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Cardio Diabetes Medicine 2017 509

Obesity And Weight Management-

Current Concepts

Dr. Isaac Christian Moses, MD.,

Medical Director, Sri Ramakrishna Hospital

OBESITY GHRELIN
Obesity is a growing health problem in our society Ghrelin is a peptide hormone produced by ghrelin-
and its treatment has been challenging as it increas- ergic cells in gastrointestinal tract. Ghrelin regulates
es the lifetime risk of hypertension, dyslipidemia, di- appetite .
abetes mellitus, sleep apnea, cardiovascular disease,
and certain cancers. BROWN ADIPOSE TISSUE
The main function is to convert food into body heat.
PREVALENCE OF OBESITY WORLDWIDE Brown adipocytes contain many lipid droplets, and a
Overall, about 13% of the world’s adult population (11% high number of iron containing mitochondria. It has
of men and 15% of women) were obese in 2014. The more capillaries because of its higher oxygen con-
worldwide prevalence of obesity more than doubled sumption. It accumulates around the neck. It plays a
between 1980 and 2014. In India there were 20 mil- key role in keeping people lean.
lion obese women in 2014 compared with 9.8 million WHITE ADIPOSE TISSUE
obese men.
It contains a single large fat droplet. They have recep-
BODY MASS INDEX AND WAIST tors for insulin, sexual hormones, nor epinephrine,
and glucocorticoids and used as a store of energy.
CIRCUMFERENCE It acts as a thermal insulator. White fat accumulates
Body Mass Index (BMI) is a measure of weight status around the hips, thighs, buttocks.
of an individual. The World Health Organisation rec-
ommended that an individual’s relative risk of type 2 TYPES OF OBESITY
diabetes and cardiovascular disease could be more Apple shaped obesity
accurately classified using both BMI and waist cir- Pear shaped obesity
cumference.
COMPLICATIONS OF OBESITY
CAUSES FOR OBESITY High Blood pressure , weight gain, High Cholester-
Genetics, Overeating, Consumption of CHO, Fre- ol, Insulin Resistance, Diabetes – Type 2 Diabetes –
quency of eating, Physical inactivity, Medications, Central Obesity, Heart Disease , Stroke, Gall bladder
Psychological factors, certain disease conditions, disease, Osteoarthritis, Sleep apnea and respiratory
Metabolism, Environment, Behavior and Culture. problems, Some cancers (Endometrial, breast and
colon).
HORMONAL INFLUENCE ON OBESITY INSULIN RESISTANCE
LEPTIN
Effectiveness of insulin in transporting glucose to the
Leptin is a polypeptide hormone, that is produced cells is diminished. Fat cells are more insulin resis-
by adipocytes as well as the stomach,heart,placenta tant. Initially pancreas responds to insulin resistance
and skeletal muscle. Leptin decreases hunger and by producing more insulin for years.
increases energy expenditure. Leptin resistance is
similar to insulin resistance. METABOLIC SYNDROME
Obesity is a major component of metabolic syn-

Cardio Diabetes Medicine