Selasa, 25 Desember 2012

Handling ideal on Obesity

(Photo: thinkstock)

Obesity is a condition excess fat tissue mass in the body. Obesity should not be defined by weight alone, because individual muscles could be overweight but without an increase in fat tissue. The method most often used for weight status and the risk of disease is the body mass index (BMI) which is equal to weight in kilograms divided by height in meters squared.

The following is a classification category of weight status and the risk of diabetes and heart disease by body mass index:

1. <18.5: underweight
2. 18.5 to 24.9: healthy weight
3. 25 to 29.9: overweight with increased risk of disease
4. 30 to 34.9: Obesity Class 1 with high risk
5. 35 to 39.9: Obese class 2 with a very high risk
6. > 40: Obesity grade 3 with a high risk of extreme

Usually obesity is caused by various factors such as increased energy intake, decreased energy expenditure or a combination of both factors. Excessive accumulation of body fat is the result of environmental factors, genetic, social and economic conditions.

As for the secondary causes of obesity include injury hypothalamus, hypothyroid state and Cushing's syndrome. Here are a variety of medications that can cause weight gain like diabetes drug class insulin, sulfonylureas and thiazolidinediones, glucocorticoids, psychogenic drugs, monoamine oxidase inhibitors, paroxetine, mirtazapine, antiepileptic drug valproate, gabapentin and karbamazepine. Obese people usually more susceptible to heart disease, high blood pressure, gallbladder disease, gout, arthritis, diabetes, certain cancers, and sleep disorders.

For the management of obesity actually is not an easy thing if it is not accompanied by intention, dietary adjustments and lifestyle are correct. Obesity is a chronic medical condition that requires constant management and lifestyle modification. Diet, exercise and behavioral therapy is recommended for patients with a BMI greater than or equal to 25 kg/m2.

Modification of Life behavior including group counseling, setting menu daily and changing the  diet should be done immediately. Feeding behavior must be monitored carefully as to avoid fast food, eat small portions but often and should eat breakfast. Physical activity should be increased to the minimum 150 minutes of moderate physical activity each week. Of course, all that would be easier if assisted by a medical nutritionist.

For commonly used drug therapy in obese individuals with a BMI over 30 kg/m2 or more than 27 kg/m2 with complications. Sibutramine is an example of drugs that block the re-uptake of the substance in the brain norepinephrine and serotonin.

This sibutramine can lose 5-9 percent of body weight over a period of 12 months. While Orlistat is a lipase inhibitor of the small intestine which causes 9-10 percent weight loss. While Metformin which is a blood sugar-lowering drugs also tend to lose weight in patients with obesity and diabetes.

Surgical treatment should be considered in patients with a BMI over 35-40 kg/m2 accompanied by a serious medical condition and can not tolerate other types of treatment. This type of surgery in general can lose weight about 30 percent could be maintained at about 60 percent of patients over 5 years.


Source:  shipment of Dr.Fendie K. Syailawan of the Hospital of Central Bangka

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