How To Tackle Obesity

Four renowned doctors decode the challenges with obesity and the conditions connected with it.

Tackling The Dual Epidemics: Diabetes & Obesity

Dr Mangesh Tiwaskar, MD (Med), FRCP (Lon./Ire./Glas./Edin.), FACP, FICP, FGSI. Diploma in Adv. Diabetology (Denmark). Gold Medalist – MD (Medicine), MBBS (Biochemistry, Pathology, Microbiology & Pharmacology). Consultant Diabetologist, Shilpa Medical Research Centre, Mumbai. Editor in Chief, JAPI, On Editorial Board of Medicine Update, IJD, Guest Editor, Insulight Journal, World Journal of Anaemia, 104 publications in Peer

There is a strong link between obesity and diabetes. These twin epidemics have become closely intertwined, with obesity emerging as a significant risk factor for the development of diabetes. It contributes 80-85% towards the development of type 2 diabetes. According to the National Diabetes Statistics Report, in 2013-2016, 45.8% adults with diabetes had obesity, and 15.5% had extreme obesity. The increasing incidence of diabetes can thus be attributed to the global epidemic of obesity.

Lifestyle factors play a pivotal role in the development and progression of obesity and diabetes. Sedentary lifestyle, an unhealthy diet and excessive calorie intake promote weight gain and can lead to insulin resistance. Inadequate sleep and chronic stress can disrupt metabolic processes and also influence obesity.

A healthy diet involves consuming a variety of nutrient-rich foods such as fruits, vegetables, whole grains, lean proteins, and healthy fats while limiting processed foods and sugary beverages. Additionally, maintaining an active lifestyle, engaging in regular exercise, managing stress levels, and getting sufficient sleep are vital. Adequate intake of essential micronutrients, including vitamin D, magnesium, chromium, and omega-3 fatty acids, can lower the risk of both.

Emphasizing the importance of an active lifestyle, a nutritious diet, and stress management techniques is crucial in addressing the dual epidemics of obesity and diabetes.

The Heavy Burden: Obesity’s Impact On Joint Health

Dr Sanjay Prasad Hegde, (M.S) Orthopaedic and Joint Replacement Surgeon, Arthroscopy and Sports Medicine, Hip Surgery, with 29 years of experience, Manipal Hospital, formerly Columbia Asia Hospital, Bangalore, India.

The prevalence of obesity has been progressively rising in recent years, and it is now a serious global health concern. Obesity can significantly affect joint health in addition to being a risk factor for chronic diseases like diabetes and cardiovascular disease. The link between obesity and joint pain is undeniable, with many individuals struggling with mobility and experiencing constant discomfort as a result of carrying excess weight.

Obesity is one major factor that causes an increase in joint pain. Obesity-related excess weight has the potential to place additional pressure and stress on joints, which results in pain, stiffness, and inflammation. It poses a significant threat to joint health, with the knees, hips, ankles, and spine particularly susceptible to the adverse effects of excess weight.

Lack of physical activity contributes to weight gain, which, in turn, places excessive stress on joints. Unhealthy dietary choices, such as consuming processed foods high in sugar and unhealthy fats, can lead to weight gain and inflammation, further worsening joint health.

Adopting an active lifestyle, engaging in regular exercise, maintaining a balanced and nutritious diet, and seeking appropriate medical care can help prevent and manage obesity while improving joint health and reducing the risk of joint-related issues.

PCOS & Obesity

Dr Rohan Palshetkar, MS OBGY, FRM, Head of Unit, DY Patil Bloom IVF, Associate Professor, DY Patil School of Medicine, Consultant OBGY, Sir HN Reliance Foundation Hospital, Surya Hospital, Santacruz, Breach Candy Hospital, DY Patil Hospital, Palshetkar Patil Nursing Home. Treasurer, AMOGS, Joint Treasurer, Maharashtra Chapter of IAGE, Managing Committee Member of Mumbai Obstetrics and Gynaecological Society and Maharashtra Chapter of ISAR.

Polycystic Ovary Syndrome (PCOS) affects one out of 16 women. It is a very common condition that affects all areas of the body, not just the reproductive system. It increases a woman’s risk of serious conditions that may have lifelong consequences. Although the cause of PCOS is not known, PCOS may be related to many different factors working together. These factors include insulin resistance, increased levels of hormones called androgens, and an irregular menstrual cycle.

More than a half of women with PCOS are obese, and later, obesity amplifies the symptoms of PCOS. It is important also to consider possible effects of PCOS on further weight gain, or at least on hampering attempts at weight loss and maintenance through lifestyle changes. Treatment is tailored to each woman according to her symptoms and other health problems.

Effective weight loss implementation remains the most effective and promising management strategy for women with PCOS. Weight loss also has been found to make menstrual periods more regular, improve cholesterol and insulin levels, and relieve symptoms such as excess hair growth and acne.

PCOS treatment focuses on managing the things that are concerning you. This could include infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication.

To help ease the effects of PCOS, try to:
• Stay at a healthy weight
• Limit carbohydrates
• Be active

Obesity & Liver Health

Dr Nageshwar Reddy, MD, DM, D.Sc, FAMS, FRCP, FASGE, FACG, MWGO, FAGA, FJGES, FAAAS. Founder & Chief of Gastroenterology, Asian Institute of Gastroenterology (AIG) Hospital, Hyderabad – an alumnus of PGI Chandigarh, the first Indian President of the World Endoscopy Organization, the first Indian doctor to start a mobile endoscopy unit, the first recipient of the Rudolf Schindler Award from the American Society of GI Endoscopy (ASGE). He has published over 730 papers in National & International Peer Review Journals, developed the NOTES procedure to enable “scarless” abdominal operations, pioneered gastro-care with innovation and research driven therapeutic endoscopy. Dr Reddy has put India at the center for GI Disease Treatment.

The alarming epidemic of obesity has fueled an increasing prevalence of liver disorders, particularly NAFLD. It is normal for the liver to contain some fat. However, if more than 5%-10% of the liver’s weight is fat, then it is called a fatty liver (steatosis). The estimated global prevalence of NAFLD in individuals over the age of 18 is 25.2%. Asia has shown a sharp increase in NAFLD cases with a pooled frequency of 29.6%. NAFLD is the leading cause of abnormal functional liver tests in the primary care setting.

It encompasses a wide spectrum of conditions starting from a build-up of fat in hepatocytes (steatosis), to developing inflammation (steatohepatitis), and reaching up to cirrhosis. It is also associated with higher rates of cardiovascular mortalities. Causes of NAFLD include excess weight/obesity, type 2 diabetes, high cholesterol, high triglycerides, high blood pressure, and excessive fat in the belly area.

Timely treatment is essential and weight loss remains the cornerstone in the treatment of obesity-related liver diseases. Oxidative stress often contributes to the progression of NAFLD, and hence, antioxidants such as silymarin, silybin, and vitamins A, C, and E added to your daily intake may help keep liver damage from getting worse. Orlistat is effective for improving serum lipid profiles, including total cholesterol, LDL, and HDL cholesterols, in patients with obesity.

To prevent NAFLD:

• Maintain a healthy weight

• Eat nutritious foods

• Exercise regularly

• Limit alcohol intake

• Only take medicines that you need and follow dose recommendations

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