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27 February 2011

•

3 minute read

Globesity and reproduction

By Globesity And Reproduction

We are what we eat

Globalization, urbanization and changing habits in Asia have led to the adoption of a western lifestyle and diet. We rather ride in a car or take a bus than walk or cycle a few blocks round the corner to the shops these days. We have become “couch potatoes” spending hours watching television and not exercising enough. We are now working longer hours compared to our parents. We prefer to eat out at restaurants and food outlets than eat healthy and nutritious home cooked food every day. McDonalds and other fast food outlets are available nearly everywhere nowadays is convenient alternative to eating at home. We are eating larger and larger portions of food each year and drinking more sweetened drinks than ever before.

Obesity is a growing problem

Obesity is a serious global epidemic. Obesity is excess fat deposition in the body and commonly measured in terms of body mass index or BMI. Obesity is not only serious global epidemic BUT a serious medical problem too.

Worldwide, there are over 1 billion over-weight (BMI 25-30kg/m2) people and over 300 million obese (BMI>30kg/m2) individuals. In the UK, one-fifth of the population is either obese or overweight while in the USA, the figure is higher with nearly one third of the population being obese or overweight with childhood and adolescent obesity rapidly increasing.

In Asia, the figures are equally alarming. More importantly, the normal cut-off values for overweight and obese are lower in Asians.

Are you an orange or a pear?

We now know that obesity is in part genetic and in part environmental. Apart from measuring one’s BMI, waist circumference measurement is a reliable and practical indicator of fat deposition in the body.

The type of obesity that is commonly associated with medical disease, such as cardiovascular disease and metabolic syndrome, is central or truncal obesity (fat deposition predominantly in the abdomen) and this occurs when the waist circumference or waist-hip ratio is high.

What does obesity cause?

Obesity is associated with detrimental medical conditions such as hypertension, diabetes, hyperlipidaemia or hypercholestrolaemia, cardiovascular disease (the metabolic syndrome), respiratory problems and cancer, just to name a few.

In reproductive health, obesity can affect both the non-pregnant and pregnant women and even her baby.

Obesity and female reproduction

Obesity causes distressing menstrual problems. Irregular periods (oligoamenorrhoea) and difficulty conceiving (infertility) can occur in obese women. Obese women may not even experience a menstrual period at times (amenorrhoea).

Obesity is associated with both male and female infertility and breast cancer.

Polycystic Ovarian Syndrome (PCOS) is a common occurrence in obese women leading to irregular cycles and infertility due to anovulation, excessive or abnormal hair growth (hirsuitism) and acne.

Even if these women do become pregnant, the chance of having a miscarriage (3-4 fold increase) and birth defects is higher.

Obese women can have difficult pregnancies that are complicated by problems such as gestational hypertension and diabetes. Their labours too can be difficult and prolonged that could result in forceps or caesarian deliveries.

Obesity is also associated with many psychological problems such as premenstrual syndrome, depression and anxiety.

What is the treatment for obesity?

Treatment regimes in obesity consist of a combination of lifestyle modification, diet, physical exercise and drugs. A well-motivated patient is an important prerequisite for weight loss programmes.

It is important to set realistic goals for weight loss e.g. modest weight loss of 10% body weight over 6 months.

A low calorie low-moderate fat diet that is low in carbohydrates and fat is advocated.

Moderate intensity exercise is recommended with a minimum of 30 mins, for 3-5 times per week to reduce cardiovascular disease. In weight management, a minimum of 45-60min of exercise on most days or every day is necessary for weight loss and maintenance.

Drug therapy with anti-obesity drugs is most effective when used as an adjunct to diet and physical activity. In severely obese patients, surgery (bariatric) may be necessary in particular when medical methods have failed.

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27 February 2011

•

3 minute read

Globesity and reproduction

By Globesity And Reproduction

Globesity And Reproduction

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