Obesity is defined as an

abnormal growth of the

adipose tissue due to an

enlargement of fat cell

size(hypertrophic

obesity)or an increase in

fat cell

number(hyperplastic

obesity)or a

combination of both.

Central obesity is defined as waist

circumference ≥ 90 cm in males

and ≥ 80 cm in females.

+

Any two of the following

-Increased triglycerides ≥ 150

mg/dl (1.70 mmol/L)

-reduced HDL cholesterol <40

mg/dl in males and < 50 mg/dl in

females.

-raised blood pressure systolic bp ≥

130 mm Hg and diastolic bp ≥

85mm Hg.

-raised fasting plasma glucose ≥

100 mg/dl.

Or treatment for previously

diagnosed any of the above

condition.

Classification BMI

(kg/m2

)

Risk of Co-morbidities

Underweight <18.5 Low (Risks are increased in

other areas)

Desirable 18.5-

22.9

Average

Overweight 22.9-

29.9

Mildly Increased

Obese >30.0

Class 1

Obesity

30.0-

34.9

Moderate

Class 11

Obesity

35.0-

39.9

Severe

Class 111

(morbid

obesity)

>40.0 Very severe

Obesity is primarily

driven by individual

decisions, and the

way society

influences them

Human biology -

genetics plays a

part but does not

pre-destine us to

be obese

Culture/Individual

psychology - it is

difficult to break

habituated

unhealthy eating

patterns, especially

when common to

those around us

The food environment - there has

also been a huge increase in the

quantity of quick convenience

foods, which tend to be high in

saturated fat, salt and sugar.

The physical environment - our

lives have become increasingly

sedentary. For e.g. last two

decades have seen marked

reduction in school walking.

RELATIVE RISK OF HEALTH PROBLEMS

ASSOCIATED WITH OBESITY

Greatly increased

(relative risk >>3)

• Diabetes

• Gall bladder diseases

• Hypertension

• Dyslipidemia

• Insulin resistance

• Sleep apnea

• Breathlessness

Moderately increased

(relative risk 2-3)

• Coronary heart disease

• Osteoarthritis (knees)

• Hyperuricemia and gout

Slightly increased

(1-2)

• Cancer(breast cancer in postmenopausal women, endometrial cancer, colon cancer)

• Reproductive hormone abnormalities

• Polycystic ovarian syndrome

• Infertility

• Low back ache

• Increased anesthetic risk

• Foetal defect arising from maternal obesity.

• Moderate calorie restriction.(to achieve a 5-10% loss of body weight in 1st yr)

• Moderate increase in physical activity.

• Change in dietary composition.Primary intervention

• Drug therapy is required to treat the metabolic syndrome associated with obesity.

• There is a definite need for treatment that can modulate the underlying mechanism of metabolic syndrome as a whole and thereby reduce the impact of all the risk factors and the long term metabolic and cardiovascular consequences.

Secondary intervention

Cut down on salt

and sugar.

Do not skip meals

Do not eat while

reading, watching

TV, playing video

games.

Eat little at

dinner.

Walk after night

meals.

Avoid foods high

in saturated fat

and cholesterol.

Take fruits in

between meals for

snacking.

Take at least 7-10

glasses of water

every day.

Use skimmed milk

instead of full fat

milk.

AVOID

•Alcoholic drinks.

•Butter , margarine

•Cakes, pancakes, cookies, doughnuts, pastries etc.

•Candies, chocolates, cream, cheese.

•French fries, potato chips, pizza, pasta, burger, snacking food.

•Jams, jellies, sugar and syrup.

•Ice cream, ice milk, sherbets, soda drinks.

D

I

E

T

EARLY YEARS(UNDER 5S)

Preschool children should be physically

active at least for 180 minutes.

All under 5s should minimize the time

spend being sedentary for extended

periods except for sleeping.

CHILDREN AND ADOLESCENTS

All children and young people should engage in

moderate to vigorous intensity physical activity

for at least 60 minutes and up to several hours

every day.

-Vigorous intensity activities, including those that

strengthen muscle and bone should be

incorporated at least thrice a week.

-They should minimize the time spend being

sedentary for extended periods.

ADULTS AND OLD AGE

-Adults should aim to be active daily. Over a

week, activity should add up to at least 150

minutes

(2½ hours) of moderate intensity activity in bouts

of 10 minutes or more – one way to approach

this is to do 30 minutes on at least 5 days a week.

Alternatively, comparable benefits can be achieved

through 75 minutes of vigorous intensity

activity spread across the week or a combination of

moderate and vigorous intensity activity.

-Adults should also undertake physical activity to

improve muscle strength on at least two days

a week.

-All adults should minimize the amount of time

spend being sedentary for long.

Ammonium carb-

Fat patients with weak heart.

Women who are tired and weary and takes cold

easily.

Leads a sedentary lifestyle.

Dry coryza-stoppage of nose-at night-can only

breathe through mouth-danger of suffocation.

Sadness with disposition to

weep, timidity, disgust with

life, heedlessness, weakness of memory, great

absence of mind.

Chilly patient < wet stormy weather ; washing

> warmth.

Ammonium muriaticum-

Body is fat and legs are thin with large buttocks.

Full of grief but cannot weep. Irritability and

disposition to be angry.

Feets get very cold in the evening in bed.

Antium crudum-

Children and old people who have a tendency to grow

fat with coated white tongue.

Belching and great eructations of ingesta.bloating

after eating.

Cold and callous excrescenses.

Patient is aggravated from extremes of temperature.

Calcarea carbonicum-

Sweating on the forehead which wets the

pillow while sleeping.

Fair, fat, flabby are the red lined symptom.

Great sensitiveness to cold damp air.

Capsicum-

Person who are weak of lax fibre.the

digestion is poor and suffer from myalgia.

Have burning pains still doesn’t like cold.

Old people who have exhausted their vitality.

Home-sickness.

>from heat

Carlsbad-

Action on liver, treatment of obesity and

diabetes.

Self satisfied, very talkative, good humored.

Discouraged and anxious about domestic

duties. Absent minded, heedless, forgets

names.

Sensitive to cold air. sweats more easily.

> Motion and open air.

Calotropis gigantea-

Helps in reducing the obesity, without

reducing the weight i.e. flesh would

decrease but the muscle would become

more firm.

There is great heat in stomach.

Ferrum metallicum-

Obesity with anaemia, puffy face with pitting of

flesh. Delicate girls, fearfully constipated with low

spirits.< cold weather. > warm weather.

Great lassitude and weakness.

Graphitis-

Obesity in females with delayed

menstruation.

Fair, fat , chilly constipated people.

Kali carbonicum-

Older fat people characterized by sweat, backache

and weakness.

Dark haired person with lax fiber and inclined to be

fat.

Esculentine-

Great fat reducer. Can be alternated

with phytoline.

Should be given in mother tincture.Fucus vesiculosus-

Given when calcarea carb fails.

Indigestion, obstinate

constipation, flatulence.

To be given in tinctures.

Phytolacca berry-

One of the best remedies in weight

reduction and corpulence reduction

Phytoline-

Great fat reducer. Recommended

when the patient is having difficulty in

walking, sitting, palpitation, dyspnoea

on least

exertion, nausea, eructations.

Given in mother tincture.

Thyroidinum-

Excessive obesity. Acts best in

pale patients.

Is a powerful diuretic and helps in

myx-odema and various types of

oedema.

COMPILED BY-

Dr Neena Mehan(Head, Deptt. of Medicine)

Dr Pavneet Kaur (Intern 2013-2014 Dr B R Sur

Homoeopathic Medical College, Hospital and

Research Centre)