Epidemiology/Causes:

a) Age: Obesity can occur at all ages. The incidence of obesity increases with age. Obese infants are more likely to be obese in later life.

One-third of obesity in adults has been life long, ie since infancy.

Most adipose cells are formed in early life, therefore infants who have more of these cells (hyperplastic obesity) are more likely to be obese in infancy and later life. It is very difficult to treat hyperplastic obesity in adult life.

b) Genetic Factors: There are genetic factors that could explain the aetiology of  obesity. There is a close relationship in the weight of identical twins, even if they are brought up in different environments.

c) Familial Tendency: It is well known that obesity runs in families. It is very difficult to determine if familial obesity is due to genetic factors, because members of the same family have similar eating habits.

d) Sex: Men are more likely to be obese at a relatively young age (between 29 and 35 years) while women gain most weight between 45 and 49 years of age.

e) Physical inactivity: There is an increased incidence of obesity among people who are physically inactive (Company executives) .This is a vicious cycle,ie the increase in obesity causes reduction in physical activity which in turn increases obesity.

f) Endocrine factors: This provides the explanation of obesity in Cushing’s syndrome and growth hormone deficiency. Endocrine factors are probably not involved in obesity in normal ndividuals.

g) Socio-economic status: There is an inverse relationship between obesity and socio-economic status.

h) Eating habits: This is very important. Eating in-between meals and preference to fats, refined foods and sweets can easily cause obesity.

Prevention of Obesity:

Prevention of obesity should begin in early childhood. Children should be taught about healthy eating habits.

Individuals at risk of obesity should be told to eat diets low in fat and high in fiber (like roots, cereals, legumes, fruits and vegetables). They should also avoid sedentary lifestyle and take regular exercise.

Control of Obesity:

i) Weight reduction by dietary changes: Dietary changes include an increase in high fiber foods (Please see above-as discussed in prevention of obesity). It is unfortunate that attempts in reduction in weight by dietary advice is usually unsuccessful.

ii) Increased physical activity: Regular physical activity can help reduce obesity, for effective reduction of weight this must be combined with dietary advice.

iii) Severe Obesity: In severe obesity surgery may be beneficial in some patients (eg Gastric bypass, gastroplasty etc).

References:

Short Textbook of Public Health Medicine for the Tropics- Adetokunbo O. Lucas and Herbert M. Gilles-4th edition.

Obesity and Pregnancy -Chapter 33 by Rani Akhil Bhat .Medical Disorders in Pregnancy- An Update .edited by Hiralal Konar and Pralhad Kushtagi. Federation of Obstetric and Gynaecological Societies of India.First Edition.

WHO 2000 No. 894

WHO 1995 No 854

FAO/WHO/UNU 1985 No. 724- Energy and protein requirements.

Chapter 6 Epidemiology of Non- Communicable diseases -Park’s Textbook of Preventive and Social Medicine by K Park.

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