Obesity 

is now one of the major health risks in the developed countries. An obese person is at the risk of different disease and losing his or her productivity. Quality and quantity of activities of an obese person always remain far below than an average weight person. Recent statistics shows the current prevalence of obesity in UK1 is 24% of adult female and 25% of adult male and in USA2 is 34.9% of adults. And globally the prevalence is 35% of adult is overweight and 11% of adult is obese3.

Obesity is one of the major risk factors for developing Ischemic Heart Disease, Hypertension, Cerebro-vascular disease like stroke, Hypertension, colon or breast cancer, osteoarthritis, diabetes etc. A statistic of 2007 shows that the total cost for treating overweight and obesity, and related morbidity in the UK was £4.2 billion4. This report also indicates that, if obesity increase in this rate, within 2050 about 50% of the total population of the UK will be obese.

Obesity is not affecting only government funds it also impairing personal and social strategies regarding financial and medical aspects. Mental depression and social acceptance also act as additive factors for poor health status and developing other health problems.

Obesity not only causing non communicable diseases, like IHD or hypertension or stroke, it also affecting our reproductive health, which is always being overlooked. There are few studies have done regarding obesity and its effects on our reproductive system. In 2010 an exclusive research work was published by Brewer CJ & Balen AH5 showing relationship between infertility and obesity. The research also established that, weight loss through lifestyle modification or Bariatric surgery improves regularity of the menstrual cycle and ovulation as well as improves the possibility of conception.

Here we will try to focus and review about obesity and its effects on human reproductive system with current knowledge of pathophysiology.

1.Obesity:

WHO defines obesity as,

Obesity is the accumulation of abnormal and excessive fat that may impair health.

According to WHO statistics in 2008 over 200 million adult males and over 300 million adult females were obese3. It is an alarming issue. If obesity increases in this rate, the different health hazard cost will climb up so high rapidly.

Obesity is usually measured by body mass index (BMI) and waist circumference. But BMI is well accepted technique. 

Causes of obesity:

There are many causes in the modern age to develop obesity. Lifestyle and inactivity are the main cause. Dependency to the invention of modern science is another factor. Life becomes more comfortable day by day. Here is some important cause of obesity.

Poor Dietary habit:

Inappropriate diet habit is the main cause of developing obesity in developed countries. Oily and high fat containing fast food intake, frequent sugary beverage drinking and unawareness about calorie requirement and intake are the main reason of getting fatty health.

Some so called high energy containing food supplements are also responsible. Though dieting is now a trendy matter in our society, but following an inappropriate diet plan causing the failure to reaching the goal.

Other habits, like alcoholism, also cause obesity and predispose other morbid conditions.

Physical inactivity:

With the blessings of modern science, life becomes more comfortable and easy. We are getting lazy in every aspect of our life.

We start with brushing teeth with an electronic brush and don’t walk 100 meters to reach our office or work place. Everything is now run by computer programs; even we don’t need to go another desk to transfer a file to a colleague. Increased use of transportation and busy schedule is responsible for avoiding walking and cycling.

Video games and uncountable hours with a computer and internet using also affecting our child and teenagers and they are gradually losing interest in outdoor games. Inactive lazy life style also affecting their health and they are getting obese gradually.

Lack of exercise:

Another cause of obesity is lack of exercise. Daily 20-30 minute fast walking or jogging is enough for maintaining a good health. But busy working schedule and stressful working environment are decreasing the interest to do daily exercise. Irregular sleep pattern or using our bedroom as an office is also responsible for late rising from bed and unable to schedule an hour for exercise.

Some myths or wrong conception like, “dieting is the only factor to be skinny, weight loss supplements is enough to reduce weight, proper guidance is needed to start exercise, where is the time for exercise?”, are also interrupting different awareness building programs about exercise and healthy living.

Genetic predisposition:

Whatever the dietary habit or lifestyle, some people don’t gain weight and some become obese. Researches show that obesity and weight gain tend to run in families6. These genes may affect our metabolic processes. A body of some people can metabolize and store more calories and more fat than the other.

 The appetite controlling gene may differ from person to person, and genes related to perception like smell and taste may be more responsive than others.

All these are hypothesis. But it is true that genetic predisposition is a key factor to being obese.

Diseases causing obesity:

There are some medical conditions also responsible for being obese-a. Hypothyroidism: It is a disease where the thyroid gland cannot produce the proper amount of thyroid hormone. Regulation of metabolism in cellular level is one of the major functions of thyroid hormone. Low thyroid status may reduce the metabolic process and causes weight gain.

-Cushing’s syndrome:In this disease adrenal gland secrets excess amount of corticosteroid called cortisol. This steroid caused obesity within few months.

-Stress and Depression: Stress and repression cause release of stress hormones like cortisol. These hormones may act as a key factor to develop obesity.

-Some drugs: Prolong use of some common drugs like estrogen containing oral contraceptive pills, steroid therapy for any disease, steroid containing herbal medications etc. will cause obesity too.

 

Complications of obesity:

Obesity is not a morbid disease but it is a strong predisposing factor of different diseases. For example-

  • Cardio vascular diseases-Ischemic heart disease, Heart failure, Hypertension
  • Endocrine diseases-Diabetes mellitus, polycystic ovarian syndrome, birth defects,
  • Neurological diseases-Stroke, meralgia paresthetica, migraines, idiopathic intracranial hypertension, multiple sclerosis etc.
  • Psychiatric diseases-
  • Rheumatic diseases-Gout, osteoarthritis, low back pain etc.
  • And very lightly discussed reproductive system involvement due to obesity-menstrual disorders, infertility, intrauterine fetal death (IUD), complications during pregnancy etc.

 

Obesity affecting on lifestyle:

  1. Sleep disturbance:Maximum obese patients suffer from sleep disturbance due to snoring.
  2. Sleep apnea:Obese patient also feel respiratory distress during sleep. Sleep apnea is a common phenomenon for all obese patients. It sometime may be very dangerous and may cause sudden death.
  3. Lethargic feelings:An obese patient feels tired all the day, because of their impaired sleep at night and sleep apnea.
  4. Reduce activity:An obese person usually less active than his colleagues. Active participation in any work is not seen by him.
  5. Increase expenses:Obesity related diseases increase expenses and put some extra pressure on shoulder for more income. But already an obese person is fighting with current income status.
  6. Social participation:Obese person, especially a female person does not want to participate in social programs. She hesitates to attend any social visit for her physical structure.

So, it has not only health hazards but also it affects on our personal, social and productive life. It causes sleep apnea, lack of interest in work, reduce efficiency, and decrease social acceptance and finally an obese person become depressed. It cost money not only in medical purpose but also reduces income by decreasing productivity.

Dr. Hasan Ebna Amin

References:

  1. Statistics on Obesity, Physical Activity and Diet: England 2014; Health and Social Care Information Centre Uk.
  2. http://www.cdc.gov/obesity/data/adult.html
  3. http://www.who.int/mediacentre/factsheets/fs311/en/
  4. Butland B, Jebb S, Kopelman P, et al. Tackling obesities: future choices – project report (2nd Ed). London: Foresight Programme of the Government Office for Science, 2007
  5. http://www.reproduction-online.org/content/140/3/347
  6. http://www.cancerresearchuk.org/cancer-info/healthyliving/obesityandweight/whatcausesobesity/the-causes-of-obesity-genes-behaviour-and-the-environment

 


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