Causes of obesity

Overeating
Lack of Exercise Heredity factors which reduce basal metabolic rate
Insulin resistance, leads to sugar build up causing obesity and diabetes.
Low leptin levels – does not allow brain to get signal that food intake is enough.
Endocrine and chromosomal abnormalities

Obesity is a national epidemic, causing higher medical costs and a lower quality of life.

• • • Obesity is a contributing cause of many other health problems, including heart disease, stroke, diabetes, and some types of cancer. These are some of the leading causes of death in the U.S. Obesity can cause sleep apnea and breathing problems and make activity more difficult. Obesity can also cause problems during pregnancy or make it more difficult for a woman to become pregnant.
    • Obese persons require more costly medical care. This places a huge financial burden on our medical care system.

Why is this epidemic happening?
• Weight gain occurs when people eat too much food and get too little physical activity.
• Societal and community changes have accompanied the rise in obesity.
• People eat differently:

• • Restaurants, snack shops, and vending machines provide food that is often higher in calories and fat than food made at home.
  • There is too much sugar in our diet. Six out of 10 teens drink at least 1 sugary drink per day.
  • It is often easier and cheaper to get less healthy foods and beverages.
  • Foods high in sugar, fat, and salt are highly advertised and marketed.

• Many communities are built in ways that make it difficult or unsafe to be physically active:

• • Access to parks and recreation centers may be difficult or lacking and public transportation may not available.
  • Safe routes for walking or biking to school, work, or play may not exist.
  • Too few students get quality, daily physical education in school.

Source: Adapted from Yale University Rudd Center for Food Policy and Obesity

Obesity Table

Source: National Heart, Lung, and Blood Institute Table Calculate Your Body Mass Index Web Site.

Obesity is a complex problem that requires a strong call for action, at many levels, for both adults as well as children.
• Promote change

• • Empowering parents and caregivers.
  • Providing healthy food in schools.
  • Improving access to healthy, affordable foods.
  • Increasing physical activity.

This can be achieved by multipronged approached at different levels:

Government can
• Support hospital programs that encourage breastfeeding.
• Adopt policies that promote bicycling and public transportation.

Communities can
• Create and maintain safe neighborhoods for physical activity and improve access to parks and playgrounds.
• Advocate for quality physical education in schools and childcare facilities.
• Encourage breastfeeding through peer-to- peer support programs.
• Support programs that bring local fruits and vegetables to schools, businesses, and communities.

General population can
• Eat more fruits and vegetables and fewer foods high in fat and sugar.
• Drink more water instead of sugary drinks.
• Limit TV watching in kids to less than 2 hours a day and don’t put one in their room at all.
• Support breastfeeding.
• Promote policies and programs at school, at work, and in the community that make the healthy choice the easy choice.
Try going for a 10-minute brisk walk, 3 times a day, 5 days a week.

Teen Obesity
Obesity continues to increase dramatically in India.

Obesity is an excessive accumulation of body fat such that individuals are at least 20 percent heavier than their ideal body weight. “Overweight” is defined as any weight in excess of the ideal range. Obesity is a common eating disorder associated with adolescence.

overweight children are at high risk of becoming overweight adolescents and adults
Obesity can weaken physical health and well-being, and can shorten life expectancy. It can also lead to social disabilities and unhappiness, which may cause stress and even mental illness. Studies suggest that overweight children are more likely to be involved in bullying than normal-weight children are, both as victims and as perpetrators of teasing, name-calling and physical bullying.

The development of a personal identity and body image is an important goal for adolescents. Your parents, physician and teachers can help you. If you think you are overweight, talk to a trusted adult about what you can do to improve your health.

Why is childhood obesity considered a health problem?
Doctors and scientists are concerned about the rise of obesity in children and youth because obesity may lead to the following health problems:
• Heart disease, caused by:
high cholesterol and/or
high blood pressure
• Type 2 diabetes
• Asthma
• Skin fold infections
• Sleep apnea
• Social discrimination
• Stroke

Liver and Gallbladder disease Backaches, ankle fractures, joint dislocations and joint pains are common
Hyperinsulinism leads to Diabetes
• Sleep apnea and respiratory problems
Backaches, ankle fractures, joint dislocations and joint pains are common

Hyperinsulinism leads to Diabetes
• Inflammation of pancreas
• Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)
• Gynecological problems (abnormal menses, infertility)
• Emotional damage due taunts, ridicule, feeling of negative body image causing anxiety and depression

Childhood obesity is associated with various health-related consequences. Obese children and adolescents may experience immediate health consequences and may be at risk for weight-related health problems in adulthood.

Psychosocial Risks
Some consequences of childhood and adolescent overweight are psychosocial. Obese children and adolescents are targets of early and systematic social discrimination.

The psychological stress of social stigmatization can cause low self-esteem which, in turn, can hinder academic and social functioning, and persist into adulthood.

Cardiovascular Disease Risks
Obese children and teens have been found to have risk factors for cardiovascular disease (CVD), including high cholesterol levels, high blood pressure, and abnormal glucose tolerance. In a population-based sample of 5- to 17-year-olds, almost 60% of overweight children had at least one CVD risk factor while 25 percent of overweight children had two or more CVD risk factors.

Additional Health Risks
Less common health conditions associated with increased weight include asthma, hepatic steatosis, sleep apnea and Type 2 diabetes.
Asthma is a disease of the lungs in which the airways become blocked or narrowed causing breathing difficulty. Studies have identified an association between childhood overweight and asthma.
Hepatic steatosis is the fatty degeneration of the liver caused by a high concentration of liver enzymes. Weight reduction causes liver enzymes to normalize.
Sleep apnea is a less common complication of overweight for children and adolescents. Sleep apnea is a sleep-associated breathing disorder defined as the cessation of breathing during sleep that lasts for at least 10 seconds. Sleep apnea is characterized by loud snoring and labored breathing. During sleep apnea, oxygen levels in the blood can fall dramatically. One study estimated that sleep apnea occurs in about 7% of overweight children.
Type 2 diabetes is increasingly being reported among children and adolescents who are overweight.
While diabetes and glucose intolerance, a precursor of diabetes, are common health effects of adult obesity, only in recent years has Type 2 diabetes begun to emerge as a health-related problem among children and adolescents. Onset of diabetes in children and adolescents can result in advanced complications such as CVD and kidney failure.
In addition, studies have shown that obese children and teens are more likely to become obese as adults.

References
1NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available online:
http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf (PDF-1.25Mb)

When it comes to weight loss, there’s no lack of fad diets & programs promising fast results It’s about a lifestyle that includes healthy eating, regular physical activity, and balancing the number of calories you consume with the number of calories your body uses.

Staying in control of your weight contributes to good health now and as you age.
Take Control

Assess Your Weight
The first step is to determine whether or not your current weight is healthy. BMI – Body Mass Index is one way to measure your weight.
Lose Weight
Healthy weight loss isn’t just about a “diet” or “program”. It’s about an ongoing lifestyle that includes long-term changes in daily eating and exercise habits.
Prevent Weight Gain
To stay at a healthy weight, it’s worth doing a little planning now. If you are overweight but aren’t ready to lose weight, preventing further weight gain is a worthy goal.

You may have noticed a change in how your clothes fit. Or maybe you’ve been told by a health care professional that you have high blood pressure or high cholesterol and that excessive weight could be a contributing factor. The first step is to assess whether or not your current weight is healthy.

IS MY WEIGHT HEALTHY ?

BMI
calculate your “body mass index” (BMI) to determine whether your weight is healthy. For most people, BMI is a reliable indicator of body fatness. It is calculated based on your height and weight.

BMI chart.
• If your BMI is less than 18.5, it falls within the “underweight” range.
• If your BMI is 18.5 to 24.9, it falls within the “normal” or Healthy Weight range.
• If your BMI is 25.0 to 29.9, it falls within the “overweight” range.
• If your BMI is 30.0 or higher, it falls within the “obese” range.

If your BMI falls outside of the “normal” or Healthy Weight range, you may want to talk to your doctor or health care provider about how you might achieve a healthier body weight. At an individual level, BMI can be used as a screening tool but is not diagnostic of the body fatness or health of an individual.

A trained healthcare provider should perform appropriate health assessments in order to evaluate an individual’s health status and risks.

Waist Circumference
Another way to assess your weight is to measure your waist size. Your waistline may be telling you that you have a higher risk of developing obesity-related conditions if you are:
• A man whose waist circumference is more than 40 inches
• A non-pregnant woman whose waist circumference is more than 35 inches

Excessive abdominal fat is serious because it places you at greater risk for developing obesity-related conditions, such as Type 2 Diabetes, high blood cholesterol, high triglycerides, high blood pressure, and coronary artery disease. Individuals who have excessive abdominal fat should consult with their physicians or other health care providers to develop a plan for losing weight.

How To Measure Your Waist Size1
To measure your waist size (circumference), place a tape measure around your bare abdomen just above your hip bone. Be sure that the tape is snug, but does not compress your skin, and is parallel to the floor. Relax, exhale, and measure your waist.

Balancing Calories
Balanced diet is one which has carbohydrates, proteins , fats , vitamins , minerals and water in the right proportion. Whether you’re consuming carbohydrates, fats, or proteins all of them contain calories. If your diet focus is on any one of these alone, you’re missing the bigger picture.

The Caloric Balance Equation
Weight management is all about balance—balancing the number of calories you consume with the number of calories your body uses or “burns off.”
A calorie is defined as a unit of energy supplied by food. A calorie is a calorie regardless of its source. Whether you’re eating carbohydrates, fats, sugars, or proteins, all of them contain calories.
Caloric balance is like a scale. To remain in balance and maintain your body weight, the calories consumed (from foods) must be balanced by the calories used (in normal body functions, daily activities, and exercise).
If you are… Your caloric balance status is…
Maintaining your weight “in balance.your caloric intake is almost the same as your caloric expenditure. Hence your weight is stable
Gaining weight “in caloric excess.” You are eating more calories than your body is using. You will store these extra calories as fat and you’ll gain weight.
Losing weight “in caloric deficit.” You are eating fewer calories than you are using. Your body is pulling from its fat storage cells for energy, so your weight is decreasing.

Am I in Caloric Balance? (pic)

If you are maintaining your current body weight, you are in caloric balance. If you need to gain weight or to lose weight, you’ll need to tip the balance scale in one direction or another to achieve your goal.

If you need to lose weight, keep in mind that it takes approximately 7,500 calories below your calorie needs to lose 1 kg of body fat.1 To lose about 1 kg per week, you’ll need to reduce your caloric intake by 1100 calories per day.

To learn how many calories you are currently eating, start writing down the foods you eat and the beverages you drink each day.. Also write down the physical activity you do each day and the length of time you do it.

Recommended Physical Activity Levels
2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).
Increasing the intensity or the amount of time that you are physically active can have even greater health benefits and may be needed to control body weight.
Encourage children and teenagers to be physically active for at least 60 minutes each day, or almost every day.
The bottom line is… each person’s body is unique and may have different caloric needs. A healthy lifestyle requires balance, in the foods you eat, in the beverages you consume, in the way you carry out your daily activities, and in the amount of physical activity or exercise you include in your daily routine. While counting calories is not necessary, it may help you in the beginning to gain an awareness of your eating habits as you strive to achieve energy balance. The ultimate test of balance is whether or not you are gaining, maintaining, or losing weight.

Questions and Answers About Calories

Q: Are fat-free and low-fat foods low in calories?
A: Not always. Some fat-free and low-fat foods have extra sugars, which push the calorie amount right back up. The following list of foods and their reduced fat varieties will show you that just because a product is fat-free, it doesn’t mean that it is “calorie-free.” And, calories do count!
Always read the Nutrition Facts food label to find out the calorie content. Remember, this is the calorie content for one serving of the food item, so be sure and check the serving size. If you eat more than one serving, you’ll be eating more calories than is listed on the food label.

Q: If I eat late at night, will these calories automatically turn into body fat?
A: The time of day isn’t what affects how your body uses calories. It’s the overall number of calories you eat and the calories you burn over the course of 24 hours that affects your weight.

Q: I’ve heard it is more important to worry about carbohydrates than calories. Is this true?
A: By focusing only on carbohydrates, you can still eat too many calories. Also, if you drastically reduce the variety of foods in your diet, you could end up sacrificing vital nutrients and not be able to sustain the diet over time.

Q: Does it matter how many calories I eat as long as I’m maintaining an active lifestyle
A: While physical activity is a vital part of weight control, so is controlling the number of calories you eat. If your caloric consumption and expenditure are not balanced , you will gain weight.

Q. What other factors contribute to overweight and obesity?
A: Besides diet and behavior, environment, and genetic factors may also have an effect in causing people to be overweight and obese.

Cutting Calories at Every Meal
You can cut calories by eating foods high in fiber, making better drink choices, avoiding large portion size, and adding more fruits and vegetables to your eating plan.

Losing Weight
Even a modest weight loss, such as 5 to 10 percent of your total body weight, can produce health benefits as it kick starts your body metabolism and you will lose weight at a rapid rate.

Physical Activity for a Healthy Weight
Physical activity can increase the number of calories your body uses for energy or “burns off.” The burning of calories through physical activity, combined with reducing the number of calories you eat, creates a “calorie deficit” that can help with weight loss.

Other Factors in Weight Gain
Overall there are a variety of factors that play a role in obesity – behavior, environment, and genetics may have an effect in causing people to be overweight and obese.

Environment
People may make decisions based on their environment or community. For example, a person may choose not to walk to the store or to work because of a lack of sidewalks. Communities, homes, and workplaces can all influence people’s health decisions. Because of this influence, it is important to create environments in these locations that make it easier to engage in physical activity and to eat a healthy diet. Parks , sidewalks, trails , recreation and fitness centres , even malls provide good opportunity for walking

Genetics
How do genes affect obesity?

Science shows that genetics plays a role in obesity. Genes can directly cause obesity in specific disorders such as Bardet-Biedl syndrome and Prader-Willi syndrome.

However genes do not always predict future health. Genes and behavior may both be needed for a person to be overweight. In some cases multiple genes may increase one’s susceptibility for obesity and require outside factors; such as abundant food supply or little physical activity.

Diseases and Drugs
Some illnesses may lead to obesity or weight gain. These may include Cushing’s disease, and polycystic ovary syndrome. Drugs such as steroids and some antidepressants may also cause weight gain.

A doctor is the best source to tell you whether illnesses, medications, or psychological factors are contributing to weight gain or making weight loss hard.

Preventing Weight Gain
As people age, their body composition gradually shifts — the proportion of muscle decreases and the proportion of fat increases. This shift slows their metabolism, making it easier to gain weight. In addition, some people become less physically active as they get older, increasing the risk of weight gain.

Prevention can be done by choosing a lifestyle that includes good eating habits and daily physical activity. By avoiding weight gain, you avoid higher risks of many chronic diseases, such as heart disease, stroke, type 2 diabetes, high blood pressure, osteoarthritis, and some forms of cancer.

Choosing an Eating Plan to Prevent Weight Gain
The goal is to make a habit out of choosing foods that are nutritious and healthful. Choose a diet that has adequate caloric requirement for body and should be balanced by caloric expenditure to prevent weight gain. his number varies from person to person. It depends on many factors, including your height, weight, age, sex, and activity level..

Get Moving!
Although physical activity is an integral part of weight management, it’s also a vital part of health in general. Regular physical activity can reduce your risk for many chronic diseases and it can help keep your body healthy and strong..

Self-monitoring
You may also find it helpful to weigh yourself on a regular basis. If you see increase in weight , assess your lifestyle and make appropriate changes.
Ask yourself—
• Has my activity level changed?
• Am I eating more than usual? You may find it helpful to keep a food diary for a few days to make you more aware of your eating choices.

Keeping the Weight Off
Losing weight is the first step. Once you’ve lost weight, you’ll want to learn how to keep it off.

Losing Weight

What is healthy weight loss?
Gradual weight loss is more effective than rapid weight loss. Since almost 1500 calories/day have to be burnt over a week to lose 1 kg of fat , it is very difficult and can be achieved at a gradual rate . Too rapid weight loss leads to loss of muscles which puts a load on the kidneys in the long run and causes renal damage. Losing weight is not easy, and it takes commitment. But if you’re ready to get started, we’ve got a step-by-step guide to help get you on the road to weight loss and better health.

Even Modest Weight Loss Can Mean Big Benefits
The good news is that no matter what your weight loss goal is, even a modest weight loss, such as 5 to 10 percent of your total body weight, is likely to produce health benefits, such as improvements in blood pressure, blood cholesterol, and blood sugars.

So even if the overall goal seems largecontinuing the journey is important rather than jumping to the final destination. You’ll learn new eating and physical activity habits that will help you live a healthier lifestyle. These habits may help you maintain your weight loss over time.

In addition to improving your health, maintaining a weight loss is likely to improve your life in other ways. That those who had maintained a significant weight loss reported improvements in not only their physical health, but also their energy levels, physical mobility, general mood, and self-confidence.

Improving Your Eating Habits
Your eating habits may be leading to weight gain; for example, eating too fast, always clearing your plate, eating when you not hungry and skipping meals (or maybe just breakfast).

Keeping the Weight Off
Losing weight is the first step. Once you’ve lost weight, you’ll want to learn how to keep it off. remove calorie-rich temptations!

Although everything can be enjoyed in moderation, reducing the calorie-rich temptations of high-fat and high-sugar, or salty snacks can also help you develop healthy eating habits.