Expertise Details



• The term obesity implies excess of adipose tissue measured by the following-

• Body mass index (BMI). It is defined as person's weight (kg) divided by the square of person's height (metres).

WHO has recommended following standards for definitions of obesity and other terms:

*Obesity: BMI >30 kg/m2.

*Overweight: BMI 23.1-29.9 kg/m2.

*Normal: BMI 18.5-23 kg/m2.

*Underweight: BMI <18.5 kg/m2.

• Ideal body weight for height. Calculated by multiplying square of height in meters by 22.5.

*Overweight: More than 10% of ideal body weight.

*Obesity: More than 20% of ideal body weight.

*Underweight: Less than 20% of ideal body weight.

• Skin fold thickness.

*Estimated by using special calipers.

*Skin fold thickness measured over triceps, biceps, subscapular and suprailiac regions.

*Normal triceps skin fold thickness in males-12.5 mm.

*Normal triceps skin fold thickness in females-16.5 mm.

• Waist circumference and waist to hip ratio.

*Waist measurement at the narrowest segment between ribcage and iliac crests. Waist circumference >80 cm in females and >90 cm in males indicate abdominal obesity.

*Maximum measurement over buttocks as hip measurement.

*Waist:hip ratio <0.8 in females and <0.9 in males-normal.

*Waist:hip ratio >0.8 in females and >0.9 in males-abnormal.


Simple Obesity- • Physical inactivity • Eating habits

• Psychological factors (overeating may be a symptom of depression, anxiety and frustration)

• Genetic factors

Secondary Obesity- • Hypothyroidism • Cushing's syndrome

• Hypothalamic disorders • Diabetes mellitus

• Medications-valproic acid, carbamazepine, antidepressants, corticosteroids, antipsychotics and glipizide.

Risk Associated with Obesity

• Coronary artery disease • Type 2 diabetes mellitus and insulin resistance • Hypertension • Stroke

• Breast, endometrial and colon cancers • Varicose veins • Depression • Dyslipidaemia

• Cholelithiasis • Sleep apnoea syndrome • Osteoarthritis • Increase in all-cause mortality

• Deep vein thrombosis



•Attempt initially to reduce weight by approximately 10% from baseline. Further weight reduction is attempted after initial success.

• Reduce weight at a rate of about 1/2-l kg per week for 6 months.

1-Diet Therapy

A-Low- Fat Diet

• Encourage low-calorie diets with low fat. The reduction is usually to the tune of about 500 calories per day.

• Reducing fat alone without reducing total calories is not sufficient.

B-Very Low Carbohydrate Diet or Atkins Diet

C-High-Protein Diet

• It makes use of the increased satiating effect of protein with reduction in carbohydrate. Fat is kept low at 30%.

• These high protein-low carbohydrate diets induce fat burning and mild ketosis, which results in suppression of hunger and promotion of satiety.

2-Physical Exercise

• It reduces abdominal fat and increases cardiorespiratory fitness.

• Moderate exercise should be done for 30-45 minutes/day and 3-5 days a week.

3-Behaviour Modification

• It is a useful adjunct to diet and physical exercise.

• Patients often require motivation to lose weight.



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