Medically, obesity means accumulation of excessive body fat. Obestiy is becoming increasingly common throughout the world. It is more common among women than men. Obesity in the most common mutritional disaster of the recent years. Specialised clinics offering weight-loss therapy have sprung like mushrooms and now the obesity treatment is a money – spiring enterprise. Many people believe that obesity indicates prosperity and the midrif paunch begets respect!

How to determine obesity:

There is medically, a differentiation between over – weight and obesity. The body mass index (BMI) is used to determine these conditions. It is a reliable method.

BMI = Weigth in kilograms

——————————

Heigth x Height inmetres

Example: Your weight is 80 K.G. and height is 1.7 meters.

Your BMI = 80

—————– = 27

1.70 x 1.70

Refer, then to the BMI table

Box

BMI table

17 – Under Weight

18-25 – Normal

25.1 to 29.9 – Over weight

30 to 40 – Obesity (moderate)

More than 40 – Obesity (severe)

Measurement of your waist line also is to be considered. A waist circumference of more than 40 inches in men and 35 inches in women, usually indicates and excess of fat around the waist.

Causes of obesity

The simple cause is eating more calories than what the body uses. The require ment of calories varies from person to person and is dependent on factors like age, life style habits, physical activity etc. Binge eating, quickly large amounts of food. When not hungry, heavy intake of sweet and oily, fried food etc are reasons for obesity. Eating well or rather too well is related to affluence. Hence the side effect of prosperity could be obesity. Followed by Diabetes. Food of the rich people is normally high in fats. Fats could trigger over – acting because fats donot satiate appetite like carbohydrates or protein. Fats contain twice as many calories per gram as carbo – hydrates and proteins.

? Genetic factors could cause obesity. In herent metabolic problem can promote obesity. Obesity tends to run in families and in some ethnic or social groups. However, the exact role of genetics in etiology of obesity is still not clear, though there is evidence that hereditory could cause obesity. Both here ditory and environment play a role in body weight regulation. Scientists found that mutations in the ‘ob’ gene

? Prevent production of Leptin, a protein made by fat cells. Leptin interacts with hypothalamus in controlling appetite. If leptin production is prevented, appetite can not be satiated, thus overeating is the result. With all these research, there is still no positive genetic treatment of obesity.

? Lack of physical activity is one of the principle causes of obesity. Physical activity mayincrease food intake but when physical activity decreases, correspondingly food intake must decrease but in reality this does not happen. For some people it even increases. Sedantary people need fever calories.

? Certain drugs can cause obesity-notably anti – depressant, anti – psychotic drugs, antihypertensives, cortico – steroids and drugs for diabetes cause weight gain.

? Women tend to gain body weight, after menopause. This could be attributed to hormonal changes, stress, reduction in physical activity during the menopause period.

? Conditions like hypothyroidism, stress, depression, cushings syndrome etc may cause over eating and consequent accumulation of fat. But some researchers say that except stress other emotional disturbances are no longer considered an important cause of obesity.

? Drinking alcohol may cause obesity. It is relatively high in calories. One gram of alcohol yields 200 K cal/ownce, almost as much as fat.

The mechanism of fat digestion and absorption

Every one knows that fat is one of three main constituents of food (the others being carbohydrates and protein). Fat supplies energy to the body. It is stored by the body as energy in the Adipose tissues.

The digestion of fats starts in the stomach with the action of gastric lipse. It breaks down short etain triglycerides (found in butter) into fatty acids and glycerol. The stomach stops with this action as it can not break down larger mole cules of fat. In the small intestine bile breaks down the large molecules of fat to smaller fat particles. The fatty acids and glycerol are reassembled to triglycerides, which along with cholesterol and phospholipids, are surrounded by a protein coat, forming chylomicrons. In this form, these are then caused to the liver and adipose tissue for metabolism and storage.

Adipose tissues are fibrous connective tishues packed with masses of fat cells. The body stores excessive fat in the adipose tissues of the abdomen (omental fat), under the skin and in the buttocks for use when needed. The body cannot synthesize some fats called essential fatty acids. These are linoleic, linolenic and arachidonic acids. These are to be absorbed from food. Linolein and linolenic are found invegetable oils – cornoil, soya bean oil etc. All fats and oils have three types of fatty acids – saturated, mono-saturated and poly unsaturated. If saturated fatty acids are taken in large quantities, cholestered level will increase. Poly unsaturated fatty acids do not raise cholesterol levels and mono – unsaturated acids lower cholesterol levels and raise HDL (good cholesterol) levels. The following table shows the ratio of these fatty acids in various types of edible oils.

Risk factors

? Obesity doubles or triple the risk of premature death

? The heart has to work harder and cardio – vascular problems are caused. Heart failure is more common among fat people.

? Even minimum exertion brings on breathing difficulties.

? The limbs have to carry more weight, the body joints need

Hence ostoe – arthritis may develop. Low back pain also may result.

? Fat people sweat more because they can not eliminate body heat efficiently. Skin disorders are common because of moisture trapped in skin folds.

? Breathing problems may disturb sleep.

? Fatigue, obese persons tire easily.

? While men may flaunt their obse body, obese women may feel inferior for fat women are normally called ugly. This leads to inferiority complex and emotional disturlances. If the fat in women is located around their waist (omentum fat) like a “tyre”, it causes the so called “apple” shape and it fat accumulates around the thighs and buttocks it causes the “pear” shape. Obese women start haring low self esteam, social rejection and continue over eating for consolation.

? Obesity is one of the main reason for Diabetes and high blood pressure.

Ayurvedic conception of obesity

The term for obesity in Ayurveda is “sthaulya”. “Meda” in Ayurveda means fat and obesity is termed also as “Medaroga”

Causes of obesity according of Ayurveda:

? Consuming sweetened foods, also cold and fatty foods (Madhura Annaha), wrong food habits.

? Not exerting physically (Avyama), laziness

? Sleeping in the afternoon – (Divaswapna)

? The diet and life style which increase khapa (shleshmala Ahara vihara)

? Impairment of digestive Agni.

? Any change in the equlibrium of 7 dhatus (basic tissue elements) in the body. Fat (Meda) is one of these 7 dhatus.

? Lack of sexual activity.

? Lack of mental exercise.

? Hereditory and genetic disorders.

Health risks of obesity according to caraka

Caraka lists eight problems

1. Shortened life span

2. Copious sweating

3. Difficulty in movement

4. Difficulty in sexual inter course

5. Fatigue

6. Body odour

7. Excessive Hunger

8. Excessive Thirst

Management obesity

1. First and foremost requirement is motivation and determination to reduce weight. Behaviour modification is needed for weight loss. The obese person must understand that 1. Obesity is a disorder resulting from excess calorie intake. 2. Obese individual eats more and is more sensitive to food stimuli than non – obese individual. 3. Without controlling the diet or dieting without physical exercises, weigh reduction is not possible 4. One should not believe advertisements of slimming centres claiming huge reduction in weight in just a few weeks, 5. Remember that you will bose weight if you turn more calories than your consume. Activities that burn calories are giving below.

2. Ayurveda recommends a judicious mixture of exercises and slimming diet. Regular exercises are very important component in the treatment of obesity. Walking is the easiest and best form of exercise. Start with 1 km distance initially and in 3 months reach the goal of 5 kms. Swimming also is a good exercise that helps to shed the extra kilos – Jogging and Aerobic exercises are overy good.

Tips on eating

? Avoid foods that increase kapha and medha (fat). Avoid sweets and oily food.

? Consume more wheat products than rice varieties

? Horse gram helps in reduction of fat.

? Use butter milk instead of curd

? Drink warm water

? Food should include yava (barley), green gram, Amla and snake gourd.

? Take honey (one teaspoon) with Lemon juice (made with 1/2 lemon) twice or thrice a day, preferably on empty stomach.

? To lessen the use of cooking oil, use non – stick cook ware. Reduce deep trying – Instead, resort to boiling.

? Reduce intake of salt. Salt may increase body weight.

? Opt for low calorie foods, artificial sweeteners.

? Cut down intake of fatty foods.

? Drink warm water instead of chilled water.

? Eat small portions of food, more number of times than eating one or two heavy meals at a time.

? Strive to take off 200 of 300 calories from your food. Increase physical activities so that you can burn off another 100-200 calories a day. You will surely boose weight.

Other Ayurvedic remedies / tips

? Ayurveda advises increase in sexual activities.

? Avoid sleeping during the daytime.

? Obese persons should take daily one tablespoon of Triphala (Haritaki – cherubic myrobalan, ve-bee thaki – Terminalia belerica and Amla – phyllanthus embilica) mixed with honey.

? Ayurvedic treatment for obesity, consists of

1. Oil massage (Athyanga) – Massage with medicated oil

2. Dry massage (Udwarthana) – Massage using weight reducing powders, Normally a combination of Triphala and horse gram bowders are used. This is one of the good Ayurvedic treatment and should be taken for 14 to 21 days, atleast for 1 hour a day. Udwardhana brings down body weight, considerably. Amlaki churna, Nimbro (Neem) chinna powders are also used in this massage therapy.

3. Combination of Abhyanga, swedhanam (hot fomentation) and Udwardhana is also carried out the ensure positive weight reduction.

4. Ultimately the special Ayurvedic treatment ‘Pancha karma’ can be given. The treatment comprises of Vamana (emesis) Virechana (laxatives), Kasya Vasthy (decoction enema) etc. A special panchakarma treatment called ‘Basti’ also is carred out. This will fortify the metabolism.

Another thumb – rule to calculate

how much you should weight.

Substract the figure 100 from your height in centi – metres. Ninety percent (90%) of the balance is the correct weight you should have. It your actud weight is more than 10% of your theoretical weight, then you are obese.

e.g. your height – 180 cm.

180 – 100 = 80 c.m. 80 x 90

——— = 72 kilos.

100

Ayurvedic Herbs

Ayurvedha considers that digestive ‘Agni’ is important for breaking up and assimilating fats.

Impairment of this Agni causes obesity. Therefore if recommends use of herbs like

1. Guggulu – (Commiphora Mukul)

2. Sunthi – (Dried ginger)

3. Pippali – (Piper longum)

4. Maricha – (Piper Nigrum)

Medications

1. Navaka Guggulu

2. Arogyavarthani vati

3. Triphala Guggulu

4. Sthulyabara kashayam etc.

Yoga

It goes without saying that yoga is as essential to weight – reduction as diet or medication.

Vipareetha karani, savasana Dhanurasana, Trikonasana, Pawamukhtasana, Bhujangasana, etc. Yogasanas will give positive results.

Siddha vaidya advocates drinking plaintain stem juice or Ashgourd juice (1/2 cup) frequently. It also advises weekly once consumption Agattigreen (sesbania grandiflora)

Obesity can be corrected. But donot fall pray to hype that claim to reduce your weight in just 2 weeks. Resort to a combined therapy, consisting of life style changes, diet regimen, physical exercises, yoga and medications, if messary.