Obesity and the modern woman

weightage

Obesity is a growing epidemic that affects women more often than men. The prevalence of overweight and obesity among women in the India has reached the point where it is more common than normal weight women.
 
Obesity negatively impacts the health of women in many ways. Being overweight or obese increases the relative risk of diabetes and coronary artery disease in women. Women who are obese have a higher risk of low back pain and knee osteoarthritis. It also has negative effects such as pregnancy complications, menstrual disorders, psychological disorders, and urinary stress incontinence.

Maternal obesity is associated with a decreased intention to breastfeed, decreased initiation of breastfeeding, and decreased duration of breastfeeding. There seems to be an association between obesity and depression in women, though cultural factors may influence this association. Obese women are at higher risk for multiple cancers, including endometrial cancer, cervical cancer, breast cancer, and perhaps ovarian cancer.

The modern woman has much more to perform and prove today. Along with the family responsibility, her partnership in fiscal endeavors, social activities and her personal expectations all influence her lifestyle. With limited hours and increasing chores, two vital aspects of health are affected – diet and exercise.

Diet strays towards fast foods, junk foods and take-aways rather than home-cooked food. This affects more than one person as the food habits of entire family maybe at peril leading to adolescent obesity. On the other hand, exercise duration diminishes and mental stress increases. All this have immense negative impact on weight and associated diseases.

The social impact of obesity is tremendous. It becomes challenging for an obese woman to carry out her routine activities. Office pressures due to low productivity, ridicule in social circles and early fatigue making her unable to provide enough support to all at home. All these create a sense of ‘not being up to the mark’ which then starts a vicious cycle of depression, low self esteem and worthlessness.

It is not difficult to imagine that a disease such as obesity, which has multi-factorial cause and far-reaching implications, would require more than just a simple prescription of diet and exercise. A balanced diet, less in calories and high in protein and nutrients, definitely is the main stone in the barricade against obesity. Likewise, an exercise regimen is very important to keep muscles strong and cholesterols low. Many drugs came in use but most were withdrawn due to their meager weight loss effect and severe side-effect profile.

Bariatrics surgery is the most drastic and durable way to lose weight. No other modality causes more than 80% Excess Weight Loss. The use of laparoscopy in recent years to perform these operations have made the procedures very comfortable for the patients. Moreover, the small incisions used in this approach gives women a major cosmetic advantage. Persons who are in the ‘surgical bracket’ i.e. have their Body Mass Index (ratio of weight and height) above 32kg/m2 and/or having the above co-morbidities derive the greatest benefit.  Weight loss starts immediately after surgery. Patient loses 6-10 kgs in first 10 days and then approximately 10 %of excess weight per month. By the end of year, about 60-70 % excess weight is lost.

(The writer is a metabolic and bariatric surgeon)