Obesity may be described as a bodily condition charactrised by excessive storage of fat in the adipose tissues. It usually results from consumption of food in excess of physiological needs. Obesity is common among people in Western countries and among the higher income groups in India and other developing countries.

Obesity can occur at any age in either sex. Its incidence is higher in persons who consume more food and lead sedentary lives. IN women, obesity is liable to occur after pregnancy and at menopause. A woman usually gains about 12 kgs. weight during pregnancy. Part of this is an increase in the adipose tissue which serves as a store against the demands of lactation. Many women gain more and retain a part of this weight. They become progressively obese with each succeeding child.

Assessment

Obesity is generally assessed by relating the patient’s weight to charts of standard weight according to age, sex and height and then categorise them as 10, 20, or 30 per cent over-weight. However, normal weight depends on body build and some people, who inherit a large frame and bulk muscles, may weight more than the standard weight, without being obese. A more scientific assessment of obesity would, therefore, be by the proportion of fat in the total body weight. Mean values of body fat for the normal young men are about 12 per cent and for young women about 26 per cent. A man whose body fat amounts to more than 20 per cent of his total weight may be regarded obese and for a woman a figure of more than 30 per cent represents obesity.

Obesity is serious health hazard as the extra fat puts a strain on the heart, kidneys and liver as well as the large weight-bearing joints such as the hips, knees and ankles, which ultimately shortens the life span. It has been truly said, ‘ the longer the belt, the shorter the life. ‘ Overweight persons are susceptible to several diseases like coronary thrombosis, heart failure, high blood pressure, diabetes, arthritis, gout and liver and gall-bladder disorders.

Causes

The chief cause of obesity , most often, is overeating - that is, the intake of calories beyond the body’s energy requirement. Some people have a habit of eating too much while others may be in the habit of consuming high- calorie foods. These people gain weight continuously as they fail to adjust their appetite to reduced energy requirements. There has, in recent times, been an increasing awareness of the psychological aspects of obesity. Persons who are generally bored, unhappy, lonely or unloved, those who are discontented with their families, or social or financial standing usually tend to overeat as eating is a pleasure and solace to them.

Obesity is sometimes also the result of disturbances of the thyroid or pituitary glands. But glandular disorders account for only about two per cent of the total incidence of obesity. In such persons the basal metabolic rate is low and they keep gaining weight unless they take a low- calorie diet.

Dietary Cure

A suitably planned course of dietetic treatment, in conjunction with suitable exercise and other measures for promoting elimination, is the only scientific way of dealing with obesity. The chief consideration in this treatment should be the balanced selection of foods which provide the maximum essential nutrients with the least number of calories.

To begin with, the patient should undertake a juice fast for seven to ten days, juices of lemon , grapefruit, orange, pineapple, cabbage, celery may be taken during this period. Long juice fast upto forty days can also be undertaken, but only under the expert guidance and supervision. In the alternative, short juice fasts should be repeated at regular intervals of two months or so till the desired reduction in weight is achieved. During the first few days of the treatment and afterwards if necessary, the bowels should be cleansed daily with a warm water enema.

After the juice fast, the patient should spend a further four to five days on all-fruit diet. IN this regimen he should have three meals a day of fresh juicy fruits such as oranges, grape-fruit, pineapples and papayas. Thereafter, he may gradually embark upon a low-calorie well- balanced diet of three basic food groups, namely seeds, nuts and grains, vegetables and fruits, with emphasis on raw fruits. vegetables and fresh juices.

The foods which should be drastically curtailed or altogether avoided are high-fat foods such as butter, cheese, chocolate, cream, ice cream, fat meats, fried foods, foods high in carbohydrates like breads, candy, cake, cookies, cereal products, legumes, potatoes, honey, sugar, syrup and rich puddings ; beverages such as all cold drinks and alcoholic drinks.

To overcome the hunger pangs brought on by a lowered consumption of food , the patient should sip water gradually or take low-calorie and high-water foods like vegetables and certain fruits. Skimmed milk, butter- milk, barley water, fruit juices, green steamed vegetables and raw salads are good for reducing weight. Six to eight glasses of water should be taken every day but never with meals.

Other precautions which should be taken in regard to foods are : meals should be taken at fixed hours and snacks should be avoided in between ; all foods should be taken in small quantities, ; salt should be restricted in the diet as excessive intake produces water retention.

Fletcherism

One sure method of reducing weight is by practising what is known as " Fletcherism." It was discovered in 1898 by Horace Fletcher of the U.S.A. Fletcher, who at 40, considered himself an old man. He was 50 pounds overweight, contracted flu every six months and constantly complained of indigestion and a tired feeling. After a deep study, he made some important discoveries and prescribed the rules for "Fletcherism" which are as follows :

1. Chew your food to a pulp or milky liquid until it practically swallows itself.
   
2. Never eat until hungry.
   
3. Enjoy every bite or morsel, savouring the flavour until it is swallowed.
   
4. Do not eat when tired, angry, worried, and at mealtimes refuse to think or talk about unpleasant subjects.

Fletchet considered complete mastication the most important rule of all. He tried fixing an ideal number at first but found that chewing less than thirty times per mouthful was insufficient. Consequently, he decided that chewing food to a pulp or liquid should become the standard. Horace Fletcher followed these rules for five months. As a result he lost more than 60 pounds and felt better than he had for 20 years. A weight reducing programme built on Fletcherism works wonders and is worth a trial.

Suggested Menu

It is important that the overweight person should so devise his diet as to lose weight gradually - a pound in a week or ten days. This will enable him to get used to the new eating habits. The following menu is suggested as a guideline :

Early morning : A glass of warm water mixed with the juice of half a lemon.

Breakfast : Wheat, mung or Bengal gram sprouts and one cup skimmed milk.

Mid-morning : A glass of orange, pineapple or carrot juice.

Lunch : Salad of raw vegetables such as carrot, beet, cucumber, cabbage, cauliflower, tomato and onion, whole wheat dry chappatis and a glass of butter-milk.

Mid-afternoon : Coconut water or any fruit juice ( except apple juice ) or lemon tea or vegetable soup.

Dinner : Whole wheat dry chappatis, steamed vegetables and any seasonal fruit, except banana and apple.

Along with dietetic treatment, the patient should adopt all other natural methods of reducing weight. Exercise is an important part of weight reduction plan. It helps to use up calories stored in body fat and relieves tension, besides toning up the muscles of the body. Certain yogic asanas such as sarvngasana, bhujangasana, dhanurasana, chakrasana, vajrasana and yogamudra are also highly beneficial. They help slimming by breaking up or redistributing fatty deposits and strengthen the flabby areas. The patient should adopt measures which bring on excessive perspiration such as sauna baths, steam bath and heavy massage. They help to reduce weight. And above all, the obese persons should make every effort to avoid negative emotions such as anxiety, fear, hostility and insecurity and develop a positive outlook on life.