By Dr. Kiran Rukadikar
The prevalence of overweight and obesity has risen rapidly in India. The research shows that obesity was higher among women than men (41.88 per cent vs 38.67 per cent). Also, India has the world’s second highest population of diabetics. Genetic predisposition, inherent ethnicity, obesity, rapid urbanisation, high intake of fast foods, and lack of exercise contribute to this rise in India. Out of all these factors, obesity is the major modifiable risk factor for development of Type 2-diabetes. According to ICMR (Indian Council of Medical Research), 40 percent to 50 percent of men and women are overweight in most of the urban metros.
Obesity in particular, increased adiposity in the Visceral Compartment {i.e. around waistline} decreases the tissue sensitivity to insulin by about 30-40 percent.
Lipolysis of fat and release of free fatty acids from visceral fat is more pronounced than the subcutaneous fat. These free fatty acids interfere with the action of cellular levels. Impaired insulin-stimulated glucose transport in skeletal muscle is responsible for insulin resistance.
Visceral fats release a lot of free fatty acids. These free fatty acids can reach the liver through portal circulation. In the liver it again interferes with the action of insulin on the cells. This causes gluconeogenesis (a process of formation of glucose from substances which are not carbohydrates, such as proteins or fats).
Diabesity –obesity induced diabetes
Together, overweight and obesity account for about two-thirds cases of type 2 diabetes. Various research reports stated that overweight or obesity is the single most important predictor of diabetes. For every 1 kg increase in measured weight, it increases the risk of diabetes by 4.5 percent.
In recent times, the risk of Obesity in females has increased. The reasons include:
Overconsumption, that is eating behaviours that predispose females to consume too much food in relation to energy needs, possibly including physiologically determined disorders of appetite regulation.
Metabolic efficiency, for example – physiological factors that predispose females to store relatively more consumed energy at any level of intake.
Low energy expenditure that is, possibly behavioural / sex differences in the ability to offset energy intake through routine or leisure-time physical activity; and
Less success in voluntary weight control because of, either behavioural or physiological factors.
The problems that women face because of obesity and diabetes vary as they depend on their age, family history, etc. PCOD, Irregular menses, and Hirsutism at a very early age, are some of the problems faced by obese women. Secondary infertility, hypothyroidism, diabetes, hypertension are common among middle-aged and older women who are overweight. Further, obese women with diabetes are at very high risk of suffering from heart disease and hypertension. We have often seen higher number of cases of breast cancers, gallstones, severe Acid peptic disorders in obese patients.
Other issues faced by obese women include chronic stress, anxiety, eating disorder, mood swings, and depression.
The solutions:
Healthy low calorie but balanced diet helps in controlling and prevention of Obesity and Diabetes. Avoiding fried foods, sweets, dry fruits and nuts, and high fat milk products can make a huge difference to them. Including cereals, pulses, vegetables, fruits, salads, skimmed milk products, and low calorie non-veg foods will help them to reduce weight. Of course, the quantity depends upon your height, age and physical activities. Exercising for obese patients is not advisable; physical activity like walking is sufficient for weight reduction. DietQueen, a women’s weight loss and nutrition app, recommends comprehensive, customised diet plans for women who are suffering from obesity and diabetes.
(The author is a renowned Obesity Physician and Weight Loss Specialist; Founder of DietQueen App. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)