Open response letter to my patient
OBESITY OR JUST LOOKING GOOD?
Dear Dr I have heard of people saying that I am obese, am I really or I am just looking good?
Obesity is widely regarded as a pandemic whilst other people consider it a pride. For you to know that you are obese or not. Medically, we advise that you calculate your body mass index (BMI) which the rapport between your body mass and your height.(BMI=Body weight in kg / Height2 in cm2).
Obesity is classified in 3 categories by the world health organization. The higher the BMI, the more risky you are: 
- Normal weight 18-25
- Overweight above 25 to 29.9
- Obese above30 to 39.9
- Severe obesity above 40
The prevalence of obesity has increased –threefold within the last 20 years.  May you kindly check your BMI and let me know.
Dr Lets say I am obese then so what? Is it disease?
Obesity is the accumulation of excess fat in your body. Of course, fat helps shape the person and already the excess disturbs the very original shape. But that is not worry yet. When it comes to health consequences of obesity. The excess fat can expose a person to different type of diseases such as: [1, 3]
- Type 2 Diabetes: when it accumulate around major organs in the stomach.
- Hypertension with it complications such (stroke, heart diseases and kidney diseases).: when it accumulates in blood vessels.
- Liver fat accumulation which can lead to cirrhosis.
- Difficult breathing and excessive snoring ( sleep apnoea)
- Obesity can bring some mechanical condition such as swelling of the vessels (varicises),
- Osteoarthritis and poor control of the urine.
- It can lead to cancer (bowel cancer)
- It can as well lead to other conditions: low self esteem to the patient which can lead to depression (of course you sound far from this so far), and skin infection.
Yes, what if somebody has the”bad obesity”, what can she/he do?
Obesity is generally reversible. People with obesity can reduce weight/burn fat by lifestyle modifications: healthy balanced diet( see healthy plate below) , and increasing physical exercise( at least 30 minutes walk/ bicycle ride… per day for at least 5 days a week … and overall prevention is better than cure.
Thank you for your question, I hope this helps,
- Davidson’s Principles & Practice of Medicine 20th Edition, Elsevier Health Sciences.
- Classification of obesity. Wikipedia [homepage on Internet]. Available from: https://en.wikipedia.org/wiki/Classification_of_obesity
- Beers MH, Berkow R. The Merck manual of diagnosis and therapy. Merck and Co. Inc.; 1999
- Amod A. The 2012 SEMDSA guideline for the management of type 2 diabetes. Journal of Endocrinology, Metabolism and Diabetes of South Africa. 2012;17(1):61-2.
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