Int. J. Life. Sci. Scienti. Res., 1(1): 12-14, September 2015

 

A METHODOLOGICAL ANALYSIS ON OBESITY

Deepak Prashar^1*, Ram Kumar Sahu²

¹Department of Pharmacy, PAHER University, Udaipur (RJ), India

²Department of Pharmacy, Columbia Institute of Pharmacy, Raipur (CG), India

 

^*Address for Correspondence: Mr. Deepak Prashar, Department of Pharmacy, PAHER University, Udaipur (RJ), India

 

ABSTRACT- Obesity is the problem of global concerned. All over the world it is considered to be the most improbable dilemma both health and appearance wise. Obesity not only makes the person to feel low in society but also indulge them with other health related disorders. Present review tries to focus on the different aspects allied with the obesity. Diseases associated with obesity and different therapies of concerned are being discussed.

Keywords: Obesity, BMI, Negative Energy Balance, Anti-Obesity Agents

INTRODUCTION- Obesity is the nutritional disorder caused by storage of excessive fat in the body as a reserve of energy. This storage of fats in the body might leads to negative outcomes. BMI (Body Mass Index) clearly indicates the difference between overweight and obese. Body Mass Index between 25 and 29.9 is consider overweight whereas BMI value 30 or above is considered as obese. The main problem with obesity is that in most cases, there is a strong tendency to regain weight; about one-third of lost weight is regained within a year, and almost all within five years.

WHO has recommended the definition of obesity based on the range of BMI (Table 1). Healthcare professionals around the world often use Body Mass Index while determining whether patients are underweight, healthy weight, overweight or clinically obese. Clinically obese persons have a higher risk of developing diabetes, stroke, cancer and cardiovascular disorders.

Table 1: Classification of body weight status based on BMI¹

BMI Value	Body Weight Status
less than 18.5	Underweight
between 18.5 and 25	Healthy Weight
between 25 and 30	Overweight
between 30 and 40	Obese
above 40	Extremely Obese/Morbidly Obese

 

According to a research carried out in the area of USA, Canada and Western Europe it has been concluded that the daily consumption of calories in both man and women depends upon their age and working conditions/activity status (Table 2). Some studies establish the fact that people risk malnutrition if they are not consuming a well planned balanced diet. This result in demotivation and most dieters drop out before reaching their target.

Table 2: Daily Recommended Calorie Consumption (in Calorie) To Maintain Weight

Gender	Age limits (year)	Activity Status
		Sedentary	Moderately active	Active
Male	19-30	2400-2600	2600-2800	3000
	31-50	2200-2400	2400-2600	2800-3000
	Above 51	2000-2200	2200-2400	2400-2800
Female	19-30	1800-2000	2000-2200	2400
	31-50	1800	2000	2200
	Above 51	1600	1800	2000-2200

 

Causes of obesity- Earlier it was assumed that overeating and less workout are the only causes of obesity. However, literature reviews suggests that there are many other reasons for the development of obesity. The reasons which initiate obesity can be summarized in Figure 1.

 

Fig. 1: Enlisted the Various Causes of Obesity

 

Ailments/Symptoms allied with obesity- There are always the risks of disease association with obese patients. Directly or indirectly accumulation of excess body fat might have harmful effect on patients’ health.  In order to lose weight patients starts exerting more energy than normal resulting in a state of negative energy balance. In this state of negative energy balance, body seeks out stores of energy, such as fat or muscle to make up for the shortfall - it will start using up your excess weight. In extreme cases, this leads to the generation of obesity associated diseases^2-8.

Ø  Coronary heart disease

Ø  Bone and cartilage degeneration (Osteoarthritis) 

Ø  High blood pressure (Hypertension)

Ø  High total cholesterol, high levels of triglycerides (Dyslipidemia)

Ø  Gallbladder disease (gallstone)

Ø  Respiratory problems

Ø  Sleep apnea and depression

Ø  Several cancers

Ø  Stroke

Ø  Type 2 diabetes

Apart from these diseases, which appears in the later stages many other preliminary symptoms evoke which need to be monitored. Patient’s emergence is adequate to arrive at a diagnosis in most cases, determined by the persons BMI (body mass index) depending on weight to height, though each adolescent may experience symptoms differently. Symptoms may include:

Ø  Large body frame

Ø  Difficulty in doing daily activities

Ø  Lethargy

Ø  Breathlessness

Ø  Disproportionate facial features

Ø  Breast region adiposity - (sagging fat cells) in boys

Ø  Big belly (abdomen), sometimes marked with white or purple blemishes

Ø  Male external genitalia may appear disproportionately small

Ø  Flabby fat in the upper arms and thighs

Ø  Knock-knees (Genu valgum)

Human studies considering flora as anti-obesity agents- From the literature, it has been proven since long that plants and its derivatives can be used as an anti-obesity agents. All over the world researchers have carried out many clinical investigations to prove the same. Human studies however are considered to be the best allowing for use of flora in the treatment and prevention of obesity.

Ø  Lehtonen et al. (2011) carried out a comparative study on over weight and obese women’s using bilberries. The study reveals the reduction in waist circumference as well as the body weight.

Ø  Datau et al. (2010) through his double blind study reveals the significant decrease in body weight, waist circumference and systolic blood pressure using Nigella sativa.

Ø  Gurrola-Diaz et al. (2010) carried double blind study on human (target) using Hibiscus sabdariffa and reach to the conclusion that the herb helps in reducing glucose and total cholesterol levels.

Ø  Pal et al. (2011) use psyllium fibre and carried out 12 week double blind study on over weight and obese target reaching to the result i.e. significant decrease in weight, BMI and %total body fat.

Ø  Rehman Riaz et al. (2011) find out the decrease in BMI and waist circumference in 100 obese targets using debese. The study was carried out for 2 years and also showed the Reduction of triceps skin fold.

Ø  Snitker et al. (2009) through his randomized clinical trials on 80 healthy persons using Capsinoids reach to the conclusions that abdominal adiposity is decreased but no major change in resting energy expenditure, higher fat oxidation, overall percentage body fat is observed.

Ø  Wang et al. (2009) use the extract of Catechin in the form of green tea on moderately over weight 182 samples. The randomized clinical trials outcome showed decrease in estimated intra-abdominal fat area, waist circumference, body weight and total body fat.

Many other researchers have also carried out the similar studies using different herbs and showed almost the same results.  

Anti-Obesity Products Therapies Differences- There are different therapies which are being used in India and across the world for the treatment and prevention of obesity. Some therapies use medication (tablet, capsule, syrup etc.) while other uses the extract, powder, tea. Some therapies also believe in massage, and hot stone therapies.

Table 3: Enlisted the Diverse Products Used in Different Therapies¹⁶

Therapies	Features Of Therapy
Allopathy17	Direct use of the medicine to prevent and dissolve the excess of deposited fats in tissues and muscles.
Ayurvedic	In obese persons, digestive fire may be optimum. To improve its power, herbs like trikatu, shilajit, cyperus, kashtha, barberry, calamus, ativisha, katuka, chitraka, karanja, turmeric, guggulu, arjuna, catechu, camphor, neem, rohitaka, shinshipa, apaamarga, brahmi, bilwa are used.
Homeopathic	It role is bit similar to Ayurveda, but instead of herbs the crude extracts are used
Naturopathy18	It focus less on diet and try to correct underlying imbalance through life style change and proper planning
Chinese therapy	Acupuncture
Electroconvulsive19 therapy	Often used for depression  but in recent years showed significant weight loss in obese patients
Psychotherapy Or Behavioral therapy20	Reduces the peer pressure related to surgery and weight loss diet pattern follow-ups
Gene therapy21	It increases or decreases gene product and restore and maintain energy homeostasis.

 

CONCLUSIONS- Literature review suggested that obesity is a matter of concern. The methodological analysis on obesity clearly indicates that prevention is better than cure. Obesity is not lethal but the associated ailments may prove to be fatal if proper care is not taken. Moreover, different therapies are available with the physician which might prevent and treat obesity. Systematic reviews are available and discussed by many researchers, yet there is the need of Meta analysis for the statistical combination of the available data. This clinical based Systematic and Meta analysis might prove to be a boon for the physician for the rationalized therapies.

REFERENCES-

1.      National Heart, Lung, and Blood Institute. Guidelines on overweight and obesity: the electronic textbook. Assessment of weight and body fat.

2.      Bray GA. “Risks of obesity”. Endocrinol Metab Clin N Am 2003; 32:787– 804.

3.      Gallagher EJ, LeRoith D, Karnieli E. “The metabolic syndrome–from insulin resistance to obesity and diabetes”. Endocrinol Metab Clin North Am 2008; 37:559 –579.

4.      Grundy SM, Brewer HB Jr, Cleeman JI. “Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition”. Circulation 2004; 109:433–438.

5.      Faith MS, Matz PE, Jorge MA. “Obesity-depression associations in the population”. J Psychosom Res 2002; 53:935– 942.

6.      Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ. “Are the obese at greater risk for depression?” Am J Epidemiol 2000; 152:163–170.

7. Crisp AH, McGuiness B. “Jolly fat relation between obesity and psychoneurosis in general population”. BMJ 1976; 1:7–9.

8.      Kuhl H. “Breast cancer risk in the WHI study: the problem of obesity”. Maturitas 2005; 51:83–97.

9.      Lehtonen HM, Suomela JP, Tahvonen R, Yang B, Venojarvi M, Viikari J, Kallio H. “Different berries and berry fractions have various but slightly positive effects on the associated variables of metabolic diseases on overweight and obese women”. Eur J Clin Nutr 2011; 65:394–401.

10.  Datau E, Surachmanto EE, Pandelaki K, Langi J. “Efficacy of Nigella sativa on serum free testosterone and metabolic disturbances in central obese male”. Acta Med Indones 2010; 42:130–134.

11.  Gurrola-Diaz C, Garcia-Lopez P, Sanchez-Enriquez S, Troyo-Sanroman R, Andrade-Gonzalez I, Gomez-Leyva J. “Effects of Hibiscus sabdariffa extract powder and preventive treatment [diet] on the lipid profiles of patients with metabolic syndrome [MeSy]”. Phytomedicine 2010;17:500–505.

12.  Pal S, Khossousi A, Binns C, Dhaliwal S, Ellis V. “The effect of a fibre supplement compared to a healthy diet on body composition, lipids, glucose, insulin and other metabolic syndrome risk factors in overweight and obese individuals”. Br J Nutr 2011; 105:90–100.

13.  Rehman RU, Usmanghani K, Nazar H, Uddin S, Akram M, Asif HM. “Clinical study on the management of obesity with certain natural medicine”. J Med Plants Res 2011; 5:4094–4098.

14.  Snitker S, Fujishima Y, Shen H, Ott S, Pi-Sunyer X, Furuhata Y, Sato H, Takahashi M. Effects of novel capsinoid treatment on fatness and energy metabolism in humans: possible pharmacogenetic implications”. Am J Clin Nutr 2009; 89:45–50.

15.  Wang H, Wen Y, Du Y, Yan X, Guo H, Rycroft JA, Boon N, Kovacs EM, Mela DJ. “Effects of catechin enriched green tea on body composition”. Obesity 2009; 18:773–779.

16.  Fujioka K, Lee MW. “Pharmacologic treatment options for obesity: current and potential medications”. Nutr Clin Prac 2007; 22(1):50–54.

17.  Kaplan LM. “Pharmacological therapies for obesity”. Gastroent Clin North Am 2005; 34(1): 91–104.

18.  Koithan M, Sutherland E.” Naturopathic treatment of obesity”. J Nur Practi 2009; 5(9): 693-694.

19.  Eldor J, Kotlovker V, Kotlovker S. “Electroconvulsive therapy for obesity treatment”. Open J Anesth 2014; 4:68-71.

20.     Jacob JJ, Isaac R. “Behavioral Therapy for management of obesity” Ind J Endo Met 2012; 16(1):28-32.

21.  Gao M. “Gene therapy for obesity: Progress and Prospect”. Dis Med 2014; 17(96); 319-328.