OBESITY is a pathological condition whereby there is an accumulation of fat in excess of what the body needs to function. It is different from overweight which may not be an accumulation of fat but excess weight for age and height.
Obesity is a nutritional disorder. It can be detected by visual inspection, but it is important to estimate it by using height-weight for age tablets, and by measuring the skin fold thickness. Obesity is incriminated in many diseases which can shorten the individual’s life.

CAUSES
Overeating is the commonest cause of obesity. Overeating is due either to loss of self control (gluttony) or to more serious problems of personality. Other causes are genetic factors (hereditary), disease of the brain, disease of the endocrine system, psychological disturbances and psychic trauma.
Obesity occurring in childhood is likely to lead to adult obesity with all the problems of the heart, the joints and possibly fertility. It occurs more in women than men because of the factor of pregnancy. A woman gains about 13kg during pregnancy; part of this is an increase in fat under the skin. At the end of pregnancy, part of the weight is retained. Therefore, with each pregnancy and childbirth, a woman can become progressively fat. It is seen in people who eat much and take alcohol with meals. Those who consume more starchy and fatty foods. It is also commoner in caterers, housewives who eat five, six times daily; it is also common in those who are not physically active, or whose lives are largely sedentary.
Trying to attain and maintain an appropriate body weight for height and age throughout the life cycle is a guideline that should be followed and which is achievable through good diet.
Moderate intake of food rich in protein, less fat, adequate but not excess starch is desirable. There has to be increased physical activity. By controlling food intake and being physically active appropriate weight for height can be maintained.
The risk factors due to obesity are many: it has adverse effects on health; It changes the lifestyle of affected persons. It shortens life. Weight reduction prolongs life. Obesity is associated with hypertension, heart diseases, gall bladder diseases, diabetes mellitus, some forms of cancer. Fat people experience greater risk at operations during pregnancy and childbirth. Their quality of life is interfered with; they can’t quickly get away from danger due to their sluggish movement. This makes them accident-prone. They spend more money on clothes. Sometimes they can’t make friends easily.

TREATMENT
The affected person should be made to understand the reasons he should reduce his weight. He must be convinced that he has to give up permanently those habits which led to obesity. He has to be convinced that diet is a better treatment than drugs.
The intake of foods rich in starch should be reduced. These are Sugar, Bread, Cakes, Biscuit, Yam, Rice, Garri, Potatoes and Plantain. Snacks taken in between meals are not permitted. Chocolates, sweets, beer stout, other alcoholic drinks as well as soft drinks are not permitted. Fat should be avoided. Small quantity of palm oil, vegetable oil or any cooking oil is used when cooking. There has to be cut in the quantity of milk taken. When taking tea, there should be little or no sugar with a few drops of milk. Boiled eggs are better than fried ones. Plenty of fruits and vegetables should be taken as they provide little starch while they fill the stomach and relieve hunger. They also help to relieve constipation. Lean meat is better than fatty ones. Shell fish contains less oil than those without shells such as mackerel, Titus, etc Pork should be avoided. Plain water can be taken as much as possible but not sweetened drinks. Most fat people lead sedentary lives.
Urban and industrial life restricts activity. In spite of this, the affected person has to be physically active. Walking, jogging, running, swimming and other forms of sports are desirable. Gardening, farming, cycling, etc should be taken up where possible. Walking for at least an hour a day does a lot of good.
In order to achieve a satisfactory weight loss, fat people have to keep a regime of restricted food intake and exercise for many months. Even where progress is slow at the onset, don’t be discouraged, keep the regime .It is advisable to keep a fortnight or a monthly record of weight to be able to assess oneself.
Sometimes fasting is recommended for very obese patients. Fasting is for 14hours, light meals are taken in the evenings when breaking the fast. Fasting for a week with a break in the evenings and continuing this for six months has yielded good results.
Drugs are used in the treatment of obesity. Because of their side effects and because they don’t confer lasting benefits, their use should be discouraged. They are used as a last resort where diet and exercise had failed.
Where there are underlying diseases resulting in obesity, they should be treated. In the treatment of obesity a major advance is the coming together of obese patients as a group forming an Association or Club, There exist the Diabetic Club and Sickle Cell Club. Obesity Club will help members a great deal.
Wise selection of food adhering to minimum servings, increased physical will help to control overweight and obesity.
To avoid a relapse, once weight reduction is achieved, there has to be a permanent change in eating and exercise habits.

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