Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. An increase of 20% or more above the “ideal body weight” is the point at which excess weight becomes a health risk. India is now facing an epidemic of obesity with about 5% of its population having morbid obesity. (NFHS 2007). Indians are genetically susceptible to obesity especially around the waist
 

What causes obesity?

Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity and genetic susceptibility although a few cases are caused primarily due to hereditary causes, endocrine disorders, medications or psychiatric disorders

Morbid obesity is a complex multi factorial, chronic disease, where weight and symptoms build up slowly over time. Obesity becomes “ Morbid” when it reaches the point where it has an adverse effect on health, particularly causing heart disease, type 2 diabetes, obstructive sleep apnoea, certain types of cancer and osteoarthritis. Class II and class III obesity is considered morbid obesity.

Body Mass Index (BMI) is a tool to measure the extent of obesity, where weight and height are used in a formula. 

BMI = Weight in kgs/(Height in meters2).
 

Classification of Obesity

• Overweight (pre-obese) if BMI is between 25-  29.9
• Class I Obesity if BMI is between 30- 34.9
• Class II Obesity if BMI is between 35 – 39.9
• Class III Obesity if BMI is =/>40

Overweight and class I obesity can usually be treated with diet modification, exercise and behavioural changes and do not require surgery. Class II and III require bariatric surgery
 

Consequences of Morbid Obesity

• Cardiac disease
• Arteriosclerosis
• CVA
• Renal failure
• Hypertension
• Hypercholesterolemia
• Type-II Diabetes mellitus
• Drowsiness (day time)
• Sleep Apnea
• Heart Burn
• Barrett's oesophagus
• Gallstones
• Jaundice
• Stress urinary incontinence
• Accelerated arthritis of spine
• Degenerative arthritis of the Hip, Knees
• Venous stasis in legs
• Anxiety
• Depression
• Pseudo tumor cerebri
• Migraines
• Polycystic ovarian syndrome
• Asthma
• GERD (Gastro esophageal reflux disease)
• Infertility
• Pregnancy complications