This document discusses obesity and related topics. It defines obesity as having excess adipose tissue that poses health risks, with a body weight 20% over the ideal weight considered obese. Obesity occurs when caloric intake exceeds utilization, which can be due to overeating, lack of physical activity, genetics, diet composition, or underlying diseases. Complications of obesity include diabetes, hypertension, dyslipidemia, heart disease, respiratory issues, cancers, and more. Leptin and other molecules released by adipose tissue help regulate energy levels and metabolism.

1. AISWARYA THOMAS
2nd YEAR PHARM D
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4. Dietary imbalance and over
nutrition may lead to diseases like
obesity.
Defined as an excess of adipose
tissues that imparts health risk; a
body weight of 20% excess over
ideal weight for age, sex and height
is considered a health risk.
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5. •The most widely used method to gauge
obesity is Body Mass Index(BMI) which
is equal to weight in Kg/height in m2.
•A cut off BMI value of 30 is used for
obesity in both men and women.
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7.  Obesity results when caloric intake exceeds
utilization.
 The imbalance of these two components can
occur in the following situations:
1.Inadequate pushing of oneself away from
dining table causing over eating.
2.Insufficient pushing of oneself out of the
chair leading to inactivity and sedentary life style.
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8. 3.Genetic predeposition to develop
obesity (heredity) .
4.Diets largely derived from
carbohydrates and fats than protein-rich
diet (fat and sugar rich diet).
5. Secondary obesity may result from
diseases such as hypothyroidism,
Cushing’s disease, insulinoma and
hypothalamic disorders.
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9.  Adipocytes (lipid storing cells) comprise the
adipose tissue, and are present in the vascular
and stromal compartments of the body.
 Besides the function of fat storage, adipocytes
also release endocrine regulating molecules.
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10. Molecules include:
1) Energy regulating hormone(leptin),
2) Cytokines(TNF-alpha & IL-6),
3) Insulin sensitivity regulating
agents(adiponectin, resistin and RBP4),
4) Prothrombotic factors(plasminogen
activator inhibitor),
5) BP regulating agent(angeotensingen).
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•Adipose mass is increased due to :
a) enlargement of adipose cells due to excess
of intra cellular lipid deposition
b) increase in the number of adipocytes.
•Environmental factor of excess consumption of
nutrients can lead to obesity.

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Underlying molecular mechanisms of obesity
are beginning to unfold that obesity is familial
and is seen in identical twins.
 Recently, two obesity genes have been found
:
 ob gene and its protein product lepton,
 ab gene and its protein product leptin.

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The physiological role of leptin is to
communicate to the central nervous system (CNS)
•the abundance of available energy store
•To suppress food intake
•To permit energy expenditure.
The absence of leptin therefore leads to
increased appetite and food intake that results in
morbid obesity.

16.  An absolute deficit of leptin does not underlie in
most cases of obesity.
 Most obese individuals exhibit elevated circulating
leptin levels, which implies the existence of leptin
resistance.
 The failure of high levels of leptin to suppress
feeding or decrease adiposity to prevent obesity is
due to relative resistance to the catabolic effects of
leptin action in obesity.
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COMPLICATIONS OF OBESITY
1.Diabetes Mellitus
There is a strong association between obesity and type 2
diabetes mellitus, in both genders and all ethnic groups.
2. Hypertension
•It has been estimated that excess body weight may account for
up to 26% of cases of hypertension in men and 28% in women.
•Not only is obesity linked with hypertension, but weight loss in
obese subjects is associated with a decline in blood pressure

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3.Dyslipidaemia
•Obesity is associated with an unfavorable lipid profile.
•Lipid abnormalities related to obesity include an elevated
serum concentration of LDL & VLDL cholesterol,
triglycerides and apolipoprotein B, as well as a reduction in
serum HDL cholesterol.
4.Heart disease
•coronary artery disease
•heart failure
•atrial fibrillation.

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5.Cerebrovascular disease
6.Respiratory disease
•Obstructive sleep apnoea
•Asthma
7.Gastrointestinal system
•Gastro esophageal reflux
Gastro esophageal reflux disease (GORD) is a common
disorder that has been linked to obesity. Most population-
based studies showed a gradual increase in GORD
symptoms as BMI increased.
•Hepatobiliary disease
•Non-alcoholic fatty liver disease (NAFLD)

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8.Osteoarthritis
It is most common in the knees and the ankles, which
may be a consequence of trauma related to the excess
body weight.
9.Cancer
The WHO estimated that overweight and inactivity
account for from a quarter to a third of all cancers of
the breast, colon, endometrium, kidney and oesophagus.

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10.Gynaecological and obstetric complications
Obesity during pregnancy is associated with an
increased risk of complications, including gestational
diabetes, pre-eclampsia, and delivery complications
such as macrosomia, shoulder dystocia and higher
rates of caesarean sections and infections. Maternal
obesity may also be an independent risk factor for
neural tube defects and fetal mortality.

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11.Surgical and anaesthetic complications
12. Chronic kidney disease

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24.  Textbook of Pathoogy –Harsh Mohan
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