Approach to OBESITY and Weight gain - causes, risk factors, BMI, complications and treatment

obesity is defined as excess fat with many associated comorbidities it is associated with a significant increase in mortality including a reduced life expectancy of up to 10 years the body mass index or bmi is the accepted standard measure of obesity and weight the bmi is represented by kilograms per meter squared being underweight has a bmi of less than 18.5 a normal bmi is 18.5 to 24.9 overweight 25 to 29.9 and obesity is greater than 30 which is then further divided into three different classes another measurement of obesity is waist circumference which takes into account central

auto adiposity and really has a better correlation to cardiovascular disease obesity is defined when the waist circumference in men is greater than 102 centimeters or greater than 40 inches in women greater than 85 centimeters or 35 inches the waist circumference is measured at the level of the iliac crest obesity is complex and the pathophysiology involves genetics and behavioral habits there is energy intake versus energy expenditure as well as changes in the neuroendocrine pathways but to put it simply really obesity occurs when you have increased energy intake but reduced expenditure and so all this accumulation of

energy just goes into fat deposits around the body the etiologies and risk factors of obesity it can be divided into behavioral things such as physical inactivity poor diet such as high you know take away foods also cessation of smoking because people take up other habits such as eating more further poor eating patterns such as overeating binge eating or night eating is associated with increased energy intake sleep deprivation is also a risk factor there are many medical causes of obesity these include hypothalamic obesity caused by damage to the hypothalamus a part of the brain that makes

hormones that control specific body function such as sleep as well as hunger growth hormone deficiency hypothyroidism low thyroid levels released from the thyroid gland hypogonadism in woman polycystic ovarian syndrome which is also associated with hirsutism syndrome is a very important medical cause and really patients manifest with elevated cortisol levels and you could get moon like faces and a buffalo hump there are many medications that can cause increase in weight these include namely corticosteroids which really lead to cushing's appearance and stimulates appetite so you eat more antipsychotics antidepressants beta blockers there are also anti-diabetic agents such

as insulin which causes mild weight gain as well as sulfonylureas complications of obesity is a lot and these include stroke the stigma associated with being obese respiratory issues such as obstructive sleep apnea obesity hypoventilation syndrome which is really characterized when you have slightly increased amounts of carbon dioxide in the body gastroesophageal reflux disease heart diseases including heart attacks hypertension hyperlipidemia a fatty liver disease diabetes urinary incontinence osteoarthritis from all the weight increased risk of gout venous thrombosis hernias as well as a increased risk of certain malignancies as well to know something called metabolic syndrome which

is really encompasses obesity as well metabolic syndrome describes a constellation of medical condition which increases the risk of cardiovascular disease these conditions include insulin resistance hypertension hyperlipidemia and obesity all this make up metabolic syndrome the treatments for obesity well there's many approaches but first is to address the underlying cause if it's medical or behavioral as well as addressing the triggers you want to set a realistic goal for example five percent body weight reduction per year and good idea to create an action plan involving a certain diet such as a low calorie diet an exercise program

pharmacotherapy or medications also have a role in the treatment of obesity usually when all other things fail these pharmacotherapies include a glp-1 agonist now a glp-1 is a normal peptide that's produced by the body which slow gastric which slows gastric emptying inhibits glucagon excretion and stimulates insulin production the side effects of this include nausea and vomiting further glp-1 agonists are given as an injection into the tummy or the thigh and so this could also be a sort of a side effect in a way orlistat is another medication that works on the pancreas by inhibiting the

pancreatic lipase lipase is an enzyme which helps break down fat so that fat can be absorbed by the body by inhibiting you know fat absorption you're essentially preventing fat accumulation the side effects of all this that include gastrointestinal upset as well as diatoria a fatty stool sympathomimetics can also be used for the treatment of obesity and these include phenteramine sympathomimetics really they increase the sympathetic activity in your body and so your fight or flight response and so you increase energy expenditure another very very important treatment for obesity is bariatric surgery and there are many types

there's the adjustable gastric band so it really suppresses appetite by really you know reducing the amount of food that you can actually take in to your stomach there's a sleeve gastrectomy you're shaving off part of the stomach and so you have less space for food there's a roux and wire gastric bypass which looks complicated but really the take-off message for barack surgery is that bariatric surgery is associated with the reduced all-cause mortality to non-surgical management for obesity and what all-cause mortality means is that any death that occurs in patients who have obesity regardless of the

cause of the death so i hope you enjoyed this video we talked about obesity how to measure weight using bmi or waist circumference the different causes and risk factors for obesity as well as the complications and treatment thank you for watching i hope you enjoyed this video [Music] you