Article by Dr. Manjunath Malige, Lead Consultant – Bariatric Endocrinology & Diabetes, Aster RV Hospital
Pune, 9 April 2021: The world has seen increasing rates of obesity over the years, making this a growing epidemic that has also been witnessed in India. It is estimated that about 1.5 billion people in the world are overweight. According to the latest National Family Health Survey (NFHS) conducted in 2019-20, there is an increased share of obese men and women in India, with the state of Karnataka reporting the most increase in the numbers of obese women over the years. This is a worrying sign as not only does unaddressed obesity in women lead to multiple health complications, obesity during pregnancy could also have an impact on the child, putting them at a greater risk of developing obesity in adulthood, creating a vicious cycle that will be difficult to break. India is on a lower rung in terms of obesity burden compared to regions such as the US and Europe, however considering the growing adherence to Western food and lifestyle habits, we must address the issue before it reaches greater proportions.
How do I know if I am obese?
Broadly speaking, calculating the BMI is the standard for determining where a person falls on the weight range. A BMI that is 30 or greater is considered to be in the range of obesity, and between 25-30 is considered to be overweight. Calculating the BMI is simple – just divide body weight in kgs with height in meters. However several other factors also play a role in determining a healthy weight and lifestyle for a person, including the person’s body frame and activity levels. Skinny people for example may not appear obese due to a fast metabolism but as a result of an unhealthy lifestyle, they could also be at risk of developing health issues that are connected to obesity. It’s important to visit a weight management clinic to understand exactly where you stand.
How does obesity impact women?
There is overwhelming evidence that obesity can wreak havoc on a woman’s health in several different ways. Indians in particular suffer from abdominal specific fat which has a direct impact on the function of the organs located in the abdominal region such as the liver, uterus, gall bladder etc which can have a ripple effect on the rest of the body.
- Impact on Fertility: Overweight women often have imbalanced hormonal levels, making it difficult for her to conceive in comparison to normal weight women. Severely imbalanced hormonal levels can lead to menstrual dysfunction, break in ovulation, and an increased risk of developing PCOS.
- Impact on pregnancy: Pregnant women suffering from obesity are often at a higher risk of suffering miscarriage and pregnancy related complications. The child is also likely to be more prone to developing obesity during its later years.
- Type 2 Diabetes: Obesity leads to an increased risk of developing pre-diabetes or Type 2 diabetes. Extra weight in the body over time leads to high levels of inflammation and fatty acids in the body, eventually causing insulin resistance.
- Stroke, hypertension and heart disease: Extra weight puts excessive pressure on the heart to supply blood to different parts of the body, leading to an increased risk of high blood pressure/hypertension, blockages and poor blood flow. This puts the individual at an increased risk of developing stroke, hypertension and even heart attack. Obesity has a big role to play in the increasing incidence of heart disease in women in India
- Cancer: Excessive weight leads to chronic inflammation in the body which over time can lead to the formation of cancerous cells. Such women are at a higher risk of developing endometrial, ovarian and breast cancers.
Returning to good health
It can be beneficial for severely obese people to visit a weight management clinic to seek help. In most cases, it has been observed that severely obese people have tried to lose weight on their own but have not succeeded due to various reasons, due to which they become disheartened and lose hope. In such cases, support from family, a dedicated plan and a motivated set of individuals is required to help address each person’s obesity on an individual basis. Severe obesity needs to be treated with sensitivity as it can lead to mental health issues as the person struggles with losing weight while facing backlash from society. In certain cases, bariatric surgery has shown great merit in helping control weight and reverse obesity related comorbidities. People who are moderately overweight can attempt to devise their own exercise and food routine to return to a healthy weight, and if unsuccessful, they can reach out to a dietitian or an endocrinologist experienced in weight management.