e Health Counselor

From the heading, all of you may have started to think that how can obesity be a receptionist?

What do you mean by receptionist? – Wow! A sweet, beautiful girl who welcomes everybody at an office with her soft voice. Obesity is like that- it welcomes softly all the major diseases in our body.

Obesity is widely regarded as a pandemic with potentially disastrous consequences for human health. More than 20% of adults in the UK, and more than 30% in USA, are obese the prevalence of obesity has increased ∼threefold within the last 20 years and continues to rise. In developing countries, average national rates of obesity are not nearly so high, but these figures disguise alarmingly high rates of obesity in many urban communities.

Obesity has adverse effects on both mortality and morbidity. Changes in mortality are difficult to analyze due to the confounding effects of lower body weight in cigarette smokers. However, it is clear that the lowest mortality rates are seen in individuals with a BMI(body Mass Index, an unit of measuring obesity, with the normal range is 18-25) of 18.5-24. Data from population studies, such as that in Framingham, USA, show that for individuals aged between 30 and 42 years, the risk of death increases by 1% per annum for each 0.5 kg increase in weight; for those aged 50-62, this figure is 2%. The result is that obesity reduces life expectancy by 7.1 years in men and 5.8 years in women amongst non-smokers, and by 13.7 and 13.3 years respectively amongst smokers. Coronary heart disease is the major cause of death but cancer rates are also increased in the overweight, especially colorectal cancer in males and cancer of the gallbladder, biliary tract, breast, endometrium and cervix in females. Epidemic obesity is accompanied by an epidemic of type 2 diabetes. Obesity may lead to profound psychological consequences for individuals. Society also suffers from the effects of obesity-related disability and early retirement.

Behavioural modification to avoid some of the effects of the ‘obesogenic’ environment is the cornerstone of long-term control of weight. A study of subjects followed up after successful weight loss in Colorado found that the principal predictors of sustained weight loss are the maintenance of high physical activity levels and the regular consumption of breakfast (suggesting a regular eating pattern). All patients should be advised to maximise their physical activity. Where possible, this should be incorporated in the daily routine (e.g. walking rather than driving to work) since this is more likely to be sustained. Alternative exercise, e.g. swimming, may be necessary if musculoskeletal complications prevent walking. Changes in eating behaviour (including food selection, portion size control, avoidance of snacking, regular meals to encourage satiety, and substitution of sugar with artificial sweeteners) should be discussed. Support from a trained health-care professional (e.g. a dietitian) and participation in a group discussion may be helpful.