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 Obesity

By Dr. (Hk.) Faizee Ab Karim

Obesity is excess accumulation of fat tissues beyond the limitation of the skeletal and muscular requirement. Weight of normal persons of 25 years of age in relation to their height. Because that is the prime age when the skeleto-muscular structure is well-developed & physical adjustment to adulthood is at its peak. The vital organs would have reached optimum capacity to carry out their functions. So any increase in weight as one age must be in keeping with the average of what it was at the age of 25. If not, it is always detrimental to good health.

TYPES OF OBESITY

The two types of obesity android & gynoid. Android in the male type of obesity where excess fat is marked in the upper half of the body.

Android

Android type of obesity is shape of like an apple. The shoulders, face, arms, neck, chest & upper portion of the abdomen are bloated. The stomach gives a stiff appearance.  The   neck is compressed and there will be protruding chest because of the bulk in the stomach. The lower portion of the body the hips, thighs & legs are thinner beyond proportion in comparison with the upper part. This typed of obesity is found more in males some females also found. It occurs in females around menopause too due to thyroid gland's functional disturbance. In this type, the excess flesh is less likely to reduce especially in female than males. Android type of obesity is a major risk for heart damage & heart disease due to high cholesterol.

Gynoid

This type of obesity is also common to both sexes. In this type the lower part of the body has the extra flesh and is similar to pears. The flesh is somewhat flabby in the abdomen, thighs, buttocks & legs. The face & neck mostly give a normal appearance. In some persons, the cheeks may be drawn too. As these persons grow old the whole figure assumes a stooping posture and the spine is never erect due to the heavy hips & thighs. This vital organs affected mostly are the kidneys, uterus, intestines, bladder & bowls. But the functions of these organs some times have a direct effect on the heart.

In this type of obesity, exercises or dieting will not help appreciably in reducing weight. Here unani medicine is the only hope. One should have more patience & undertake proper treatment to achieve the coal of reducing weight & preventing further weight again.

The third type: - Besides android & gynoid, there is one more type of obesity. Some persons neither belong to android or to gynoid category. Their whole body from head to toe looks like a barrel. Their gait is more to rolling rather than walking. The fat tissues in their body hinder the movement of all the internal organs & consequently affect their brisk functioning. For them any exercise is difficult due to the enormous size of the body. So such person should follow a strict in diet & do plenty of exercise. But unani medicines & treatment help successfully in reducing weight.

Medications That Promote Weight Loss

Most available weight-loss medications are "appetite-suppressant" medications. Appetite-suppressant medications promote weight loss by decreasing appetite or increasing the feeling of being full. These medications decrease appetite by increasing serotonin or catecholamine--two brain chemicals that affect mood and appetite.

In 1999, the drug orlistat was approved by the Food and Drug Administration (FDA) as an obesity treatment. Orlistat works by reducing the body's ability to absorb dietary fat by about one third.

Most currently available weight-loss medications are approved by the U.S. Food and Drug Administration (FDA) for short-term use, meaning a few weeks or months. Sibutramine and orlistat are the only weight-loss medications approved for longer-term use in significantly obese patients, although the safety and effectiveness have not been established for use beyond 1 year. (See table 1 for the generic and trade names of prescription weight-loss medications.) While the FDA regulates how a medication can be advertised or promoted by the manufacturer, these regulations do not restrict a doctor's ability to prescribe the medication for different conditions, in different doses, or for different lengths of time. The practice of prescribing medication for periods of time or for conditions not approved is known as "off-label" use. While such use often occurs in the treatment of many conditions, you should feel comfortable about asking your doctor if he or she is using a medication or combination of medications in a manner that is not approved by the FDA. The use of more than one weight-loss medication at a time (combined drug treatment) is an example of an off-label use. Using weight-loss medications other than sibutramine or orlistat for more than a short period of time (i.e., more than "a few weeks") is also considered off-label use.

Table 1 - Prescription Weight-Loss Medications  

Single Drug Treatment

Several weight-loss medications are available to treat obesity. In general, these medications are modestly effective, leading to an average weight loss of 5 to 22 pounds above that expected with non-drug obesity treatments. People respond differently to weight-loss medications, and some people experience more weight loss than others. Some obese patients using medication lose more than 10 percent of their starting body weight--an amount of weight loss that may reduce risk factors for obesity-related diseases, such as high blood pressure or diabetes. Maximum weight loss usually occurs within 6 months of starting medication treatment. Weight then tends to level off or increase during the remainder of treatment. Studies suggest that if a patient does not lose at least 4 pounds over 4 weeks on a particular medication, then that medication is unlikely to help the patient achieve significant weight loss. Few studies have looked at how safe or effective these medications are when taken for more than 1 year. Both orlistat and sibutramine have been studied for as long as 2 years in some patients.

Some antidepressant medications have been studied as appetite-suppressant medications. While these medications are FDA approved for the treatment of depression, their use in weight loss is an "off-label" use. Studies of these medications generally have found that patients lost modest amounts of weight for up to 6 months. However, most studies have found that patients who lost weight while taking antidepressant medications tended to regain weight while they were still on the drug treatment.

NOTE

Amphetamines and closely related compounds are not recommended for use in the treatment of obesity due to their potential for abuse and dependence.

(By Dr. (Hk.) Faizee Ab Karim is a lecturer at

Mohammadia Tibbia College, Malegaon. He can be reached at fak1964@rediffmail.com)

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