Dr Ravinder K Gupta, Dr Mridul Gupta
Adequate nutrition is essential for human development. Malnutrition includes both undernutrition as well as over nutrition and refers to deficiencies, excesses or imbalances in the intake of energy, protein and/or other nutrients. Benefits of good health are perceived not only at the individual level but also at the level of society and country level as well. Health of an individual is determined by interplay of various factors like social, economic, dietary, lifestyle related, environmental, governmental policies and political commitment, etc. Overweight and Obesity occur when there is too much fat in the body. Exogenous obesity occurs when take in of calories is more than burnt. The body stores these excess calories as fat. It is linked to diet, exercise, sleep, weight gaining medicines. Endogenous obesity is caused by hormonal influences or genetic factors.

World Obesity Day

Other factors include cultural,societal, behavioral, metabolic.
Obesity is a common, serious, complex disorder that is defined as abnormal or excessive fat accumulation that presents a risk to health. As per WHO, from 1990 to 2022, the percentage of children and adolescents aged 5-19 years living with obesity has increased four-fold from 2% to 8% globally, while the percentage of adults above18 years of age and older living with obesity are more than double i.e 7% to 16%. It is the second most common cause of preventable death after smoking that has become a public health concern. Measurement of weight is the earliest parameter used for definition of obesity. Parameters like body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), total body fat, fat mass index can be used
BMI is calculated as weight in kilograms divided by height in meter squared. In adults, overweight or pre-obesity, is defined as BMI of 25-29.9 kg/m2, while a BMI > or equal to 30kg/m2 defines obesity. These BMI thresholds were proposed by World Health Organization (WHO).
A diet that is high in calories, lacking in fruits and vegetables, full of fast food, high-calorie beverages
like-sugared soft drinks, alcohol can contribute to weight gain. Intake of more calories every day than burnt through exercise and routine daily activities predisposes to obesity. Increased screen time i.e looking at computer, tablet and phone screens is also considered inactivity. The number of hours spent in front of a screen is highly associated with weight gain. In the present world of competition, parents want their child to focus on education. First attending school and then back-to-back tuition the whole day is spent sitting at a place. Focus on physical activity in the form of sports, walking, running has decreased. Late night studies also affect the diet of child as they prefer having junk food as their companion with books.
Eating habits of people have been destroyed to such an extent that they prefer momos, burger, pizza except for a normal balanced diet consisting of fruits, vegetable, whole grains and protein sources.
Obesity can occur at any age, even in young children. But as one ages, hormonal changes increase the risk of obesity. Leptin is a hormone in the body that reduces food intake and body weight. Resistance to this hormone is associated with obesity. The number of muscles in the body also tends to decrease with age. Lower muscle mass often leads to a decrease in metabolism. These changes also reduce calorie needs and can make it harder to keep off excess weight.
Obesity tends to run in families. That’s not just because of the genes shared. Family members also tend to share similar eating and activity habits.
Not getting enough sleep can cause changes in hormones that increase appetite. Not getting too much sleep also may crave food high in calories and carbohydrates, which may contribute to weight gain.
Many external factors that affect mood and well-being may contribute to obesity. People often seek more high-calorie food during stressful situations whether they are happy, sad, bored, excited, lonely or stressed
In some people, obesity can be traced to a medical cause, such as hypothyroidism, Cushing syndrome, Prader-Willi syndrome and other conditions. Medical problems such as arthritis can lead to decreased activity, which may result in weight gain.Some medicines can lead to weight gain include steroids, antidepressants, anti-seizure medicines, diabetes medicines, antipsychotic medicines.
Obesity isn’t just a cosmetic concern. It’s a medical problem that increases the risk of many other diseases and health problems. These can include heart disease, diabetes, high blood pressure, high cholesterol, liver disease and certain cancers.
Obesity increases the likelihood of developing heartburn, gallbladder disease and liver problems
It also increases the stress placed on weight-bearing joints. It also promotes inflammation, which includes swelling, pain and a feeling of heat within the body. These factors may lead to complications such as osteoarthritis. Obesity increases the risk of fatty liver disease due to excessive fat deposit in the liver. In some cases, this can lead to serious liver damage, known as liver cirrhosis. This complex disorder is also associated with some cancer including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney and colon. Carrying excess weight can lead to musculoskeletal disorders like osteoarthritis.
People with obesity are more likely to have sleep apnea, a potentially serious disorder in which breathing repeatedly stops and starts during sleep.
Obesity can diminish the overall quality of life. People may not be able to do physical activities that you used to enjoy. Also, may avoid public places and face discrimination.
Weight-related issues that may include:
* Dépression, persistent anxiety, anger outbursts
* Disability (eating disorder)
* Shame and guilt (body shaming or teasing by peers regarding weight/appearance)
* Social isolation (eg: school absenteeism)
* Lower work achievement.
PREVENTION
Many of the causes of obesity are preventable and reversible. Although many factors are involved, the fundamental cause of obesity is an imbalance of calories consumed and calories expended. As global diets have changed in recent decades, there has been an increase in the consumption of energy-dense foods high in fat and free sugars. Improving the entire family’s diet and exercise habits is one of the best ways to achieve a healthy weight in the child.There has also been a decrease in physical activity due to the changing nature of many types of work, more access to transportation and increased urbanization.
Lowering the risk of overweight and obesity includes:
* Ensuring appropriate weight gain during pregnancy;
* Practicing exclusive breastfeeding in the first 6 months after birth and continued breastfeeding until 24 months or beyond; it reduces the risk of infants becoming overweight or obese.
* Reducing the number of calories consumed from fats and sugars by monitoring eating habits
* Increasing the portion of daily intake of fruit, vegetables, legumes, whole grains and nuts.
* Eating slowly and only when hungry, and avoiding using food as a reward or punishment.
* Avoidance of snacking, screen exposure while eating and rigorous dieting
* Engaging in regular physical activity (45 minutes per day for children and 150 minutes per week for adults).
* Plenty of fluid intake is recommended
* Practice stress management techniques like meditation or yoga
* Get enough sleep
* Seek support from friends, family or a healthcare professional
* The food industry can play a significant role in promoting healthy diet by: reducing the fat, sugar and salt content of processed foods; ensuring that healthy and nutritious choices are available and affordable to all consumers;restricting marketing of foods high in sugars, salt and fats, especially those foods aimed at children and teenage and ensuring the availability of healthy food choices and supporting regular physical activity practice in the workplace.
4th March 2025 is observed as WORLD OBESITY DAY. The day encourages practical solution to help people achieve and maintain a healthy weight, undertake proper treatment and reverse the obesity crisis. Even the modest weight loss can improve or prevent health problem associated with obesity
Indian Academic of Pediatrics (IAP) aims to compact obesity by creating awareness about it by organizing walkathons, aerobic dances, 1-week WALKERCISE challenge, obesity camps at clinics, awareness activities at school (nutritional counselling, height and weight measurement), live streaming of lectures and online webinar on obesity. An interactive session named LET’S TALK ABOUT OBESITY – CHANGING PERSPECTIVE focuses on people’s stories on obesity, experience, good food practices, lifestyle modifications and preventive measures to be taken from early childhood.
(The authors are from Department of Pediatrics, Acharya Shri Chander College of Medical Sciences (ASCOMS), Jammu)

Follow our WhatsApp channel