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  1. 1. Obesity is defined as an abnormal growth of the adipose tissue due to an enlargement of fat cell size(hypertrophic obesity)or an increase in fat cell number(hyperplastic obesity)or a combination of both. Central obesity is defined as waist circumference ≥ 90 cm in males and ≥ 80 cm in females. + Any two of the following -Increased triglycerides ≥ 150 mg/dl (1.70 mmol/L) -reduced HDL cholesterol <40 mg/dl in males and < 50 mg/dl in females. -raised blood pressure systolic bp ≥ 130 mm Hg and diastolic bp ≥ 85mm Hg. -raised fasting plasma glucose ≥ 100 mg/dl. Or treatment for previously diagnosed any of the above condition.
  2. 2. Classification BMI Risk of Co-morbidities (kg/m2 ) Underweight <18.5 Low (Risks are increased in other areas) Desirable 18.522.9 Average Overweight 22.929.9 Mildly Increased Obese >30.0 Class 1 Obesity 30.034.9 Moderate Class 11 Obesity 35.039.9 Severe Class 111 (morbid obesity) >40.0 Very severe
  3. 3. The food environment - there has also been a huge increase in the quantity of quick convenience foods, which tend to be high in saturated fat, salt and sugar. Culture/Individual psychology - it is difficult to break habituated unhealthy eating patterns, especially when common to those around us Obesity is primarily driven by individual decisions, and the way society influences them The physical environment our lives have become increasingly sedentary. For e.g. last two decades have seen marked reduction in school walking. Human biology genetics plays a part but does not pre-destine us to be obese
  4. 4. RELATIVE RISK OF HEALTH PROBLEMS ASSOCIATED WITH OBESITY Greatly increased (relative risk >>3) • • • • • • • Moderately increased (relative risk 2-3) Slightly increased (1-2) Diabetes Gall bladder diseases Hypertension Dyslipidemia Insulin resistance Sleep apnea Breathlessness • Coronary heart disease • Osteoarthritis (knees) • Hyperuricemia and gout • Cancer(breast cancer in postmenopausal women, endometrial cancer, colon cancer) • Reproductive hormone abnormalities • Polycystic ovarian syndrome • Infertility • Low back ache • Increased anesthetic risk • Foetal defect arising from maternal obesity.
  5. 5. Primary intervention Secondary intervention • Moderate calorie restriction.(to achieve a 510% loss of body weight in 1st yr) • Moderate increase in physical activity. • Change in dietary composition. • Drug therapy is required to treat the metabolic syndrome associated with obesity. • There is a definite need for treatment that can modulate the underlying mechanism of metabolic syndrome as a whole and thereby reduce the impact of all the risk factors and the long term metabolic and cardiovascular consequences.
  6. 6. D I E T Cut down on salt and sugar. Eat little at dinner. Take fruits in between meals for snacking. Do not skip meals Walk after night meals. Take at least 7-10 glasses of water every day. Do not eat while reading, watching TV, playing video games. Avoid foods high in saturated fat and cholesterol. Use skimmed milk instead of full fat milk. AVOID •Alcoholic drinks. •Butter , margarine •Cakes, pancakes, cookies, doughnuts, pastries etc. •Candies, chocolates, cream, cheese. •French fries, potato chips, pizza, pasta, burger, snacking food. •Jams, jellies, sugar and syrup. •Ice cream, ice milk, sherbets, soda drinks.
  7. 7. EARLY YEARS(UNDER 5S) Preschool children should be physically active at least for 180 minutes. All under 5s should minimize the time spend being sedentary for extended periods except for sleeping. CHILDREN AND ADOLESCENTS All children and young people should engage in moderate to vigorous intensity physical activity for at least 60 minutes and up to several hours every day. -Vigorous intensity activities, including those that strengthen muscle and bone should be incorporated at least thrice a week. -They should minimize the time spend being sedentary for extended periods. ADULTS AND OLD AGE -Adults should aim to be active daily. Over a week, activity should add up to at least 150 minutes (2½ hours) of moderate intensity activity in bouts of 10 minutes or more – one way to approach this is to do 30 minutes on at least 5 days a week. Alternatively, comparable benefits can be achieved through 75 minutes of vigorous intensity activity spread across the week or a combination of moderate and vigorous intensity activity. -Adults should also undertake physical activity to improve muscle strength on at least two days a week. -All adults should minimize the amount of time spend being sedentary for long.
  8. 8. Ammonium carbFat patients with weak heart. Women who are tired and weary and takes cold easily. Leads a sedentary lifestyle. Dry coryza-stoppage of nose-at night-can only breathe through mouth-danger of suffocation. Sadness with disposition to weep, timidity, disgust with life, heedlessness, weakness of memory, great absence of mind. Chilly patient < wet stormy weather ; washing > warmth. Ammonium muriaticumBody is fat and legs are thin with large buttocks. Full of grief but cannot weep. Irritability and disposition to be angry. Feets get very cold in the evening in bed.
  9. 9. Antium crudumChildren and old people who have a tendency to grow fat with coated white tongue. Belching and great eructations of ingesta.bloating after eating. Cold and callous excrescenses. Patient is aggravated from extremes of temperature. Calcarea carbonicumSweating on the forehead which wets the pillow while sleeping. Fair, fat, flabby are the red lined symptom. Great sensitiveness to cold damp air.
  10. 10. Calotropis giganteaHelps in reducing the obesity, without reducing the weight i.e. flesh would decrease but the muscle would become more firm. There is great heat in stomach. CapsicumPerson who are weak of lax fibre.the digestion is poor and suffer from myalgia. Have burning pains still doesn’t like cold. Old people who have exhausted their vitality. Home-sickness. >from heat CarlsbadAction on liver, treatment of obesity and diabetes. Self satisfied, very talkative, good humored. Discouraged and anxious about domestic duties. Absent minded, heedless, forgets names. Sensitive to cold air. sweats more easily. > Motion and open air.
  11. 11. Ferrum metallicumObesity with anaemia, puffy face with pitting of flesh. Delicate girls, fearfully constipated with low spirits.< cold weather. > warm weather. Great lassitude and weakness. GraphitisObesity in females with delayed menstruation. Fair, fat , chilly constipated people. Kali carbonicumOlder fat people characterized by sweat, backache and weakness. Dark haired person with lax fiber and inclined to be fat.
  12. 12. EsculentineGreat fat reducer. Can be alternated with phytoline. Should be given in mother tincture. Fucus vesiculosusGiven when calcarea carb fails. Indigestion, obstinate constipation, flatulence. To be given in tinctures. Phytolacca berryOne of the best remedies in weight reduction and corpulence reduction ThyroidinumExcessive obesity. Acts best in pale patients. Is a powerful diuretic and helps in myx-odema and various types of oedema. PhytolineGreat fat reducer. Recommended when the patient is having difficulty in walking, sitting, palpitation, dyspnoea on least exertion, nausea, eructations. Given in mother tincture.
  13. 13. COMPILED BY- Dr Neena Mehan(Head, Deptt. of Medicine)  Dr Pavneet Kaur (Intern 2013-2014 Dr B R Sur Homoeopathic Medical College, Hospital and Research Centre) 