Medical Tourism

The best indicator of fatness is Body Mass Index or BMI.  It is defined as weight in kilograms divided by height in meter squared.  For Example – If your weight is 60 kg and you are 1.7 mt tall your body mass index is calculated as
         60
         BMI=---=20.8kg/m2
         (1.7)2

        Body mass index is an indicator of the health risks resulting from obesity.  A BMI  between 18.5 and 24.9 kg/m2  is seen in healthy individuals. Above this point the health risks are directly proportional to the BMI and hence it is advisable to lose weight to reduce the health risks in obese individuals (health risks discussed later.

Though in general, all excess body fat is unhealthy, fat which tends to get deposited around the waist (a spare tire around the middle or apple shaped obesity) commonly seen in men poses a greater health hazard especially cardiac  risk.  In comparision, the fat distributed over the hips and buttocks (more commonly seen in women) has less effect on the heart,  If you are a woman and your waist to hip ratio is more than 0.8 or if you are a man and your waist to hip ratio is more than 1.0 it indicates more of  a health risk.

A hyperactive fork and a hypoactive foot are the most common causes of obesity.  Eating too much and not being active enough gives more calories than what the body burns up, the extra calories being stored as fat.  Overeating because of boredom or depression is seen commonly.

        Certain hormonal unbalances may also lead to obesity.  These include low levels of thyroid hormones (hypothyroidism), increased levels of body steroids (Cushing’s syndrome) and syndrome-X 

This mysterious sounding condition often found in first degree relatives of diabetic patients is characterized by male pattern obesity (increased waist/hip ratio), increased blood levels of the hormone insulin with or without high blood sugars, high blood pressure and cholesterol abnormalities.  Patients with syndrome-X are more prone to developing heart attacks.  Young women with a variant of this syndrome often have cysts in their ovaries and fertility problems.  Those patients of syndrome-X who have high insulin levels with normal blood sugars if identified and treated early can be prevented from developing diabetes and cardiac problems.

This has assumed menacing proportions today and if left unattended would lead to an entire generation of unhealthy, obese, moribund individuals, the consequences of which are unthinkable.

        Decreased physical sports, automated means of transport, cable television and computers, coupled with a diet high in refined carbohydrates and lacking  in dietary fibre and vitamins are causing today’s children to develop high blood pressure and even type 2 Diabetes Mellitus( commonly seen in adults) .  Even now 25% of children and adolescents in the cities are overweight and more and more of them are approaching obesity and developing associated complications.

        Drugs which may be used in adults are not recommended for children and hence prevention is of utmost importance.

Being overweight or obese can also cause respiratory problems, back pain, increased cholesterol levels and osteoarthritis.  Overall, being overweight/obese can decrease your lifespan.

Ideally, weight loss should be steady and sustained.  The aim should be to lose approximately  5-10% of  current weight over a period of 6-12 months.  Rapid weight loss causes a yo-yo effect : no sooner have have you  lost weight, it comes back again and often more than before, Even by losing 5-10% weight the health risks are significantly reduced.  Losing weight helps you feel better, makes you more active and reduces the health risks thus improving  the quality of life and also longevity.

Some surgical techniques which remove excess fat and/or alter the stomach size are done at some centers in the world for people who are morbidly obese (BMI>40kg/m2).  However, these are the last resort for morbidly obese individuals with significant health risks,    Strict criteria are used for selection of patients for surgery.

        Given the motivation and proper guidance, lifestyle modification can achieve a significant weight loss.  Medications can help achieve weight loss along with diet and exercise as is perceived by some individuals.  It is very important to take these medications under medical  supervision as certain side effects need to be monitored closely.  Prevention of obesity is better than cure.