Home Heart Health Food Liver problems, sleep apnea, GERD: Obesity can harm more than just the heart

Liver problems, sleep apnea, GERD: Obesity can harm more than just the heart

18 min read

By Rashmi Ramesh

It isn't just your heart that bears the brunt of you being overweight. Obesity impacts your body and mind in multiple ways. So, it is wise to be in the safe zone, writes Rashmi Ramesh.

It’s time you looked beyond the cardiovascular risk of obesity. Being overweight can also lead to liver problems, obstructive sleep apnea and gastroesophageal reflux disease (GERD), to name a few.

Edwina Raj, senior dietitian at Bengaluru-based Aster CMI Hospital, said obesity is a silent killer and some of the lesser-known consequences of it include being at a higher risk of developing cancers of the breast and colon, and endometrial.

“Obstructive sleep apnea can be caused due to excess weight in the upper body; non-alcoholic fatty liver disease, an abnormality in the liver function, is associated with obesity. So also hormonal imbalance (which can progress to irregular periods and increased rate of infertility), prevalence of caesarean section and increased risks during childbirth, increased cholesterol turnover related to total body fat (which can lead to gallbladder stones), musculoskeletal disorders like osteoarthritis, breathing issues like wheezing or asthma and increased risk of developing blood clots like deep vein thrombosis and pulmonary embolism,” Raj added.

Dr Vinay Dhir, head of department (gastroenterology and endoscopy) at Mumbai’s SL Raheja Hospital, too said lowered immunity and increased risk for some types of cancers such as of the breast, gallbladder, uterus and prostate, can also caused by obesity.

Dr Ashutosh Goyal, senior consultant (endocrinology) at Gurgaon-based Paras Hospitals, said obesity can be the culprit behind mental health issues like depression.

Be Happy on the Weighing Scale

- This one’s sage advice: Don't skip meals. Eat at regular intervals, mindfully, and drink plenty of water

- Track your food and daily activity to get an insight into healthy lifestyle practices and limit deviation in your weight management plan

- Get a personalised meal plan for you and your family from a qualified dietitian

- Get some exercise daily. Also, indulge yourself in activities that you like, such as swimming, playing sports, dancing or trekking two-three times a week

- Limit the use of gadgets and sitting idle for more than an hour in a day. Take breaks and go for a walk or exercise during these breaks

- Be a smart shopper. Always read food labels and add healthy options to your cart

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A recent study showed that antioxidant-rich walnuts can nearly halve the risk of developing Type-2 diabetes.
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ETPanache got in touch with doctors and dieticians to get you the ultimate list of foods you must consume to stay healthy.

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THE FAT FACTS

The reasons behind gaining weight can be multiple, ranging from lifestyle-related to genetic.

Shalini Garwin Bliss, executive dietitian, department of clinical nutrition and dietetics at Gurgaon-based Columbia Asia Hospitals, said while there are no specific age or gender factors for obesity, the individual’s lifestyle and eating habits are mostly the reasons.

“However, some underlying conditions like PCOS and hormonal imbalance in women, and intake of steroids can also cause weight gain,” she said.

Post-menopausal women too tend to gain weight, Raj added.

Goyal said while there are genetic, behavioural and hormonal influences on body weight, obesity mainly occurs when the intake of calories is more than that you burn through exercise and normal daily activities.

“Certain medications like steroids and anti-depressants, and medical problems like Prader-Willi Syndrome (a genetic disorder), Cushing’s syndrome (related to prolonged high cortisol levels in the body) and hypothyroidism can also cause obesity,” Goyal said.

“The causes of obesity in an individual can be determined by personal history, family history, treatment history, clinical examination and some investigations, when needed. The role of a clinician is to differentiate exogenous obesity (due to unhealthy lifestyle or familial tendency) from obesity due to other medical disorders or medicines. With lifestyle changes and treatment of underlying medical disorder, we can help patients lose weight in a healthy manner,” he added.

“Those consuming a high fat and carbohydrate diet and having low levels of physical activity are at risk of becoming overweight and obese. In addition, socioeconomic factors and genetic factors also play a role. For example, housewives tend to become obese despite working hard at home — this is due to lack of physical outdoor activities. Genetic factors, however, play a very minor role in a small proportion of people,” said Dhir.

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The first step in having healthy cholesterol levels is examining your diet.

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Healthy Plate
GRAINS


Make at least half of your grains whole. Eat more whole grains like whole wheat, oat meal, whole corn meal and brown rice. Limit refined grains like white rice, white bread and pasta.

PROTEIN

Go lean with protein. Choose from a variety of meat, poultry, seafood, pulses, beans, peas, eggs, soya foods like tofu, and nuts and seeds. Limit red meat and cheese, avoid cold cuts and other processed meats.

FRUITS

Eat a variety of types and colours of produce in order to give your body the mix of nutrients it needs. Eat plenty of fruits. Try to eat with the skin to ensure adequate fibre intake. Fruit juices are a good option when taken without being strained (with the pulp).

VEGETABLES

Vary your vegetables. Have dark green, red, orange and yellow-coloured vegetables. Include a variety to ensure proper intake of all essential nutrients. Include fresh salads and soups in your dietary intake. The more the veggies, the greater the variety and the better for you.

FATS

Use healthy, minimally-processed oils and fats for cooking, on salads and at the table. Variety is the key to ensure an adequate intake of all the essential fatty acids in the diet. Limit butter and other saturated fats.

WATER

Drink two-three litres of water in a day. Water contains zero calories, so it can be an excellent tool for managing weight. Avoid sugary drinks, sodas or soft drinks.

GETTING FITTER

To get fitter, you could start by “trying to be in a healthy BMI range, eating healthy by cutting down sugar and salt intake, eliminating refined cereals and including more fruits and veggies in your diet, and exercising for at least 45 minutes a day”, said Bliss.

“Obese people would have gradually lost self-confidence and hope in reducing weight since most of them would have tried crash diets and weight-loss programmes with disappointing results. Obese people suffer from joint aches, deficiencies, knee pain and fatigue, and hence regular exercise becomes impossible. Thus, it is necessary to motivate them and help them lose weight with feasible options rather than having a rigid diet and exercise regime from the word ‘go’,” Raj said.

Dr Arulvanan Nandan, senior consultant (general, laparoscopic, bariatric and metabolic surgery) at Fortis Hospital, Mumbai, said the severity of the problems is higher in those who develop obesity at a younger age.

As much as 90% of the cases are due to poor lifestyle, he said.

“If all natural methods of weight loss are ineffective, one can opt for weight loss surgeries like sleeve gastrectomy or gastric bypass, which can help one lose weight and reduce the associated issues as well,” Nandan said.

“Office-goers can lead a healthy life by altering some simple things like taking the stairs instead of the escalator, hitting the gym at the workplace, taking part in group activities to reduce stress and, if you live close to the office, walking to work — at least partially,” he advised.

SOCIAL & INSTITUTIONAL EFFORTS

“It is better to target the root cause of obesity with solutions like health education starting from school, healthy food habits, increased physical activity and decreased sedentary lifestyle,” Nandan said.

“Educational efforts can include focus on the right kind of balanced diet and physical activity. There needs to be awareness about the effects of junk food and carbohydrate rich drinks among the younger population. Those older should be made aware of the health cost of obesity and that the problem can be prevented easily, with some discipline in diet and activity,” opined Dhir.

“Social and psychological issues play a part in the unwillingness of some obese people to follow the appropriate diet and physical activity regimen. The incentives are not immediate and the positive health effects take some time to become visible. The risk factors are always around, and it is easy to cheat. The solution lies in creating awareness about adverse health and economic aspects of obesity,” added Dhir.

THE FAMILY FACTOR

Obesity tends to run in families not only due to genetic factors but also due to unhealthy family lifestyles as family members share similar eating and activity habits, said Goyal. If many people in a family are overweight, “it is always better to follow lifestyle intervention in the form of healthy eating and exercises for all family members to prevent obesity,” he said. Elders must practise, not just preach. “Parents must set an example to kids by helping each other in weight management and promoting a healthy lifestyle — one that is practised by both parents and children — rather than just laying down strict guidelines,” Raj added.

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