CHALLENGES AND MANAGEMENT OF OBESITY

BY

Dr. Musiliudeen A. AbdulSalam

WHO Bulletin updated in march 2013 says as follows.Worldwide obesity has nearly doubled since 1980 In 2008, more than 1.4billion adults,20 years and above

were overweight. Of these over 200million men and nearly 300million women were obese.

35% of adults aged 20 years and above were overweight in 2008, and 11% were obese.

65% of world population live in countries where overweight and obesity kill more people than underweight.

More than 40million children under the age of 5 were overweight in 2011.

OBESITY IS PREVENTABLE

AS SALAM-ALAIKUM WARAHMOTULAI WABARAKATUH.

The Advance Learner Dictionary defines OBESE as a person who is very fat but in general term overweight and obesity indicate weight greater than what is considered healthy.

It is important to know that obesity is not just a cosmetic consideration . It is a chronic medical disease that results essentially from the individual inability to maintain a healthy weight.

To maintain healthy weight one need to use (or “burn”) the energy from the food one eats .If you eat more than you use, your body will store the excess energy as fat.

DEFINITIONS:

Medically, you can determine your level of health by calculating your Body Mass Index.(BMI).

To calculate your BMI. Measure your weight in kilogram and your height in metre. Next square the figure you get from your height. For example if your height is 2.3m, then your height squared is 2.3x 2.3 = 5.29sq.m

Calculating your Body Mass Index.(BMI)

You can determine your (BMI) Body Mass Index as follows:.... WEIGHT(Kg) BMI= ------------ 2 Height (metre) If below 20...underweight. 20-25.Ideal weight 26-30.Overweight 31-40moderate obesity. above 40=severe obesity.For example: weight = 60kg Height = 1.2m BMI = 60 = 60 = 41 (1.2)2 1.44

BMI CAN BE RAISED IN WELL MUSCLED FIT INDIVIDUALS and for this reason it is also very important to consider Body Fat percentage alongside the BMI FOR AN OVERALL ASSESSMENT OF BODY COMPOSITION

Concern is directed not only on how much FAT a person has but also where the fat is distributed in the body.

In general women collect fat in the hips and buttocks giving their figure a PEAR shape while men collect fat around the belly giving their figure the APPLE shape .This however is not a hard and fast rule.

It has been scientifically proven that Apple-shaped people where fat is concentrated mostly in the abdomen are more likely to develop many of the health problems associated with obesity.

Body Fat Percentage

While obesity of any kind is a health risk it is better to be a pear than an apple. A very good way of estimating the amount of a person abdominal fat is by measuring the WAIST CIRCUMFERENCE. Men with waist circumference of 40inch(102cm) or greater and women with waist circumference of 35inch( 88cm)or greater are considered to have increased health risks related to obesity

Challenges of Obesity

It is a fact that once a child is overweight or obese he/she is more than likely to remain obese as adolescents and become overweight or obese adults.

An obese child or adolescent has increase risk of a range of disease and disorders in adulthood, regardless of whether the adult is obese or not.

It is therefore important to identify and start to reverse the condition before children become adults

Challenges Cont.:

People who are overweight ,and particularly those who are obese have higher rates of death and illness than those people that have healthy weight, both overall and from specific health conditions such as…

Cardiovascular diseaseHigh blood pressureType 2 diabetes Sleep apneaOsteoarthritisPsychological problems…lack of self esteem.Reproductive problem in women..

Effects of Obesity

Picture of an Obese Child

Main causes of obesity in children are.

Food choices .i.e. choosing high fat and sugary foods instead of healthier options.

Lack of physical activity such as spending valuable time on sedentary pursuits such as watching TV or video games or computer.

Overweight parents influence on a family eating patterns can have major influence on whether a child maintains a healthy weight. Some overweight parents may be less concerned about their children also being overweight than parents who have healthy weight.

Causes of obesity in children

Genetics.. Some rare gene disorders cause severe childhood obesity. In many other people, particular genes acting together probably make some children more susceptible to obesity .If there is a family tendency to become overweight , parents need to be even more aware of the need to make healthy food choices for the whole family.

STRESS. This monster can play a major role in weight gain. When we are stressed, our body produces a natural HORMONE called CORTISOL .This hormone is responsible for accumulation of fat in the abdominal area. secondly, when we are stressed , some of us reach out for comfort food as soon as we become anxious or concerned. This results in stress-induced eating and excess body weight.

SLEEP. Those who are well rested maintain healthy weight. Lack of sleep decelerates our body metabolism next morning. It is good to have 7-8 hours of sleep every night.

Cont:

This include the reduction of excess weight and maintenance of the lowered body weight as well as instituting additional measures to control any associated risk factors.To fight childhood obesity.*Government must … Build playgrounds in all communities Make physical exercise an integral part of the regular school curriculum to help

children become active and fit. *Parents must….. Keep a close watch on the eating habits of their kids. Do not leave the

responsibility to school administrators. Parents can pack healthy lunches and snacks for their children as oppose to giving them money which often end up in purchase of junk food or fast greasy menus.

Prepare healthy meals with lots of fresh vegetables and salads. Remember that sweets are TREATS AND ARE NOT INTENDED FOR

EVERYDAY CONSUMPTION.

MANAGEMENT OF OBESITY

Walk your children to school if you can. Turn the TV off and get your children playing. Have your children involved in at least one school sport or enroll them in an

out of school sport/activity. With the majority of families having both parents working these days it is

difficult to have to prepare healthy meals for them. We really need to make time as we are literally killing our kids by feeding them takeout regularly. A simple healthy meal is not too time-consuming .Every kid deserves this little time.

KEEPING ACTIVE. Regular exercise at least four days a week for at least fifteen minutes a day.

The more you exercise the more you build up your reserves of heart ,lungs, bone and muscles.

Be gentle but be persistent. Your cells will become more efficient in using oxygen and you will increase your staminal.

ENDURANCE EXERCISE will increase your energy. Walk, jog, bicycle or swim regularly. Exercise your mind as well as your body. Challenge yourself Develop the lifelong habit of physical and mental exercise.

To prepare a healthy balanced diet do not bother counting how many calories or measuring serving sizes but think in terms of colour, variety and freshness.

A proper and balanced morning can quickly boost your metabolic rate and eating small healthier food throughout the day is better than the standard 3 large (Square) meals.

Eat supper earlier in the day and fast for 14 – 16hours until morning the next day. Fill up on fruits and vegetables. Try to eat fruits, vegetables and veggies every day and

with every meal –the lighter the better. Eat better and balanced carbohydrates and whole grains for resilient energy. Whole

grains are very rich in phytochemicals and antioxides which help to prevent heart problems.

BEVERAGES Do not make the mistake of thinking that juices and beverages do not give rise to

excess weight .These contain chemical sweeteners and preservatives Best juices are those you prepare fresh.ALCOHOL The liver is the major organ which preserves metabolic processes, gets rid of toxins and

turns fats into energy. If stretched beyond capacity with toxins such as alcohol, it will be unable to process fat effectively….It gradually gets fatty.

HEALTHY BALANCE DIET.

If you are overweight or obese you must be very conscious of the following risk factors.

Cigarette smoking.

Hypertension..(BP> 140/90mmHg.

High risk low density lipoprotein(LDL) cholesterol.(Serum concentration >160mg/dL.A Cholesterol level of about 130-159mg/dL plus 2 or more other risk factors also confer high risk.

Low high desity lipoprotein (HDL) cholesterol. (Serum concentration < 35mg/dL

RISK FACTORS

Family history of premature CHD (at or before 55yrs of age among males or among females about 65yrs of age.

Impaired fasting glucose (IFG). A fasting level between 110 and 125mg/dL may be an independent risk factor for cardiovascular disease. IFG is well established as a risk factor in type 2 diabetes.

AGE > 45 yrs for men or >55yrs for women.

Risk Factors Cont.

I want to give this parting picture of a 39year old Mikel Ruffinelli She came into world attention in jan.2013 when she entered the Guinness book of records as the woman with the biggest hip in the world.

She weighs 420lbs (190kg.) Her height is 5ft 4ins( 1.62m)

Her hip measures 2.44m(8ft) in circumference. Incredibly her waist measures only 40inches.

This incredible lady said though she came from a family of biggies but she discovered that her hip got bigger with every pregnancy.(She has 3 daughters).

Her BMI IS 72.5!!!!!!!!.

Parting Shot

Mikel Ruffinelli

STATISTICS SUMMARY

She weighs 420lbs (190kg.)

Her height is 5ft 4ins( 1.62m)

Her hip measures 2.44m(8ft) in circumference.

Incredibly her waist measures only 40inches.

Her BMI IS 72.5!!!!!!!!.

I want to express my profound gratitude to the Companion Ikorodu Usrah for giving me this unique opportunity to contribute my little quota to her enlightenment programme. May ALLAH guide all of us right and accept this as an act of IBADAH.

Conclusion