Obesity is one of the most common disorders in medical practice and among the most frustrating and difficult to manage. Little progress has been made in its treatment in the last 25 years, yet major changes have been understood about its causes and its implications for health.
Obesity is defined as an excess of adipose tissue. The exact criterion for how much is too much is controversial. When greater quantities of energy (in the form of food) enter the body than are expended, the body weight increases. Therefore obesity is obviously caused by excess input over energy output. Excess energy input occurs only during the development phase of obesity, and once a person has become obese, all that is required of him to remain obese is that his energy input equals his energy output. For the person to reduce, the output must be greater than the input. Indeed, studies of obese persons, once they have become obese, show that their intake of food is almost exactly the same as that of person with normal weight.
Rate of feeding is normally regulated in proportion to the nutrient stores in the body. When these stores begin to approach an optimal level in a normal person, feeding is automatically reduced to prevent overstorage. However, in many obese persons this is not rue, for feeding does not slacken until body weight is far aoove normal. Therefore, in effect, obesity is often caused oy an abnormality of the feeding regulatory mechanism. This can result from either psychogenic factors that affect the regulation or actual abnormalities of the hypothalamus itself.
Psychogenic obesity
Studies of obese patients show that a large proportion of obesity results from psychogenic factors. Perhaps the most common psychogenic factor contributing to obesity is prevalent idea that healthy eating habits require three meals a day and that each meal must be filling. Many children are forced into this habit by over-solicitous parents, and the children continue to practice it throughout life.
Genetic Factors in Obesity
The genes can direct the degree of feeding in several different ways, including (i) a genetic abnormality of the feeding centre that sets the level of nutrient storage high or low, and (ii) abnormal hereditary psychic factors that either whet the appetite or cause the person to eat as a ‘release’ mechanism.
Childhood Overnutrition
The number of fat cells in the adult body is determined almost entirely by the amount of fat stored in the body during early life. The rate of formation of new fat cells is especially rapid in obese infants, and it continues at a lesser rate in obese children until adolescence. Thereafter, the number of fat cells remains almost constant throughout the life. Thus, it is believed that overfeeding children, especially in infancy and to a lesser extent during the older years of childhood, can lead to a life-time obesity.
Health Consequences of Obesity
Obesity is associated with significant increase in both morbidity and mortality. A great many disorders occur with greater frequency in obese people. The most important and common of these are hypertension, type-II diabetes mellitus, hyperlipidemia, coronary artery disease, degenerative joint disease and psychological disability. But certain cancers (colon, rectum and prostate in men; uterus, biliary tract, breast and ovary in women), thromboembolic disorders, digestive tract diseases and skin disorders are also more prevalent in the obese.
The death rate increases in proportion to the degree of obesity. Relative weights of 130% are associated with an excess mortality rate of 35% and relative weights of 150% are greater than two-fold excess death rate. Persons with ‘morbid’ obesity have as much as a 10-fold increase in death rate.
Preksha — Yoga management
Shat kriyas – Neti and kunjal; Shankh prakshalan (as per requirement)
Yogic exercises – Of the whole body
Asanas – Surya Namaskar, Pawan muktasana
Pranayama – Bhramari, Bhastrika and Nadi shodhana
Kayotsarga – 30 minutes
Preksha – Meditate and visualize yellow colour at the centre of purity
Anupreksha – Contemplate for the balanced general metabolism
Dietary recommendations
• Fasting should be avoided
• Simple vegetarian food
• Meal schedule should be followed strictly
• Nothing should be taken between two meals
• Sugar, oil and ghee, spices and refined food items should be avoided