The WHO states that abdominal obesity is defined as a waist–hip ratio above 0.90 for males and above 0.85 for females, or a body mass index (BMI) above 30.0.
The health risk associated with obesity cannot be overemphasized. They include increased risk for diseases such as:
· Type 2 Diabetes mellitus
· Heart failure
· Stroke
· Kidney disease
· Oeteoarthritis
· Hypertension
· Sleep apnoea
· Gall stones
· Menstrual abnormalities
· infertility
· Esophagial cancer
· Cancer of the pancreas
· Cancer of the colon and rectum
· Cancer of the breast (after menopause)
· Endometrial cancer
· Thyroid cancer
· Renal (kidney) cancer
· Gallbladder cancer.
Health consequences fall into two broad categories: those attributable to the effects of increased fat mass (such as osteoarthritis, obstructive sleep apnea, social stigmatization) and those due to the increased number of fat cells (diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease). Increases in body fat alter the body's response to insulin, potentially leading to insulin resistance.
Several mechanisms have been suggested to explain the association of obesity with increased risk of certain cancers:
· Fat tissue produces excess amounts of estrogen, high levels of which have been associated with the risk of breast, endometrial and some other cancers.
· Obese people often have increased insulin in their blood due to insulin resistance by the body tissues. This may promote the development of certain cancers.
· There is altered immunity and oxidative stress (exposing the body to excessive free radicals).
At an individual level, a combination of excessive food intake and a lack of physical activity are thought to explain most cases of obesity. A limited number of cases are due primarily to genetics, medical reasons, or psychiatric illness. In contrast, increasing rates of obesity at a societal level are felt to be due to an easily accessible and palatable diet, increased reliance on cars, and mechanized manufacturing.
A 2006 review identified ten other possible contributors to the recent increase of obesity:
· insufficient sleep,
· endocrine disruptors (environmental pollutants that interfere with lipid metabolism),
· decreased variability in ambient temperature,
· decreased rates of smoking, because smoking suppresses appetite,
· increased use of medications that can cause weight gain (e.g., atypical antipsychotics),
· proportional increases in ethnic and age groups that tend to be heavier,
· pregnancy at a later age (which may cause susceptibility to obesity in children),
· epigenetic risk factors passed on generationally, (
· natural selection for higher BMI, and
· assortative mating leading to increased concentration of obesity risk factors (this would increase the number of obese people by increasing population variance in weight).
While there is substantial evidence supporting the influence of these mechanisms on the increased prevalence of obesity, the evidence is still inconclusive, and the authors state that these are probably less influential.
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