Who it affects
Obesity is an increasingly common disorder. It is estimated that obesity will affect 40% of the population by 2020.
BMI (Body Mass Index) is used to classify patients as overweight or obese. BMI is calculated by dividing the weight (kg) by the height (m) squared. Categorising BMI into different ranges helps healthcare professionals to tailor treatment.
What gland is involved
Although fat cells are actively secreting hormones and receiving signals, obesity is not usually caused by an abnormality of these cells, but rather relates to a combination of factors including diet and exercise, medical health, psychosocial well-being and genetics. Depending on the symptoms experienced, doctors may investigate to establish whether any hormonal abnormality is contributing to a patient’s weight gain.
Symptoms
Symptoms of obesity apart from excess weight may include, tiredness, lethargy and restricted mobilising. Obesity may be associated with various disorders which in turn may cause other symptoms. These include diabetes, high blood pressure, gallstones and obstructive sleep apnoea.
Diagnosis
Diagnosis is made after taking a history and examining the patient and where necessary excluding disorders that may be contributing to the patient`s symptoms.
Treatment
Treatment is tailored to each patient. The basis of treatment in all patient`s is a healthy lifestyle, calorie control and exercise.
Medications that help limit the amount of calories absorbed from food or reduce appetite are available and used in selected patients.
Obesity surgery is generally available for patients with a BMI>40kg/m2 or those with a BMI>35kg/m2 who have an associated medical condition. Surgical techniques that have been used may be broadly classified into three groups. Restrictive, malabsorptive and a combination of these two. Specific techniques include gastric balloon insertion, gastric banding and various types of bypass surgery.
Outlook
It is important to remember that a 5% weight loss in some patients is associated with marked medical benefit, e.g. a 50% reduction in the incidence of diabetes at 4yrs. In this regard most patients will achieve a medically beneficial effect, but desire greater weight reduction.
There is an average weight loss of 10% with medication. This is not always maintained however. The prognosis in patients in whom surgery is indicated, depends on the surgical procedure performed. In very obese patients, surgery is the treatment most likely to be successful. Surgery may help to not only reduce weight, but also blood pressure, cholesterol and the risk of diabetes or treatment required to control diabetes. A rapid reduction in weight following surgery may be associated with symptoms such as feeling tired, aches, feeling cold and mood changes.
