HEALTH Tips
In the past decade, the number of obese patients, especially females, has been increasing at an alarming rate. It is therefore important to understand how to assess obesity as well as to know how best to treat the disorder.
Obesity is commonly determined by using the body mass index, or BMI. The BMI is a result of the weight in kilogrammes divided by the square of the height in metres (kg/h2).
According to Dr Lalita Khaodhiar, assistant professor of medicine at Boston University School of Medicine, a person with a BMI of 25 to less than 30 is considered to be overweight, and is classified as obese if the BMI is 30 or higher.
Waist size can also function as a rough predictor of the chances of developing obesity. Males with a waist size of more than 90cm and females with a waist size of more than 80cm are at high risk of obesity.
For people with mild levels of overweight, Dr Lalita recommends lifestyle and diet modifications coupled with regular exercise.
In cases where the BMI is over 30, or 27 for patients with other complications like high blood pressure or diabetes, however, pharmacotherapy may be considered seriously as a treatment option. Medications for the treatment of obesity function as appetite suppressants that aim to control the patients' food intake.
As anti-obesity medicines are associated with side effects like dry mouth, constipation, sleep disorder and high blood pressure, they must be used only under the close supervision of attending physicians.
Dr Lalita adds that surgery is the most effective treatment for severe obesity, and this is usually performed for patients with a BMI above or equal to 40 (or 35 for patients with co-morbidity).
The most commonly known surgery for obesity is the Roux-en-Y gastric bypass, which, according to Dr Lalita, aims to make the stomach smaller, thereby reducing the amount of food that is passed to the small intestine. After this surgical operation, obese patients will feel full more quickly. This mechanism helps greatly in reducing the amount of the calorie intake, which eventually leads to weight loss.
Within the five years following a gastric bypass procedure, Dr Lalita adds, the average patient loses 48 per cent of the initial weight, and some may lose up to 74 per cent.
It is important to note, however, that surgeons will perform gastric bypass surgery for obese patients only if non-surgical weight loss attempts have failed. Ideally, patients who undergo this type of surgery should be between 16 and 55 years of age.
'Health Tips' welcomes questions on health issues, which will be forwarded to a specialist in the field. Fax your questions to 02-240-3668, or email arusap@bangkokpost.co.th.
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