Never in human history has there been so much excess food on the table as there has been in the past few decades. Over the past 50-75 years, science and technology have greatly improved the level of food production and preservation. This really helps eliminate famine and improves the overall health of society.
However, this creates its own dangers. Throughout history, our ancestors have been wandering or physically active in some way since the days of primates. That changed over the past few decades as men were handcuffed to chairs. Human life expectancy is at its peak, with baby boomers easily living into their eighties.
Economic Survey 2023-24: Improving health of India’s youth crucial
Too much food on the table and lack of mobility are taking their toll on humanity. This is indeed the era of non-communicable diseases (NCDs) such as diabetes, hypertension, dyslipidemia and obesity.
I see patients in their seventies coming in for heart surgery. Most of these patients are not overweight, but the children who accompany them to hospital appointments or surgeries are severely obese.
It’s strange, but common now, with patients at both ends of the age range having heart problems. As expected age increases, we see many older patients. With the increase in non-communicable diseases, we are also seeing some young and middle-aged patients with heart disease.
obesity
Obesity is a chronic, complex disease defined by excess fat deposition that impairs an individual’s health. Obesity increases the risk of diabetes, high blood pressure, heart disease, and affects bone health. It also increases the risk of certain cancers and greatly affects quality of life, such as sleep and mobility.
According to the World Health Organization, the global incidence of obesity is currently high: one in eight people worldwide is obese and one in three is overweight. Since 1990, global adult obesity rates have doubled and adolescent obesity rates have quadrupled: 37 million children under five are overweight; more than 390 million children and adolescents aged 5-19 are overweight; and 160 million children and adolescents are obese.
So what do we mean by obesity? The diagnosis of overweight and obesity is based on body mass index (BMI) – weight (kg) / height2 (rice2). For adults, overweight means a BMI greater than 25 kg/m2 Obesity refers to a BMI greater than 30 kg/m2.
Genetic variation affects obesity risk
In 2000, the World Health Organization expert group proposed that the BMI standard for overweight is 23-24.9kg/m2Obesity>25kg/m2 Applicable to individuals from the Asia Pacific region based on international standards. Therefore, we need to use these values to define the level of obesity in India.
childhood obesity
Childhood obesity is a growing health hazard in India. Childhood obesity can lead to poor self-esteem and depression. Obese children are susceptible to adult obesity, leading to diabetes, hypertension and other complications early in life. India has the second highest number of obese children in the world.
Causes of childhood obesity include too little activity and too many calories from food and drink, but genetic and hormonal factors also need to be evaluated. Regular intake of high-calorie foods, such as fast food, baked goods and carbonated drinks, is a common cause of childhood obesity. While sweets and desserts can also contribute to obesity, growing evidence suggests that sugary drinks and sports drinks are the culprits.
indian pictures
Like other countries, India is affected by the obesity epidemic. The obesity rate in India is about 13%, which is much higher than other middle-income countries.
Apart from this issue, another worrying aspect of the Indian population is normal weight obesity, which means that despite having a normal body mass index (BMI), the Indian population has higher body fat. Another variant of obesity in this population is sarcopenic obesity. These people have an increased body mass index or waist circumference, along with sarcopenia (severe loss of muscle mass).
Waist circumference is a very important indicator of obesity, but it is often ignored in our country. The incidence of increased waist circumference in men and women of normal weight is as high as 65%. These people are called TOFI (thin on the outside but fat on the inside). The TOFI group has high fat deposits around the waist and a high incidence of diabetes, hypertension, and heart disease. The ideal waist circumference for this group is 90 cm for men and 80 cm for women.
Overweight and obesity kill 3.4 million people worldwide every year. India ranks third, after China and the United States. Overweight and obesity create financial burdens. In addition to the direct medical costs incurred by the nation, overweight and obesity are associated with indirect costs associated with seeking health care, financial losses from premature death, absenteeism, and negative impacts on work productivity.
Obesity has deleterious effects on individuals, families, societies and countries. One challenge is that obesity can cause mental health problems, including low self-esteem, mood disorders, motivational disorders, eating problems, body image issues, and negatively impact interpersonal interactions.
Solving the Obesity Problem
Simply losing weight can lower blood pressure, improve cholesterol levels, and reduce the incidence of diabetes, all at once and without taking any medications.
New drugs for treating obesity are quite effective, but they are expensive and not without side effects. Metabolic or bariatric surgery is effective, but the costs involved and the long-term nutritional and protein supplementation required must be considered.
Recognizing, focusing on, promoting and addressing this issue are pillars of the campaign to prevent and treat obesity.
Adhering to a healthy diet and carefully avoiding high-carb foods and junk food is the need of the hour. Regular physical activity and simple lifestyle changes are a must. It is recommended to set a goal of 6,000-8,000 steps per day, which can be easily tracked through a smart watch or mobile phone, and perform light weight training. Simple remedies, such as avoiding elevators altogether, walking short distances instead of using a car, and avoiding long periods without cell phones and television, can also help.
Organizations and companies can set walking goals for their employees. Regularly checking your weight and waist size can in itself create motivation to address this issue.
(Dr. Anbarasu Mohanraj is Director and Clinical Head, Cardiac Surgery, Vadapalani Kauvery Hospital, Chennai. anbarasu.mohanraj@gmail.com)
Published – January 3, 2025 05:00 AM (US Standard Time)