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Dr. Nalinikanta Mishra

MPH, BPT, DNGOM, CSTT, SHOUGM

Obesity is a disease characterized by excessive body fat. People who are medically obese usually are affected by behavior, genetic and environmental factors that are difficult to control with dieting. Obesity increases the likelihood of certain diseases and other related health problems.

India’s women are more likely to be obese than their male counterparts, new research shows.There were 20 million obese women in India in 2014 compared with 9.8 million obese men, according to a study published in the British medical journal, the Lancet.Severe obesity was observed in an additional 4 million Indian women. There were less than 800,000 obese women in India in 1975 compared with 400,000 obese men. The study, comparing body-mass index from 1975 to 2014 from adults in 186 countries showed middle- and poorer-income countries like China, India and Brazil jumped in rankings when it came to obesity although India and China also have the most underweight citizens in the world.Worldwide, the number of obese people rose to 641 million in 2014 from 105 million in 1975, according to the study. Global obesity rates almost tripled for men to 11% of the total from 3.2% in 1975, while among women it nearly doubled to 15% from 6.4% in 1975.

What causes obesity?

Obesity is due to an individual taking in more calories than they burn over an extended period of time. These “extra” calories are stored as fat. Although there are several factors that can lead to this energy imbalance in obese individuals, the main contributors are behavior, environment and genetics.

Behavior

In today’s fast-paced environment, it is easy to adopt unhealthy behaviors. Behavior, in the case of obesity, relates to food choices, amount of physical activity you get and the effort to maintain your health. Based on food choices, many people now select diets that are calorie-rich, but nutrient-poor. This behavioral problem also relates to the increase in meal quantity at home and when dining out.

Environment \r\n\r\nEnvironment plays a key role in shaping an individual’s habits and lifestyle. There are many environmental influences that can impact your health decisions. Today’s society has developed a more sedentary lifestyle. Walking has been replaced by driving cars, basic physical activity has been replaced by technology and nutrition has been overcome by fast foods.\r\n\r\nGenetics \r\n\r\nScience shows that genetics play a role in obesity. Genes can cause certain disorders which result in obesity. However, not all individuals who are predisposed to obesity become obese. Research is currently underway to determine which genes contribute most to obesity.

Consequences of obesity

Physical

The most prevalent obesity-related diseases include:

  • Diabetes
  • High blood pressure
  • High cholesterol
  • Heart disease
  • Stroke
  • Gallbladder disease
  • Gastroesophageal Reflux Disease (GERD)
  • Osteoarthritis
  • Sleep apnea and respiratory problems
  • Some cancers

Social

Individuals affected by obesity often face obstacles far beyond health risks. Emotional suffering may be one of the most painful parts of obesity. Society often emphasizes the importance of physical appearance. As a result, people who are obese often face prejudice or discrimination in the job market, at school and in social situations.

Effects at Work\r\n\r\nDue to the negative stigma associated with obesity, obese employees are often viewed as less competent, lazy and lacking in self-discipline by their co-workers and employers. Often times, discriminatory attitudes can negatively impact salary, promotions and employment status for obese employees.\r\n\r\nFinding a job can also be a difficult task for an obese individual. Studies show that obese applicants are less likely to be hired than thinner applicants, despite having identical job qualifications.\r\n\r\nEffects at School\r\n\r\nEducational settings also provide the possibility for discriminatory situations. Obese children face numerous obstacles, ranging from harassment, teasing and rejection from peers, to biased attitudes from teachers.\r\n\r\nAt a young age, children are exposed to obesity’s negative stigma. Obese children are sometimes characterized as being unhappy, lazy, mean and not having many friends.

MANAGEMENT

Physiotherapists have a role to play in the prevention and management of obesity. Obesity leads to restrictions in movement, affecting engagement in physical activity.

Exercise and movement is the keystone of the scope of physiotherapy practice.Along with a holistic, patientcentred, and problem solving approach, physiotherapists have advanced knowledge and skills in:

  • anatomical, physiological, and psychosocial mechanisms of health and disease
  • assessment and diagnosis
  • behavior change
  • biomechanics
  • exercise prescription and therapeutic exercise
  • Management of long-term conditions.

Physiotherapists are therefore ideally suited to address the physical and psychological complexities of obesity. Physiotherapists provide valuable input and expertise in the multi-disciplinary management of obesity, helping to optimise clinical outcomes and patient experience.

While the importance of being physically active is well recognised, in reality patients often experience difficulties in doing so. It is important to facilitate patients to increase physical activity at the right level, which can be achieved by referral to a physiotherapist. An assessment and treatment plan from a physiotherapist will help overcome the barriers to exercise.

A treatment plan for an obese patient may comprise of:

  • provision of personalised lifestyle advice, taking into account individual attitudes, beliefs,circumstances, cultural and social preferences, and readiness to change
  • prescription, supervision, and progression of appropriate physical activity to increase muscle strength, flexibility, and endurance, and sustain energy output to enhance and maintain weight loss under safe and controlled conditions
  • management of associated conditions such as arthritis, back pain, and other musculoskeletal and chronic conditions, such as heart disease
  • co-ordination of comprehensive and sustainable programmes of management in collaboration with service users, other health and social care professionals, and community services.
September 20, 2016 • No Comment