The Obese, BMI and Treatment

Sep 1, 2016,

Being overweight or obese significantly increases the risk of morbidity (disease) and mortality from Type 2 diabetes and other related diseases. It is said that Obesity is a combination of genetic (hereditary traits)  and environmental (lifestyle features) factors. A gene known as the OB gene has been implicated in families known to have a history of Obese individuals. 
Successful weight reduction also has a positive impact on mortality and morbidity outcomes.
Obesity is largely a result of diet and lifestyle and to a large extent is treatable through focused exercise modules, lifestyle modifications and occasionally medication. 


Measurements for evaluation of Obesity
The two commonest methods for determining Obesity are:
Body Mass Index(BMI): used for calculation of overall obesity of an individual. 
Waist/Hip Ratio: determination of central fat distribution.


BMI calculation:
Weight in kg divided by height in meters square (m2), expressed as Kg/m2


Classification of BMI

  • Underweight: ˂18.5 Kg/m2
  • Normal weight: 18.5 – 24.9 Kg/m2
  • Overweight: 25 – 29.9 Kg/m2
  • Obesity (Class 1): 30 – 34.9 Kg/m2
  • Obesity (Class 2): 35 – 39.9 Kg/m2
  • Extreme Obesity(Class 3): ˃40 Kg/m2

Note: BMI represents overall adipose type (overall fat distribution density in the body) 


Waist/Hip Ratio calculation

This is Determined by the Waist/Hip ratio (WHR). It 
Assesses the pattern of fat distribution in the body, whether they are mostly peripheral or centrally distributed.


WHR = Waist Circumference (in cm) divided by Hip Circumference.

How to derive Waist Circumference & Hip Circumference 

Using a well graduated tape measure for;

Waist Circumference: measures midway between the lower rib margin & the iliac crests (the bony prominence you feel around the side of your waist) 
Hip Circumference: the largest circumference of the hip. Divide the value gotten from the Waist Circumference by the value gotten for the Hip Circumference. 

Important Notes from your measurements. 
Upper limits: 102cm and 88cm in men and women respectively. Values above this indicate a higher level in central fat distribution which is very unhealthy. 

Risk factors for Obesity

  1. Sedentary lifestyle
  2. Lack of exercise 
  3. Excessive alcohol consumption4
  4. Poor sleep5
  5. High calorie consumption6
  6. Family history7
  7. Psychological/emotional factors 8
  8. Binge eating

Health Consequences

  • High Blood Pressure (Hypertension)
  • Type 2 Diabetes
  • Coronary Heart Disease/Heart attack
  • Stroke
  • Breathing and Sleep problems
  • Some Cancers (Breast, Colon, Ovarian, Kidney, endometrial, gallbladder, liver)
  • Low quality of life
  • Mental illness such as clinical depression, anxiety
  • Body pain and difficulty with physical functioning.
  • Decreased workplace productivity.

Treatment Objectives

  1. To educate patient and caregivers
  2. Achieve an ideal body weight
  3. Prevent Complications.

Management

  1. Assess dietary intake, level of physical activity as well as BMI
  2. Assess efficacy of weight loss measures or program
  3. Integrate weight control measures into the overall management of diabetes mellitus if: BMI is˃25 or Waist Circumference is 102cm (men), ˃88cm (women)
  4. Educate patients and family members
  5. Set realistic goals
  6. Dietary modification and increased level of physical activity are the most economical means to lose weight
  7. Maintain record of goals, instructions and weight loss progress charts.
  8. Surgical intervention may be required in extreme cases. 
  9. Have a plan and stick to it. Motivation is key from experience. 

Culled from Management of Common Workplace Hazards and Illnesses by Dr Chimere Kanu 

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By Chimere Kanu (ID: DOC811)       Comments       Rating: