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In 1998, WHO designated obesity as a global epidemic. It is the most
common nutritional disorder in the developed countries and one of the most
common chronic illnesses in the Western world.
The most dramatic increase has been in the UK where it has more than
doubled since 1980, and also in USA from 12 % in 1991, 17.9 % in 1998 to
19.8 % in 2000.
The rise in obesity is not restricted to more developed countries.
With increasing Westernization, the prevalence of overweight and obesity
appears to be rising amongst the populations of less developed countries,
even in those countries with current food security problems.
The economic consequences of obesity in terms of co-morbid disease
and health care expenditures make this a tremendous overall health
concern. In USA, obesity health problem represent > 5% of the total
health care costs.
Data show that any degree of overweight is unhealthy. There is a
direct relationship between the excess weight and mortality. The morbidly
obese are severely handicapped by every measure: physically, emotionally,
economically, and socially. However, its full extent is not appreciated.
An indices have been developed for the quantification of obesity.
Measures of abdominal circumference, e.g., waist to hip ratio (WHR), skin
folds offer readily available measures of obesity. Health agencies have
proposed that obesity should be defined on the basis of Body Mass Index
(BMI) {wt (kg) / ht (m)2). BMI cut off points are the same both in
childern and in adults.
MANAGEMENT OF OBESITY
Most weight reduction therapies involve one or combination of the
following approaches. Weight reduction followed by a structured program
emphasizing weight maintenance is vital. Support from a trained health
care professional is of great help. The primary goal of childhood obesity
interventions is regulation of body weight with adequate nutrition for
growth and development.
DIET THERAPY
A minor decreases in the metabolic rate correlate with the eventual
development of obesity. Thus, weight reduction by decreased caloric intake
and constant low level energy expenditure tends to be short-lived. Weight
loss is more rapid during the first few weeks of such a diet as lean
tissue and water are lost. Then the rate of weight loss slows, even though
the patient's caloric intake may remain low. The patient then becomes
depressed, often because of unrealistic expectations, & returns to
poor dietary habits.
The failure of conventional low-calorie diets had led to the use of
"very low calorie diets" (VLCDs) in addition to vitamins and minerals.
VLCD are contraindicated in patients with cardiac, cerebro-vascular
diseases, protein wasting conditions, and children and pregnant or breast
feeding women.
PHYSICAL ACTIVITY PROGRAM
A sedentiary lifestyle has been found to be related to adiposity in
childern. 60 % of US childern watch at least 2 hours of TV per day, and
the total energy intake is positively associated with hours of watched TV.
Public and health media attention has focused on modest exercise
levels as the predominant factor in achieving successful weight loss.
Weight loss achieved by exercise alone is limited. Weight reduction by
consistent modest exercise with caloric restriction provides beneficial
healthy effects.
Creation of the exercise habit throughout life is the vital goal of
any exercise program. Walking briskly exercise for 30 min each day
requires an important commitment of time and daily effort to achieve an
impact on weight reduction.
It can be useful in the treatment of moderate obesity.
BEHAVIOR MODIFICATION
Behavioral modification is a therapeutic approach based on the
assumption that habitual eating & physical activity behaviors must be
relearned to promote long-term weight change. Obesity treatment has
shifted to a comprehensive program of lifestyle modification, the key to
successful weight loss in the long term. It is designed to support a
change in the individual's attitude, perception and behavior as regards
food intake, physical activity and lifestyle. The programs involve a
number of steps focusing on modifying repetitive eating and maintaining
physical activity. The steps include 1) identifying the eating or activity
patterns to be modified, 2) setting specific behavior modification goals,
3) modifying the aspects of the behavior to be changed, and 4) providing
positive reinforcement for the desired behavior 5) family intervention
& guidance is highly recommended.
Lifestyle Modification and Obesity
Dear SIR:
In 1998, WHO designated obesity as a global epidemic. It is the most
common nutritional disorder in the developed countries and one of the most
common chronic illnesses in the Western world.
The most dramatic increase has been in the UK where it has more than
doubled since 1980, and also in USA from 12 % in 1991, 17.9 % in 1998 to
19.8 % in 2000.
The rise in obesity is not restricted to more developed countries.
With increasing Westernization, the prevalence of overweight and obesity
appears to be rising amongst the populations of less developed countries,
even in those countries with current food security problems.
The economic consequences of obesity in terms of co-morbid disease
and health care expenditures make this a tremendous overall health
concern. In USA, obesity health problem represent > 5% of the total
health care costs.
Data show that any degree of overweight is unhealthy. There is a
direct relationship between the excess weight and mortality. The morbidly
obese are severely handicapped by every measure: physically, emotionally,
economically, and socially. However, its full extent is not appreciated.
An indices have been developed for the quantification of obesity.
Measures of abdominal circumference, e.g., waist to hip ratio (WHR), skin
folds offer readily available measures of obesity. Health agencies have
proposed that obesity should be defined on the basis of Body Mass Index
(BMI) {wt (kg) / ht (m)2). BMI cut off points are the same both in
childern and in adults.
MANAGEMENT OF OBESITY
Most weight reduction therapies involve one or combination of the
following approaches. Weight reduction followed by a structured program
emphasizing weight maintenance is vital. Support from a trained health
care professional is of great help. The primary goal of childhood obesity
interventions is regulation of body weight with adequate nutrition for
growth and development.
DIET THERAPY
A minor decreases in the metabolic rate correlate with the eventual
development of obesity. Thus, weight reduction by decreased caloric intake
and constant low level energy expenditure tends to be short-lived. Weight
loss is more rapid during the first few weeks of such a diet as lean
tissue and water are lost. Then the rate of weight loss slows, even though
the patient's caloric intake may remain low. The patient then becomes
depressed, often because of unrealistic expectations, & returns to
poor dietary habits.
The failure of conventional low-calorie diets had led to the use of
"very low calorie diets" (VLCDs) in addition to vitamins and minerals.
VLCD are contraindicated in patients with cardiac, cerebro-vascular
diseases, protein wasting conditions, and children and pregnant or breast
feeding women.
PHYSICAL ACTIVITY PROGRAM
A sedentiary lifestyle has been found to be related to adiposity in
childern. 60 % of US childern watch at least 2 hours of TV per day, and
the total energy intake is positively associated with hours of watched TV.
Public and health media attention has focused on modest exercise
levels as the predominant factor in achieving successful weight loss.
Weight loss achieved by exercise alone is limited. Weight reduction by
consistent modest exercise with caloric restriction provides beneficial
healthy effects.
Creation of the exercise habit throughout life is the vital goal of
any exercise program. Walking briskly exercise for 30 min each day
requires an important commitment of time and daily effort to achieve an
impact on weight reduction.
It can be useful in the treatment of moderate obesity.
BEHAVIOR MODIFICATION
Behavioral modification is a therapeutic approach based on the
assumption that habitual eating & physical activity behaviors must be
relearned to promote long-term weight change. Obesity treatment has
shifted to a comprehensive program of lifestyle modification, the key to
successful weight loss in the long term. It is designed to support a
change in the individual's attitude, perception and behavior as regards
food intake, physical activity and lifestyle. The programs involve a
number of steps focusing on modifying repetitive eating and maintaining
physical activity. The steps include 1) identifying the eating or activity
patterns to be modified, 2) setting specific behavior modification goals,
3) modifying the aspects of the behavior to be changed, and 4) providing
positive reinforcement for the desired behavior 5) family intervention
& guidance is highly recommended.
Competing interests: No competing interests