5^thAsian Obesity Specialists and Endocrinologists Annual Meeting July 11-12, 2016 Kuala Lumpur, Malaysia

The Body mass index (BMI), or Quetelet index, is a value derived from the mass (weight) and height of an individual. The BMI is defined as the body mass divided by the square of the body height. BMI values are age-independent and the same for both sexes. However, BMI may not correspond to the same degree of fatness in different populations due, in part, to different body proportions. The health risks associated with increasing BMI are continuous and the interpretation of BMI gradings in relation to risk may differ for different populations. It is normal for children to have different amounts of body fat at different ages, and for girls and boys to have different amounts of body fat. So in children and teens, the healthy range for BMI varies based on age and gender.

Anti-obesity medication or weight loss drugs are all pharmacological agents that reduce or control weight. These drugs alter one of the fundamental processes of the human body, weight regulation, by altering either appetite, or absorption of calories. The main treatment modalities for overweight and obese individuals remain dieting and physical exercise. Lorcaserin (Belviq) was approved for obesity with other co-morbidities. The average weight loss by study participants was modest, but the most common side effects of the drug are considered benign. Some anti-obesity drugs can have severe, even, lethal side effects, fen-phen being a famous example

Obesity in children is a complex disorder. Its prevalence has increased so significantly in recent years that many consider it a major health concern of the developed world. The National Health and Nutrition Examination Survey (NHANES) indicate that the prevalence of obesity is increasing in all paediatric age groups, in both sexes, and in various ethnic and racial groups. Many factors, including genetics, environment, metabolism, lifestyle, and eating habits, are believed to play a role in the development of obesity. However, more than 90% of cases are idiopathic; less than 10% are associated with hormonal or genetic causes. Childhood obesity predisposes to insulin resistance and type 2 diabetes, hypertension, hyperlipidaemia, liver and renal disease, and reproductive dysfunction. This condition also increases the risk of adult-onset obesity and cardiovascular disease. 

Exogenous obesity is a form of obesity that results from the immoderate consumption of meals. It's triggered by using a steady consumption of meals that goes good beyond what the body requires for use as sources of chemical power, leading to the storage of any pointless quantity of energy derived from digested food particles as fats. Individuals having their bodyweight 20% more than it should be, then, he or she is considered to be an obese. If the body mass index for any person is 30 or more, then he or she has obesity disease. Obesity can be cured by various medical as well as physical therapies. There have been a number of surgeries started to cure obesity. These include gastrointestinal surgery, bariatric surgery, etc. The physical therapies are also helpful to reduce obesity in obese people.

Gynoid obesity is characterized by presence of fat at hip and thigh regions. Buttocks of people suffering from this type of obesity will be larger than that of others. Body shape of these people would be pear shaped and hence they are called pear obese or gynoid obese. But despite such, gynoid obesity having individuals are said to be at a much safer position than the android obese individuals for they are less at risk in developing chronic illnesses linked to obesity and overweight.

The past few decades have brought lifestyle changes throughout the world that have resulted in children having reduced physical activity and increased caloric intake. The amount of time that children spend playing outside has diminished during the past few decades and physical education programs in schools have been reduced or eliminated. The majority of families now have both parents or the single parent working, resulting in the need for nonparental supervision after school. Fear of children playing outside without adult supervision has led many parents to admonish their children to stay inside after school. Children are thus spending more time watching television and playing on computers than exercising. Watching television has been directly linked to obesity in childhood, with a rate of obesity that is 8.3-times greater in children who watch more than 5 h of television per day compared with those who watch up to 2 h of television per day.  

Being obese during pregnancy can have a major impact on your health and your baby's health.  It includes:

· Gestational diabetes. Women who are obese are more likely to have diabetes that develops during pregnancy (gestational diabetes) than are women who have a normal weight.

. Preeclampsia. Women who are obese are at increased risk of developing a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys (preeclampsia).

· Infection. Women who are obese during pregnancy are at increased risk of urinary tract infections. Obesity also increases the risk of postpartum infection, whether the baby is delivered vaginally or by C-section.

· Overdue pregnancy. Obesity increases the risk that pregnancy will continue beyond the expected due date.

· C-section. Obesity during pregnancy increases the likelihood of elective and emergency C-sections. Obesity also increases the risk of C-section complications, such as wound infections. Women who are obese are also less likely to have a successful vaginal delivery after a C-section (VBAC).

·  Pregnancy loss. Obesity increases the risk of miscarriage

Obesity is a complex disease resulting from the interactions of a wide variety of hereditary and environmental factors. The combined progress in quantitative genetics, genomics and bioinformatics has contributed to a better understanding of the genetic and molecular basis of obesity.Occurrences of monogenic types of obesity are evidence that obesity may be caused by genetic mutations, however, as yet, only 78 cases worldwide have been attributed to mutations of seven distinct genes. The most common forms of obesity are probably the result of variations within a large number of genes. Sequence variations within a pool of 56 different genes have been reported as being related to obesity phenotypes.

Anorexia Nervosa is a psychological and possibly life-threatening eating disorder defined by an extremely low body weight relative to stature (this is called BMI [Body Mass Index] and is a function of an individual’s height and weight), extreme and needless weight loss, illogical fear of weight gain, and distorted perception of self-image and body. There are two common types of anorexia, which are as follows: Anorexia Nervosa Binge / Purge Type , Restrictive Anorexia Nervosa. Anorexia Nervosa continues to have the highest mortality of all psychiatric conditions. Since anorexia involves both mind and body, a team approach to treatment is often best. Those who may be involved in anorexia treatment include medical doctors, psychologists, counselors, and dieticians.

Being obese or overweight can increase the risk of developing a range of serious diseases. The risks rise with BMI, and so are greater for obese individuals .Body Mass Index (BMI)  is a strong predictor of mortality among adults. Overall, moderate obesity (BMI 30-35 kg/m2) was found to reduce life expectancy by an average of three years, while morbid obesity (BMI 40-50 kg/ kg/m2) reduces life expectancy by 8-10 years. Obsesity  reduces life expectancy by an average of three years, or eight to ten years in the case of severe obesity (BMI over 40). Around 8% of annual deaths in Europe (at least one in 13) have been attributed to overweight and obesity. The cost to the UK economy of overweight and obesity was estimated at £15.8 billion per year in 2007, including £4.2 billion in costs to the NHS. The health factors that are associated with obesity are alarming. Despite increasing national and local attention, the epidimics of in many countries continues to increase. For instance, about 94 million adults in the United States are either overweight or obese. In Pennsylvania, 28.5% of our population is currently obese. In 1995, no state had an obesity rate above 20%. Now, all but one does.

Overweight and obesity are proven risk factors for:

• Diabetes
• Cardiovascular problems
• High cholesterol
• Stroke
• Hypertension
• Gallbladder disease
• Musculoskeletal problems
• Osteoarthritis
• Venous Stasis Disease
• Sleep apnea  and other respiratory illness
• Certain Cancers: uterine, breast, colorectal, kidney, and gallbladder

 Obesity is also associated with:

• Fertility issues
• Complications in Pregnancy
• Menstrual irregularities
• Hormone Abnormalities
• Urinary stress incontinence
• Psychological disorders (depression)
• Increased surgical risk
• Increased risk of death                                                             

First of all, as mentioned before, our bodies produce hormones in the amount needed to maintain a delicate balance and any additional hormones, natural or synthetic can throw off this balance and create health issues. Secondly, synthetic hormones (or synthetic anything for that matter!) are not metabolized in the body the same way their natural counterparts are. In fact, synthetic hormones act as toxins in the body and can be difficult to get out of your system. One of the main side effects of synthetic hormones is Weight Gain, especially around the abdomen, hips and thighs.

Being overweight  increases the chances of developing the common type of diabetes, type 2 diabetes. In this disease, the body makes enough insulin but the cells in the body have become resistant to the salutary   action of insulin. Almost 90% of people living with type 2 diabetes are overweight or have obesity. People who are overweight or have obesity have added pressure on their body's ability to use insulin to properly control blood sugar levels, and are therefore more likely to develop diabetes.

Obesity is a growing health concern in humans and companion animals. Obesity is highly associated with various endocrine abnormalities that are characterized by hormonal imbalance and/or resistance. Weight reduction generally normalizes these endocrine alterations, implicating obesity as a direct cause. Endocrine and metabolic diseases are the leading causes of morbidity and mortality in the Worldwide. In particular, the current epidemic of obesity is leading to early death through diabetes, cardiovascular disease and an increased incidence of cancer.

Obesity is a major public health concern worldwide. The increasing prevalence of obesity in all ages, especially children and adolescents, has gained global attention and it is widely known that obesity increases the risk of many chronic conditions and illnesses, such as Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease. Community-based programs are one potentially feasible approach that can assist individuals, families, and communities in developing healthy behaviors that promote and maintain weight loss. This review reports on nine worldwide current studies on the effectiveness of community-based programs in diverse populations targeting obesity. The purpose of this review is to examine evidenced-based interventions that can assist in the development of standard practices in the battle against obesity.

Ayurvedic Tretment :

The Ayurvedic approach to drugs in general is quite different from what we've been used to. Herbal supplements can be of great benefit in weight control without the negative side effects of conventional drugs. With the diet therapy alone, the treatment of obesity is incomplete. Diet can avoid the further possibilities of obesity, but the fat has to be treated and the defective metabolism must be corrected, which is done by Ayurvedic medicines. These medicines improve fat metabolism in an obese individual. Once a person's metabolism is correct it is easy for him to maintain his weight.

Homeopathy Treatment for obesity :

Obesity is one big health issue that is a reason for distress for people of all age groups. If the popularity of slimming centers and continued patronage of weight loss pills and diet plans is any indication, then obesity is a huge problem

Top 5 Homeopathic Medicines to Lose Weight

·         Calcarea Carbonica

·         Natrum Mur

·         Lycopodium

·         Nux Vomica

·        Antimonium Crudum

Unani Treatment: 

Obesity is the vital nutritional or the metabolic disorder where the percentage of fat tissue (adipose tissue) increases disproportionately owing in imbalance of energy intake and energy expenditure. 

One gram of Luke –e-Maghsool may be taken with water in the morning for getting positive impacts for obesity. This is an effe

Obesity and Lac (Luke –e-Maghsool)

ctive Unani medicine for obese people.

Lemon juice is quite effective for obesity patients. 5-10 ml of lemon juice is mixed with one glass of water and should be taken on empty stomach in the morning. The mix is very useful for melting of adipose tissue from the body as well as weight loss. However, it is recommended to take the above mix once a day, otherwise, the person may experience loose motion or some digestive problems.

This unani medicine may be taken 4-6 gram twice a day, are found useful for obesity patients.

10 gram  of it may be taken at the bed time. This is good in minimizing of fats from the body.

It is recommended to have 10 gram of this useful Unani product at the bed time. This is beneficial for obesity patient.

Obesity is a major health problem worldwide and has reached an epidemic proportion in the Western society. Evidence continues to accumulate that obesity is a major risk factor for many diseases and is associated with significant morbidity and mortality. Surgery  on the stomach and  intestines to help a person with extreme lose obesity weight. Bariatric surgery is an option for people who have a body mass index (BMI) above 40. Surgery is also an option for people with a body mass index between 35 and 40 who have health problems like type 2 diabetes and heart diseases.   There are four types of operations :                               

1.    Adjustable Gastric Banding (AGB)

The basic principle of this type of surgery is to decrease food intake with the use of a small bracelet-like band placed around the top of the stomach. The band restricts the size of the opening from the throat to the stomach, limiting the amount of food a patient can ingest. The size of the opening can be modified using a balloon inside the band that can be inflated or deflated with saline solution according to the needs of the patient.

2.    Roux-en-Y Gastric Bypass (RYGB)

This method is also used to decrease food intake and involves creating a small pouch that is similar in size to the pouch created with AGB. The food bypasses the rest of the stomach and reaches the small intestine, where it is absorbed to a much lesser degree than if it had passed through the stomach, duodenum, and upper intestine.

3.    Vertical Sleeve Gastrostomy (VSG)

This procedure involves removal of most of the stomach, which not only restricts food intake and absorption, but lowers levels of the hormone ghrelin that is responsible for appetite.

4.    Biliopancreatic Diversion with a Duodenal Switch (BPD-DS)

Also called the duodenal switch, this three-stage procedure involves the removal of a large part of the stomach which makes the patient feel full after eating only a small meal, followed by re-routing of the small intestines to prevent food absorption. The third step involves changing how bile and other digestive juices affect the process of digesting and absorbing calories.

Non-Surgical Treatments:

·     Medication to treat obesity-related health problems

·     Behavioural changes to improve dietary habits and increase activity levels

·     Therapy to address any eating disorders (may also require medication)

Anti-Obesity Medication or weight loss drugs are all pharmacological agents that reduce or control weight. The drugs prescribed for obese individuals mainly work by either changing an individual’s appetite or by the absorption of extra calories in the body. Weight loss in individuals who are obese may reduce health risks. Studies have found that weight loss with some medications improves blood pressure, blood cholesterol, triglycerides and insulin resistance. Some research suggests that long-term use of weight-loss medications may help individuals keep off the lost weight.

Successful weight-loss treatments include setting goals and making lifestyle changes, such as eating fewer calories and being physically active.

Healthy Eating Plan

A healthy eating plan gives your body the nutrients it needs every day. It has enough calories for good health, but not so many that you gain weight.

A healthy eating plan is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. Following a healthy eating plan will lower your risk for heart disease and other conditions.

Healthy foods include:

·         Fat-free and low-fat dairy products, such as low-fat yogurt, cheese, and milk.

·         Protein foods, such as lean meat, fish, poultry without skin, beans, and peas.

·         Whole-grain foods, such as whole-wheat bread, oatmeal, and brown rice. Other grain foods                 include pasta, cereal, bagels, bread, tortillas, couscous, and crackers.

·         Fruits, which can be fresh, canned, frozen, or dried.

·         Vegetables, which can be fresh, canned (without salt), frozen, or dried.

Most weight -loss programs can help you lose weight at first. But you will lose more and have more health benefits if you can keep with it for a longer time. You need to find the right balance of eating and Physical Activity that you can keep doing or a program that works with your lifestyle.