OBESITY

Obesity means having too much body fat. It is not the same as being overweight, which means weighing too much. A person may be overweight from extra muscle or water, as well as from having too much fat. Both terms mean that a person's weight is higher than what is thought to be healthy for his or her height.

Causes

Taking in more calories than you burn can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by: 

-Eating more food than your body can use 

-Drinking too much alcohol 

-Not getting enough exercise. 

Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost.

Today, we know that biology is a big reason why some people cannot keep the weight off. Some people who live in the same place and eat the same foods become obese, while others do not. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally.

The way we eat when we are children can affect the way we eat as adults.

The term eating disorder means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time.

See more about imbalanced nutrition: http://enfermeriastgo.blogspot.co.uk/2014/03/imbalanced-nutrition-care-plan-and-must.html

Sometimes, medical problems or treatments cause weight gain, including: 

-Underactive thyroid (hypothyroidism) 

-Medicines such as birth control pills, antidepressants and antipsychotics. 

Other things that can cause weight gain are: 

-Quitting smoking: many people who quit smoking gain 4 to 10 pounds in the first 6 months after quitting 

-Stress, anxiety, feeling sad, or not sleeping well 

-Menopause: women may gain 12 to 15 pounds during menopause 

-Pregnancy: women may not lose the weight they gained during pregnancy.

DRUGS USED IN THE TREATMENT OF OBESITY

Obesity should be managed in an appropriate setting by staff who have been trained in the management of obesity; the individual should receive advice on diet and lifestyle modification and be monitored for changes in weight as well as in blood pressure, blood lipids and other associated conditions.

An anti-obesity drug should be considered only for those with a body mass index of 30kg/m or greater in whom at least 3 months of managed care involving supervised diet, exercise and behaviour modification fails to achieve a realistic reduction in weight.

Drugs should never be used as the sole element of treatment. The individual should be monitored on a regular basis; drug treatment should be discontinued if the individual regains weight at any time whilst receiving drug treatment. 

1. Anti-obesity drugs acting on the gastro-intestinal tract:
-Orlistat (Xenical).

2. Centrally acting appetite suppressants:
-Rimonabant (Acomplia)
-Sibutramine Hydrochloride (Reductil).

In July 2012, the FDA approved two new medicines for chronic (ongoing) weight management. Lorcaserin hydrochloride (Belviq®) and Qsymia™ are approved for adults who have a BMI of 30 or greater. 

SURGERY

Weight-loss surgery might be an option for people who have extreme obesity (BMI of 40 or more) when other treatments have failed. It is also an option for people who have a BMI of 35 or more and life-threatening conditions, such as:

-Severe sleep apnea 

-Obesity-related cardiomyopathy

-Severe type 2 diabetes

Two common weight-loss surgeries include banded gastroplasty and Roux-en-Y gastric bypass. For gastroplasty, a band or staples are used to create a small pouch at the top of your stomach. This surgery limits the amount of food and liquids the stomach can hold. 

For gastric bypass, a small stomach pouch is created with a bypass around part of the small intestine where most of the calories you eat are absorbed. This surgery limits food intake and reduces the calories your body absorbs.

Like any surgery, there are risks associated to this interventions, side effects and lifelong medical followup is needed after both surgeries.

Sources:
-https://medlineplus.gov/obesity.html
-BNF 57 March 2009
-https://www.nhlbi.nih.gov/health/health-topics/topics/obe/treatment
-http://mhadegree.org/obesity-and-your-healthcare-career/
-http://lifescienceevents.com/2016-obesity-summit-12th-14th-april-2016/