02-Mar Obesity

 

Obesity

• Refers to the accumulation of excess body fat in the adipose tissue.

• In this disorder, energy intake chronically exceeds energy expenditure.

• A body mass index (BMI) of 30 kg/m² or higher is considered obese.

Classification based on BMI:

• Underweight: Less than 18.5 kg per m².

• Normal: 18.5-24.9 kg per m².

• Overweight: 25-29.9 kg per m².

• Obese: Equal to or greater than 30 kg per m².

Type of obesity:

• Phase 1: BMI 30.2-34.9.

• Phase 2: BMI 35-39.9.

• Phase 3 (Extreme): BMI greater than 40.

• Based on waist circumference:

• In males: Equal to or greater than 40 inches.

• In females: Equal to or greater than 35 inches.

Regional Fat Distribution

• Android: Excess fat in the upper body.
• Gynoid: Excess fat in the lower body.
• Mixed: Equal fat distribution.

Body Build

• Ectomorph
• Endomorph
• Mesomorph

Exercise Testing:

• Before exercise testing, appropriate medical screening should be conducted to detect the presence of other comorbidities such as diabetes, hypertension, etc., which may increase the risk classification of individuals.

• The presence of musculoskeletal or orthopedic conditions may necessitate modifications to the exercise testing.

• The appropriate cuff size should be used to measure blood pressure in overweight and obese individuals to ensure accurate measurement.

Exercise Prescription

Frequency: It should be 5 days per week to maximize calorie expenditure.

Intensity:

1. Moderate to vigorous intensity should be encouraged.
2. Initial exercise testing should be moderate, with eventual progression to vigorous activity to ensure further benefits.

Time: At least 30 minutes per day, progressing to 60 minutes per day of moderate-intensity aerobic activity.

Type:

1. The primary exercise mode should be aerobic, involving physical activities that engage large muscle groups.
2. Resistance training and flexibility exercises should also be encouraged.
3. Yoga, pranayama, and asana can be beneficial.

Special Consideration:

• Additional health benefits of resistance and aerobic exercises are important in diabetes mellitus, reducing the risk of cardiovascular diseases and other associated risk factors.

• Adults with overweight and obese may benefit from progressing to approximately more than 250 minutes per week of physical activity, as this level of activity can enhance long-term weight management and maintenance.

• An adequate amount of physical activity should be performed 5-7 days per week.

Weight Loss Program Recommendation

• Target a minimal reduction in body weight of at least 5-10% over 3-6 months.

• Target changes in eating and exercise behaviors, as sustained improvements in both behaviors result in significant long-term weight loss.