Obesity

Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat and/or body water. Obesity is defined as a  body mass index (BMI) of 30 and above. BMI=weight(kgs) divided by  height(m) squared.

Causes

• Physical inactivity

Sedentary people burn fewer calories than people who are active

• Genetics

One is more likely to develop obesity if one or both parents are obese. Genetics also affect hormones involved in fat regulation(leptin deficiency)

• Overeating
• Diet high in simple carbohydrates(sugars, fructose, desserts, soft drinks, beer, wine); fats or sugar
• Frequency of eating(eating two or three large meals daily)
• Slow metabolism

Women have a slower metabolism than men, and hence, have a tendency to put on more weight than men. So weight loss is more difficult for women.

• Physical inactivity
• Medications (anti-depressants, anti-convulsants, diabetes medications, oral contraceptives, corticosteroids, antihistamines)
• Psychological factors

Eating excessively in response to emotions (boredom, sadness, stress or anger)

• Diseases (hypothyroidism, insulin resistance, polycystic ovary syndrome, Cushing’s syndrome)

Investigations

• Weight-to-height tables

These tables give general ranges of healthy weights and overweight for adult height.

• Body fat percentage

Men with more than 25% fat and women with more than 30% fat are considered obese.

• Body mass index

Healthy = 18.5-24.9

Overweight = 25.0-29.9

Obese = 30 or greater

Morbidly obese = 40 or greater

Treatment of obesity

Ayurvedic treatment

Ayurvedic medicines improve fat metabolism in an obese individual. Once a person’s metabolism is correct it is easy for him to maintain his weight.

Few effective preparations are-

• Triphala guggulu   
• Medohar Guggulu
•  Arogyavardhini vati
• Chandraprabha Vati

Herbs—

• Guduchi
• Devadaru
• Triphala
• Takrarishta (a fermented preparation of buttermilk) and honey
• Powder of yava
• Amla powder
•  Shilajit
  Along with the juice of Agnimatha

• Powder of Vidanga
• Sunthi
• Yavakshara
• Loh bhasma

Diet and Nutrition

Food not allowed-–

• Fried foods 
• Sausages
• Burgers
• Chocolates
• Biscuits
• Cakes
• Pies
• Ice-cream
• Sweets
• Butter/margarine
• processed meat

The food you may eat-–

• Chicken
• Turkey
• Whitefish
• Peas
• Beans
• Lentils
• Tofu
• Salmon
• Tuna
• Eggs (3-4 a week)
• Pasta
• Basmati rice
• Porridge
• Fruits
• Salad leaves
• sprouted vegetables
• Celery
• Irish potato
• Carrot, radish, tomato
• Wholegrain bread, cereals

Exercises

A stepwise approach to losing weight. Do it gradually without straining yourself.

Yoga

1. Kapaal bhaati Paranayam
2. Bhujangasana

• Lie prone on the floor
• Stretch legs back.
• Spread hands on the floor under shoulders.
• Press feet, thighs and pubis firmly into the floor.
• While inhaling, straighten the arms to lift the chest off the floor
• Press the tailbone toward the pubis and lift the pubis toward the navel.
• Firm the shoulder blades against the back
• Lift through the top of the sternum
• Distribute the backbend evenly throughout the entire spine
• Release back to the floor while exhaling
• Relax

3. Pawanmuktasan

• Lie on back
• Raise legs at 90 degrees from the floor while inhaling
• Bend the knees so as to press the thighs against the abdomen
• Clasp elbows with hands
• Bend the neck towards the knees
• Exhaling slowly lower the legs
• Relax

3. Paschimottanasana

• Sit on the floor with legs straight and palms on the floor by the sides of the hips
• Deeply inhale and while exhaling bend forward and hold the big toes with corresponding hands
• keep the face on the knees
• Inhale and come up
• Release the hands
• Relax

4. Surya namaskar (sun salutations)

	Asana	Breath
	Prayer pose	exhale
	Raised Arms pose	inhale
	Standing Forward Bend pose	exhale
	Equestrian pose	inhale
	Four-Limbed Staff Pose	exhale
	Salute with the Eight Limbs pose	suspend
	Cobra pose	inhale
	Downward-Facing Dog	exhale
	Equestrian pose	inhale
	Standing Forward Bend pose	exhale
	Raised Arms pose	inhale
	Prayer pose	exhale

Physical Workout

• Bicycling
• Dancing
• Push Ups   
•  Sit-ups
• Swimming 
• Gardening

Home Remedies

• Honey is an excellent home remedy for obesity
• Drink a glass of boiled water daily after every meal.
• Use Spices like ginger, cinnamon, black pepper
• Increase the number of fruits and vegetables and low-calorie foods.
• Avoid intake of too much salt
• Eat tomato in the morning and in a salad. Make it a regular habit.
• Avoid all kinds of milk products-cheese, including butter. Be sufficient with twice a glass of milk.
• Mint is very beneficial in losing weight.
• Craving for sweets can be reduced by having 1 to 2 tsp of brewer’s yeast or some dandelion
• Eat 4-5 more small mini-meals spaced 2-3 hours apart during the day
• Use marinades for flavour
• Fruit-based desserts served with a fruit caulis/pureed fruit are both—nutritious and weight checkers.
• Opt for low-fat cooking techniques as —

1. Grilling
2. Poaching
3. Stir-fry
4. Steaming
5. Roasting

Lifestyle

• Instead of using the vehicle for the nearby office, go walking.
• Take 2-3 minutes walking break at work place few times a day
• Do not use remotes–do it yourself by going there
• Walk during commercials in between TV programmes
• Sit in a rocking chair and push off the floor with your feet
• Walk while talking on a cordless phone
• Walk the dog
• Take the stairs instead of the elevator
• Use alcohol, non-veg. in moderation

Recommended daily diet plan

Early morning

Half a Lemon +tablespoon of honey in a glass of warm water

Breakfast

Sprouted Wheat, sprouted beans or a cup of skimmed milk

Mid-morning

A glass of orange, pineapple or carrot juice.

Lunch

• Steamed / boiled vegetables
• Whole grain bread or  wheat chapattis
• Salad of raw vegetables
• Roasted cumin seeds, green coriander leaves, a little salt and some grated ginger mixed in the buttermilk.

Mid-afternoon

• Coconut water
• Dry fruits
• Lemon tea
• Fresh vegetable soup

Dinner

Whole grain bread or chapattis
Steamed vegetable

Bedtime

A glass of skimmed milk

Diet Chart For Obese Patients

VEGETABLES
TO CONSUME	TO AVOID
Green leafy vegetables like Spinach, Green onions Carrots Beetroots Tomatoes Radishes Okra Cabbage Broccoli Cauliflower Mushrooms Zucchini Pumpkin Beans Cucumber Garlic Ginger	Potatoes Sweet Potato
Eat Raw Vegetables. Have them as salads and soups.
FRUITS
TO CONSUME	TO AVOID
Black currant Peach Apple Pear Papaya Orange Lemon Guava Kiwi	Mango Banana Litchi
Have fruit salads.
CEREALS
TO CONSUME	TO AVOID
Wheat Brown rice Brown bread Wheat pasta Oatmeal Quinoa Barley Pulses	White rice White flour White bread Pasta
SPICES
TO CONSUME	TO AVOID
Fenugreek Pepper Cloves Mint Turmeric Cinnamon Mustard Coriander Parsley
Usually, Spices are used in less amount in our diet.
OTHER FOOD ITEMS
TO CONSUME	TO AVOID
Sprouted nuts Sprouts grains Buttermilk Cottage cheese Skimmed milk	Cold drinks Soda Junk food Butter Cheese Coconut cream and milk Pastries Puffs Energy drinks Fruit syrups Frozen and simple yoghurt Roasted dry fruits Sugar products

The healthy way to maintain your weight is by keeping your diet enriched with low-calorie, nutrient-rich foods that fulfil nutritional needs while reducing your calorie intake

Complications

• Insulin Resistance(a pre-diabetes condition)
• Type 2 (adult-onset) diabetes
• Hypertension  
• Hypercholesterolemia
• Stroke 
• Heart attack 
• Congestive heart failure
• Cancer
• Gallstones 
• Gout and gouty arthritis
• Osteoarthritis 
• Sleep apnea

Prevention

A balanced and timely low-fat diet and moderate regular exercise are the keys to preventing obesity.