Occupational Therapy
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. Table 2 Complications of Obesity
Asra Kermani
Obesity is an excess accumulation of adipose tissue mass, not of entire body weight alone. However, since weight gain beyond the acquisition of muscle mass is accumulation of fat tissue, the current definition still utilizes body weight, in proportion to height. Body weight divided by the square of the height is called the body mass index (BMI). Whereas most people with an increased BMI have increased fat mass, very muscular individuals may have an increased BMI without being overweight or obese. See > Table 1. . Table 1 Classification of Overweight and Obesity BMI (kg/m2) Underweight Normal Overweight Obese Class I Class II Class III
¼40 (extreme obesity)
Worldwide, there is an increasing incidence of obesity as a consequence of increasingly sedentary lifestyles coupled with the intake of high‐energy foods. According to the National Health and Nutrition Examination Survey (NHANES) 1999–2000 data, the prevalence for overweight among adults was 34% and for obesity, 30%. Therefore 64% of the population suffers from excess body weight. Obesity and overweight are rapidly increasing in both men and women. The repercussions of obesity are widespread and can be metabolic, malignant, infectious, mechanical, psychological, and social (see > Table 2). Importantly, the obesity and type 2 diabetes epidemics go hand in hand. Therefore, prompt intervention on a population‐wide scale is likely to have a great impact.
Pathophysiology Although few genetic syndromes cause obesity, it is apparent from the rapid increase in the rates of obesity that major genetic changes cannot explain this #
Springer-Verlag Berlin Heidelberg 2008
Cardiovascular High blood pressure Heart failure Angina (cardiac chest pain), heart attack Stroke Blood clots in leg veins and lungs Leg swelling Respiratory Sleep apnea Restrictive lung disease Malignancy Increased risk of cancer of the breast, uterus, colon Urinary Urinary incontinence (women) Infections Superficial fungal skin‐fold infections Leg ulcers Gastrointestinal Gallstones, gallbladder inflammation Metabolic High LDL cholesterol, high triglycerides, low HDL cholesterol Diabetes Gout, uric acid kidney stones Musculoskeletal Degenerative arthritis, knees and spine Psychosocial Depression/social isolation Impaired activities of daily living
phenomenon. What is more likely is the impact of environmental changes on pre-existing genes. For weight gain, there must be an imbalance favoring caloric intake in excess of caloric expenditure. According to NHANES 1999–2000, the caloric intake in men aged over 60 averaged 2000 calories per day; in women of the same age, 1500 calories per day. However not all individuals expend the same number of calories that they consume. The net gain in calories is stored as energy, which is most efficiently stored as fat. Importantly with age and other medical problems, one cannot only rely on exercise as a means of expending energy. Caloric restriction is required in order to lose weight; exercise is more important in m
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