.
Having said all that, you cannot underestimate the importance of diagnosing it for its risks and managing it promptly.
Why are obesity diagnostic tests necessary?
You might wonder what is there to diagnose in an obese person. We all can see that he is obese and that should confirm that he has obesity and treatment can be started.
However, there are certain tests for obesity to be done before the treatment option is finalized and management is started.
Besides seeing that he is obese, it is necessary to find out why he has gained weight. There are numerous reasons for his obesity and it is necessary to find out the cause.
Treating obesity without knowing the cause will have no success. The cause of the obesity has to be treated first and obesity will correct itself. For example, his overweight status or obesity could be due to a hypothyroid or due to some medication for some chronic condition he is taking.
Treating the hypothyroidism or stopping and changing the medication will help to contain the extra pounds.
Secondly, there are various health complications that being overweight or obese can lead to. It becomes necessary to determine if the person has been affected by any such problems so that they also can be treated.
Obesity diagnostic guidelines
There is a sequel to the diagnostic options in the assessment of obesity. They are:
- Taking the personal and family history of the patient
- A physical examination
- Measuring the waist circumference
- Checking for other comorbidities
- Laboratory blood tests
Personal and family history
Your doctor will ask you questions to find out basically why you have become obese and whether any complications of obesity have set in.
- He will ask you since when you have been overweight.
- What are your eating habits?
- The level of your physical activity
- Whether you are on any medication
- Whether you are under any stress
- Whether you have a family history of health conditions such as diabetes or hypertension
A physical examination will include checking your temperature, pulse, blood pressure, auscultation of the chest for breathing and heart sounds, palpating the abdomen, looking for any swelling in the neck (for thyroid) and legs. There are a host of other things that the doctor will also check.
He will also evaluate your symptoms and look for signs that can lead him to a provisional diagnosis.
Calculating your BMI
Body mass index (BMI) is a formula to calculate the status of your body fat based on your weight in relation to your height. It is applicable to adult men and women aged 20 and more.
If you are obese, you should check on your BMI at least once a year to make sure on the success of your treatment, which is a long drawn affair.
Your BMI helps the doctor to assess the health risks at your BMI and plan the treatment options.
Measuring your waist circumference and WHR
Besides, the BMI, your waist circumference is an important factor in assessing your health risks.
A bigger waist circumference indicates that most of your fat is stored around your abdomen. This is called visceral or abdominal fat and which is the dangerous fat. It indicates an apple-shaped obesity, which increases your risk of diabetes, heart disease, and metabolic syndrome.
In the pear-shaped obesity, the fat is deposited around the thighs and/or hips and the waist is relatively narrow. This is subcutaneous fat and is believed not to increase your health risks.
WHR or the waist to hip ratio is a measure of your central obesity to calculate your health risks.
You divide the abdominal girth by the measurement around your hips and you arrive at the WHR.
What does the waist circumference tell you?
If you are a woman with a waist circumference of more than 35 inches (80 centimeters) or a man with a waist measurement of more than 40 inches (102 cm), you lie in the danger zone prone to more health risks than those with a lesser waist.
Ruling out other health complications
Obesity has complications that span across almost all your body systems. Hypertension, heart attack, stroke, diabetes, cancer, raised cholesterol, liver disease, gallstones, gout; you name it, your risk touches almost every organ and system in the body.
Your doctor will want to look for signs of these disorders. He will also assess your mental setup to see whether there are any signs of anxiety and depression.
So, before planning your treatment, your doctor will want to rule out these conditions, by your symptoms and tests.
Laboratory and imaging tests
There are so many conditions to rule out that each case will be tested on its merits (or demerits).
Routinely, your doctor will want to do a lipid profile, liver function tests, a fasting and postprandial glucose, thyroid tests and an electrocardiogram (ECG).
All these diagnostic criteria will help to pinpoint the cause and any coexisting health conditions and help in choosing the right therapy options.
Management and treatment of obesity
The aim of managing obesity and overweight is to make you lose those extra pounds and arrive at a healthy weight.
A healthy weight will be one that is classified as normal for your height by the BMI, and which eliminates the health risks of obesity.
It is important to note that obesity is classified as a chronic disease and should be treated as such – religiously and with patience and consistency.
How to lose and reduce fat in your body involves certain progressive guidelines, which are taken up when one guideline fails.
Treating obesity should be a long time plan. You must lose your fat with a healthy long time plan because losing weight rapidly can have unhealthy side effects such as malnutrition, hair loss, electrolyte imbalance, gallstones, loss of muscle, dehydration, a sagging skin and more.
Get your calorie equation right. To start losing weight, you have to start losing calories every day gradually. This means that every day, you have to burn more calories than you consume. Eat fewer calories and increase physical activity.
1) Obesity Diet
The obesity diet consists of foods that give you adequate nourishment and contain fewer calories. The obesity diet should not contain more than 30% fat.
We all come from different continents and have our own traditional foods. Therefore, I have mentioned what foods you can eat, and what foods you must avoid, in a broad sense and not in a targeted fashion.
For example, I will not say what particular burger you can eat in MacDonald’s or Subway but my do’s and don’ts in the broader sense will help you to choose the appropriate obesity foods, where ever you eat.
These foods are explained in detail in another post. You should go out there and read about those foods.
Do follow it with zeal and motivation. Obese people are advised to take the help of a dietician to assist you on a one to one basis.
2) Physical Activity and Exercises
Exercises to lose weight is an informative post on the various exercises you can take up to lose your extra weight.
That post explains each exercise with the calories you lose by doing that exercise, in a stipulated period of time. Exercises explained are simple and enjoyable.
Being obese and starting to exercise is not an easy task. Stamina is minimal and the eagerness to lose weight is maximum. This can be a big demotivating factor and you should train yourself to be patient.
You could start by walking initially and later take up exercises, which help you lose more calories. Be assured that slowly and steadily, your capacity will improve and within a few weeks, you will be surprised that you have achieved so much.
3) Behavior Modification Program
Behavior therapy for obesity consists of treating you with the assistance of a trained psychoanalyst or psychotherapist who will analyze your mental setup vis-à-vis obesity.
This program or therapy helps to change your existing attitude towards food and exercise and molding it to one, that you should have to lose your obesity.
Support groups also help when discussions are held and remedies found for problems of common interest.
Those psychological factors are identified such as situations, that make you want to eat more. You can then avoid such situations and circumstances.
4) Prescription Drugs and Medicines
At times, obesity food and exercise do not give the desired results. Obesity drugs and medications are then used and this is the most widely used method to lose obesity.
These drugs are used as adjuvants to diet and exercise and not as standalone therapy. These drugs may not work if used alone.
The indication for weight loss pills are:
BMI of 30kg/m2
Commonly approved weight-loss medications include orlistat (Xenical), lorcaserin (Belviq), phentermine and topiramate (Qsymia).
The disadvantage of weight loss medication is that when you stop taking the drugs, you tend to gain weight.
5) Weight Loss Surgery
Obesity or weight loss surgery is called bariatric surgery. It is a recommended treatment for morbid obesity (men who are at least 100 lbs overweight or women who are at least 80 lbs overweight) in which the BMI is 40 or more.
It is also recommended if you have a BMI of 35 with obesity-related complications such as diabetes or arthritis.
Weight loss is achieved by reducing the size of the stomach with a gastric band or by removal of a portion of the stomach.
There are various techniques used, which are minimally invasive. The common ones are the gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch.
Weight loss surgeries do carry some short-term and long-term serious risks. They are mostly those associated with any surgery:
- Excessive bleeding
- Anesthesia side effects
- Formation of blood clots
- Breathing problems
- Leakages in stomach or intestines at sites of anastomosis
Other long-term effects include
- G.I. tract obstruction
- Vomiting and/or diarrhea
- Formation of gallstones
- Perforation at the site of surgery
Advantages of weight loss surgery lie in the fact that it provides long-term weight loss results.
The surgery also resolves other co-existing conditions such as GERD, diabetes, high cholesterol, and sleep apnea.