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Obesity: Types, Causes, Symptoms, Complications And Treatment

Obesity is the excess of body fat. In India, obesity has become an epidemic with 5 per cent of the country being affected by it. The issue is not just a mere cosmetic concern but one that can increase your risk of developing other diseases and several health problems.

Obesity is defined as having a body mass index (BMI) of 30 or more. BMI is calculated by taking into account the height and weight of an individual. Certain factors such as age, sex, ethnicity, and muscle mass of an individual can impact the link between body fat and BMI. However, BMI is the standard indicator for excess weight [1] [2] .

To determine your BMI, you have to divide your weight in kilograms by your height in metres squared (BMI = kg/m2).

Check your BMI here.

Types Of Obesity

There are multiple classifications of obesity. The condition is differentiated depending on the area of fat deposition, association with other diseases and the size and number of fat cells [3] .

Depending on the association with other diseases, obesity is classified into two and they are as follows:

  • Type-1 obesity: This type of obesity is caused by excessive intake of calories and lack of physical activity.
  • Type-2 obesity: It is caused by diseases such as hypothyroidism, polycystic ovarian disease, and insulinoma etc. Type-2 obesity is rare and accords to only 1 per cent of the total obesity cases. An individual with type-2 obesity will gain an abnormal amount of weight even with little intake of food.

Depending on the area of fat deposition, obesity is classified into three and they are as follows [4] :

  • Peripheral obesity: This type of obesity is when the accumulation of excess fat is located in the hips, buttocks and thighs.
  • Central obesity: This type of obesity is when the accumulation of excess fat is centralised in the abdominal area.
  • Combination of both

Depending on the size and number of fat cells, obesity can be divided into two types and they are [4] :

  • Adult-type obesity: In this type of obesity, only the size of fat cells are increased and develops during middle age.
  • Child-type obesity: In this, the number of fat cells increase and is extremely complex because the number of cells is almost impossible to be reduced.

Causes Of Obesity

Fat gain is usually caused by behavioural, genetic, metabolic and hormonal influences on body weight, with calorie intake being the primary reason. That is, eating more calories than you burn in daily activity and exercise leads to obesity [5] .

The most common causes of obesity are as follows:

  • A poor diet of foods high in fats and calories
  • Ageing because growing older can lead to less muscle mass and a slower metabolic rate
  • Lack of sleep, which can lead to hormonal changes that make you feel hungrier and crave high-calorie foods
  • Sedentary lifestyle
  • Genetics
  • Pregnancy

Apart from these, certain medical conditions can also lead to obesity, such as the following [6] :

  • Hypothyroidism (under-active thyroid)
  • Cushing syndrome
  • Polycystic ovary syndrome (PCOS)
  • Prader-Willi syndrome
  • Osteoarthritis

Symptoms Of Obesity

The first warning sign of obesity is gaining above-average body weight. Apart from that, the symptoms of obesity are as follows [7] :

  • Sleep apnoea
  • Gallstones
  • Osteoarthritis
  • Trouble sleeping
  • Shortness of breath
  • Varicose veins
  • Skin problems caused by moisture

Risk Factors Of Obesity

Various factors such as a mix of genetic, environmental, and psychological factors play a major role in increasing an individual's risk of developing obesity [8] .

  • Genetics or family inheritance (i.e. the genes you inherit from your parents may affect the amount of body fat stored and distributed in your body).
  • Lifestyle choices such as an unhealthy diet, high-calorie beverages, lack of activities etc.
  • Certain diseases (like Prader-Willi syndrome, Cushing syndrome etc.)
  • Medications such as anti-seizure medications, antidepressants, diabetes medications, antipsychotic medication etc.
  • Friend-circle and family (if you obese people around, the chances of being obese increases)
  • Age
  • Pregnancy
  • Smoking
  • Microbiome (gut bacteria)
  • Lack of sleep
  • Stress
  • Yo-yo dieting

Complications Of Obesity

Individuals who are obese are increasingly prone to various health problems that are extremely severe in nature.

The major complications include the following [9] [10] :

  • Type 2 diabetes
  • Heart disease
  • Certain cancer (ovary, breast, cervix, uterus, colon, rectum, liver, gallbladder, kidney, prostate etc.)
  • High cholesterol
  • Gallbladder diseases
  • Stroke
  • Gynaecological and sexual problems
  • Digestive problems

Apart from these, obesity can adversely affect one's quality of life. Depression, social isolation, disability, low work achievement, shame etc. are some of the ways obesity can affect one's quality of life [10] .

Diagnosis Of Obesity

The doctor will begin with a physical examination and recommend tests to understand the severity of the condition [11] .

  • Health history examination
  • General physical exam
  • BMI calculation
  • Waist circumference measuring to understand body fat distribution include skin-fold thickness, waist-to-hip comparisons
  • Blood tests
  • Screening tests such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) scans

Treatment For Obesity

The goal of obesity treatment is to attain a healthy weight and maintain it. The treatment is carried out to improve your overall health and reduce the risk of developing health complications.

  • Dietary change: The first and foremost step adopted to treat obesity is dietary changes. Reducing calories and practising healthier eating habits are necessary. So start by cutting down calories, eating larger portions of foods that have fewer calories (like vegetables and fruits), eating plant-based foods, such as fruits, vegetables and whole-grain carbohydrates. Restrict your consumption of high-carbohydrate or full-fat foods [12] .
  • Exercise: Increasing your physical activities is an essential step in obesity treatment. People with obesity need to get at least 150 minutes a week of physical activity. It is efficient and effective to choose exercises that help burn calories. Simple changes such as taking the stairs instead of the elevator, gardening, walking short distances instead of taking your vehicle can help shed that extra weight [13] .
  • Behavioural change: Behaviour modification programs can help you make lifestyle changes and encourage you to lose weight. Also termed as behavioural therapy, it can help you in understanding you and your habits better and work accordingly for weight loss. Going for counselling and support groups can be beneficial [14] .
  • Medication: Apart from the exercises and diet habits, prescription weight-loss medication is also an effective means of treatment for obesity. Your doctor may recommend weight-loss medication if other diet and exercise programs were futile. The medicines will be prescribed based on your health history, as well as possible side effects.
  • Surgery: For severe cases, doctors opt for weight-loss surgery, also called bariatric surgery. These surgeries help in limiting your consumption levels (and) or can decrease the absorption of food and calories. Some of the common weight-loss surgeries include gastric bypass surgery, adjustable gastric banding, biliopancreatic diversion with duodenal switch and gastric sleeve [15] [16] .

On A Final Note ...

Obesity can be prevented. By adopting lifestyle changes and good diet choices, you can help yourself from gaining all that extra weight. Do not neglect (light) exercising daily for at least 20-30 minutes, eat nutritious foods like fruits and vegetables and avoid consuming high-fat foods.

Infographics by Sharan Jayanth

View Article References
  1. [1] Ranjani, H., Mehreen, T. S., Pradeepa, R., Anjana, R. M., Garg, R., Anand, K., & Mohan, V. (2016). Epidemiology of childhood overweight & obesity in India: A systematic review. The Indian journal of medical research, 143(2), 160.
  2. [2] Tripathy, J. P., Thakur, J. S., Jeet, G., Chawla, S., Jain, S., & Prasad, R. (2016). Urban-rural differences in diet, physical activity and obesity in India: are we witnessing the great Indian equalisation? Results from a cross-sectional STEPS survey. BMC Public Health, 16(1), 816.
  3. [3] Filatova, O., Polovinkin, S., Baklanova, E., Plyasova, I., & Burtsev, Y. (2018). Constitutional features of females with different types of obesity. Ukrainian Journal of Ecology, 8(2), 371-379.
  4. [4] Gilmartin, S., Maclean, J., & Edwards, J. (2019). Body types following obesity surgery and skin re-countouring: a secondary level of analysis. Journal of Surgery and Surgical Research, 5(1), 036-042.
  5. [5] Allender, S., Owen, B., Kuhlberg, J., Lowe, J., Nagorcka-Smith, P., Whelan, J., & Bell, C. (2015). A community based systems diagram of obesity causes. PloS one, 10(7), e0129683.
  6. [6] Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: causes and consequences. Journal of family medicine and primary care, 4(2), 187.
  7. [7] Delgado, I., Huet, L., Dexpert, S., Beau, C., Forestier, D., Ledaguenel, P., ... & Capuron, L. (2018). Depressive symptoms in obesity: Relative contribution of low-grade inflammation and metabolic health. Psychoneuroendocrinology, 91, 55-61.
  8. [8] Blümel Méndez, J., Fica, J., Chedraui, P., Mezones Holguín, E., Zúñiga, M. C., Witis, S., ... & Ojeda, E. (2016). Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity.
  9. [9] Camilleri, M., Malhi, H., & Acosta, A. (2017). Gastrointestinal complications of obesity. Gastroenterology, 152(7), 1656-1670.
  10. [10] Jakobsen, G. S., Småstuen, M. C., Sandbu, R., Nordstrand, N., Hofsø, D., Lindberg, M., ... & Hjelmesæth, J. (2018). Association of bariatric surgery vs medical obesity treatment with long-term medical complications and obesity-related comorbidities. Jama, 319(3), 291-301.
  11. [11] Suvan, J. E., Finer, N., & D'Aiuto, F. (2018). Periodontal complications with obesity. Periodontology 2000, 78(1), 98-128.
  12. [12] Nimptsch, K., Konigorski, S., & Pischon, T. (2018). Diagnosis of obesity and use of obesity biomarkers in science and clinical medicine. Metabolism.
  13. [13] Garvey, W. T. (2018). The Diagnosis and Evaluation of Patients with Obesity. Current Opinion in Endocrine and Metabolic Research.
  14. [14] Liu, J., Lee, J., Hernandez, M. A. S., Mazitschek, R., & Ozcan, U. (2015). Treatment of obesity with celastrol. Cell, 161(5), 999-1011.
  15. [15] Kusminski, C. M., Bickel, P. E., & Scherer, P. E. (2016). Targeting adipose tissue in the treatment of obesity-associated diabetes. Nature reviews Drug discovery, 15(9), 639.
  16. [16] Olson, K. (2017). Behavioral approaches to the treatment of obesity. Rhode Island Medical Journal, 100(3), 21.

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