Written by: Dr. Shraddha Thakur
Edited by : Pratibha Thakur
obesity is a medical condition of excess body weight when a person is 20% or more above the ideal body weight it can occur at any age in either sex
Major causes of obesity is due to overeating and lack of exercise
The body mass index ( BMI) and waist circumference are obesity measure that normally used to detect and classify the state and level of obesity. Further in this article, we will define obesity in detail and also describe the obesity treatment in detail in this article.
Table of Contents
- Definition
- WHO classification of BMI
- Etiology
- Causes
- Sign and Symptoms
- type of obesity
- Diagnosis
- Differential Diagnosis
- Complication
- Naturopathy diagnosis
- Investigation
- Management through naturopathy
- Yoga therapy
Definition of obesity
obesity is a chronic condition defined by an excessive deposition of storage of fat in adipose tissue that is sufficient magnitude to impair health. It usually result from consumption of food in excess of physiological needs
Normally a certain amount of body fats necessary for storing energy, heat insulation, shock absorption and other functions
WHO classification of obesity
- classification BMI Associated Health risk
- Underweight <18.5 Low
- Normal 18.5-24.9 Average
- Overweight > 25
- Pre- obese 25-29.9 increased
- Obese class-1 30-34.9 moderate increased
- Obese class-2 35-39.9 Severe increased
- class -3 ( obese) >40 Very severely increased
The body mass index ( BMI)
The body mass index is calculated using a person height and weight
The body mass index ( BMI) equal a person weight in kilograms (kg) divided by their height in meter ( m) square
Etiology
the balance between calorie intake and energy expenditure determines a person's weight. The most common cause of obesity are overeating and physical inactivity there are various causes of obesity described below
Causes of obesity
1. inherited causes/ genetic causes
2. Environmental causes-
(a) eating habits-
overeating
Frequency of eating
A diet high in simple carbohydrate
(b) physical inactivity
(c) other cause - 1. Age
2. Pregnancy
3. Lack of Sleep
4. Socioeconomic conditions
5. Certain medications like steroids , ocp's
6. Psychological factors
7. Disease like hypothyroidism, polycystic ovarian syndrome, insulin resistance, high eating syndrome etc
Sign and symptoms of obesity
1. Increased weight
2. Thickness around the midsection
3. Difficulty in movement
4. Darkening and thickening around neck, axilla, elbow, under breast, waist and groin
5. Feeling dull , lazy and lethargic
6. Breathlessness
7. Difficulty in sleep
8. Feeling very tired every day
9. Inability to cope with sudden physical activity
10. Back and joint pains
11. Low confidence levels
12. feeling isolated in society
13. People may also experience psychological problem such as- low self esteem
14. Obesity can also cause change such as hypertension, high cholesterol level and type 2 diabetes
15. Snoring
16. Pain in joints
Type of obesity
1. Android type/ apple shape/ central obesity -
Adipose tissue accumulation occurs predominantly in the upper half of the body
These patient have - hyperinsulinemia , diabetes mellitus , dyslipidemia, hyperuricemia ,
Coronary artery disease, hypertension.
These type of obesity is hypertrophic and the treatment offers slightly better result
2. Gynoid shape / pear shape/ visceral obesity-
Adipose tissue accumulation occurs predominantly in the lower half of the body ( pelvis, thigh) it is associated with varicose vein and arthritis
This type of obesity is hyperplasia and resistant to treatment
Diagnosis
obesity is usually determined by looking at the body
Measuring weight in proportion to height is the traditional way of determining whether one person is overweight, obese or normal weight
Test to diagnose obesity includes -
- Taking case history
- A general physical exam
- Calculating body mass index ( BMI)
- Waist circumference or waist to hip ratio
- Skinfold caliper/ thickness
- Water displacement test
- Checking for other health problems
- Blood test
Differential diagnosis
- Acromegaly
- Ascites
- Down syndrome
- Cushing syndrome
- Polycystic ovary disease
- Hypothyroidism
- Myxedema
- Chronic hepatic disease
Complication of obesity
Type -2 diabetes, hypertension, hyperlipidemia , hyperuricemia , ( metabolic syndrome)
Osteoarthritis , varicose veins, urinary incontinence ( mechanical effect of weight)
Gall stone commonly cholesterol stones ( due to enhanced biliary secretion of cholesterol, super saturation of bile)
Non- alcoholic fatty liver disease ( non -alcoholic steatohepatitis which may lead to cirrhosis)
Hormone- dependent peripheral steroid inter - conversion in adipose tissue
Gout , hernia, cervical and lumbar spondylitis
Increase risk of fetal defect associated with maternal obesity
Cancer ( obesity in males increase risk of cancer of esophagus, colon, rectum , pancreas, liver and prostate . Obesity in females is associated with endometrium ,ovaries and cervix
Naturopathy diagnosis -
1.facial diagnosis -
(a) general obesity is represented by mixed encumbrance
(b) central obesity is represented by front encumbrance
2. Iris diagnosis -
weekend and relaxed digestive tract is indicated by distention of areas of stomach and bowel in iris
3. Swara diagnosis -
dominance of left nostril breathing is observed
4. Chromo diagnosis -
red deficient
Investigation
1. Fasting lipid profile ( total cholesterol,
Triglycerides, LDL, HDL, VLDL)
2. Fasting thyroid profile ( T3, T4, TSH)
3. Fasting insulin
4. Fasting blood sugar (FBS)
5. Post Prandial blood sugar ( PPBS)
6. Liver function test
7. Renal function test
8. Serum Uric acid , urea , growth hormone (GH) cortisol
Abdominal USG
Management through naturopathy
Counselling -
Importance of diet, physical activity, permanent lifestyle changes after the ideal weight is achieved should monitor, record the circumstance related to eating
Fasting therapy -
( intermittent fasting followed by calorie restriction)
The basic principle of fasting - to improve insulin resistance by reducing the food intake, intermittent fasting for 2 days a week improve leptin sensitivity
Intermittent fasting also decrease key indicator of coronary heart disease ( CHD) risk such as LDL cholesterol and triglycerides
Diet therapy -
Food becomes poison, when the quantity is increased
Water drinking
Juice diet ( seasonal fruit juice, vegetable juice) this juice diet may be continued for a week depending on the condition of the patient, juice like mango juice, grape juice may be avoided because of its high sugar and calories
- Live or natural food
- Low fat
- Low carbohydrates
- Low calories
- High fiber diet
- Sattvic diet
- Liberal amount of fluid
- Sprouts includes
Commonly used herbs and spices including- fenugreek seed, ginger, turmeric and cinnamon have quality that aid digestion, lower inflammation, control blood sugar levels and speed up metabolism- using herbs as a form of morning and night herbal tea
Time. Food
- Morning Herbal tea
- Breakfast One bowl (400 (gm) Fruit Salad
- Lunch Germinated seeds (Approx -50-100gm,This may be seasonal
With fresh lemon juice , pepper a pinch of black Salt ,coriander leaves and mint according to Individual taste .
- Midafternoon One glass of coconut Water
- Dinner One bowl of seasonal Fruit Salad
- Night drink Herbal drink
Above diet may be given for a week.
After a week evening fruit salad may be replaced with one bowl of steamed vegetables.
This type of diet not only help to reduce obesity but also prevent cardiovascular disease, arthritis, cancer etc .
Following food are strictly banned for obese individuals-
1. White sugar
2. Refined wheat flour ( maida)
3. Soft drink , health drink
4. Cake , pastries, chips , samosa
5. Bottled juice, sauces, syrups
6. Preserved stored, ready foods Noodles, pasta etc
7. Deep fried, oily foods, cheese, Butter, paneer
8. Refined grains- white bread, White rice, white pasta
9. Potatoes ( fried)
10. Red meat ( beef , pork , lamb) And processed meats ( salami,
Ham, bacon , sausage
Hydrotherapy
1. Gastro hepatic pack
2. Local cold pack and sauna bath are recommended which are clinically significant
3. Steam bath
4. Cold hip bath (20 minutes during fasting and juice diet)
5. Neem water enema ( for treatment of any unsatisfactory bowel evaluation and essential during liquid diet
6. Water drinking 2 to 3 .5 liters of water daily
Chromotherapy
metabolic disorder are generally caused due to deficiency of yellow and orange colors ( application of light filtered through different colored glasses, external or internal use of color charged water
Massage therapy
full body massage once a week followed by hot water bath and partial massage on abdomen and waist on alternate days can be advocated
Heliotherapy
1. Sun bath for about 15- 20 minutes early morning 6- 7 am
2. Plantain leaf bath
Mud therapy
1. mud pack on abdomen for 20 to 30 minutes
( Early morning )
2. Full mud bath once a week
Acupuncture therapy
Treatment - Main points -
- CV -6
- CV -1
- St -2
- St -25
- St -29
- Sp -15
Supplementary points-
- GB -21
- H -7
- P-6
- St -36
- GB -34
- Sp -6
Ear points -
- Stomach
- Shenmen
- Large intestine
Scalp needling - Gastric area
Stimulation -
1. Mild electrical stimulation, 20 to 30 minutes daily, for 2 weeks
2. Course may be repeated after 2 to 3 weeks
3. Tapping with seven star needle should be done on Hauto's point on alternate days
Remarks -
1. Fat and carbohydrate free diet should also be advised with acupuncture
2. Motivation of the patient is very essential
3. Author has got very good results in case of obesity with acupuncture in combination with yogic exercise like Surya namaskar, vajrasana etc
4. Results are very good
Yoga therapy
Aim - 1. To improve overall health
2. To reduce weight
3. To modify the lifestyle
4. To maintain ideal body weight
5. To reduce stress and depression
- Asana -
- Trikonasana
- Vajarasana
- Halasana
- Vipritkarni
- Ardha matsyendrasana
- Naukasana
- Shavasana
- Sarvangasana
- Pavanmuktasana
- Shalabhasana
- Bhujangasana more details.....
- Dhanurasana
- Surya namaskar
2. Pranayama -
- Nadishodhana
- Bhastrika
- Kapalbhati
3. Kriya -
- Kunjal kriya
4. Relaxation -
- Yoga nidra
5. Meditation -
- Breath awareness
Other therapy -
1.exercise therapy -
(a) stepping exercise is very effective in burning the calories
(b) under water exercise are useful to improve mobility and circulation
(c) obese children have to be motivated to do skipping and dancing
2. Music therapy -
Music therapy decrease chronic stress and improve harmonal balance
3. Reflexology and acupressure -
Bare foot walking, pebble walking help to balance the energy in all form ( PRANA, TRIDOSHA, PANCHA MAHABHUTAS)