Abstract: Obesity is a globally accepted one of the major health problems which affects all the ages which needs proper management in terms of both dietary and medicinal to prevent further complications and systemic disorders. Medicines alone can not control weight gain but it needs proper dieting and regulated lifestyle. Homoeopathic medicines have great scopes in obesity to control and to prevent it.
Introduction:
Obesity has reached epidemic proportions globally, with more than 1 billion adults overweight – at least 300 million of them clinically obese – and is a major contributor to the global burden of chronic disease and disability. Obesity is a complex condition in developing countries, with serious social and psychological dimensions, affecting virtually all ages and socioeconomic groups. Increased consumption of more energy-dense, nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity led to increase rates of obese people in our society. The obesity epidemic is not restricted to industrialized societies; this increase is often faster in developing countries than in the developed world.
Obesity is a condition of excess accumulation of fat in fat depots. Fat deposition usually results from the discrepancy between energy consumption and expenditure. A small excess consumption of only 0.2 – 0.8 MJ (50-200 Kcal) daily will lead to a weight gain of 2-20 kg over a period of 4-10 years. Weight tends to stabilize when the increased metabolic demands of the body balance the energy intake. Obesity may happen with all ages but excess weight gain usually starts at the age of 20-40 years and maximum weight gain is achieved in middle age. Once the weight gain has started in a person, it is very difficult to lose weight before the age of 65 years. Moreover weight gain has a hereditary tendency in most of the cases.
Obesity and overweight pose a major risk for serious diet-related chronic diseases, including type-2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer. The health consequences range from increased risk of premature death, to serious chronic conditions that reduce the overall quality of life. Of especial concern is the increasing incidence of child obesity. Obesity itself is not a big problem but the complications which arise out of it are more serious and often become life-threatening. This global health hazard requires special attention to prevent and control its progression. We have a considerable number of homoeopathic medicines which can successfully control obesity.
How people become Obese?
The simple obesity is mainly due to environmental factors, overeating, and habits of living (sedentary life) and has hereditary tendency. The secondary obesity is mainly due to various systemic diseases. In obese individuals two distinct types of phenotypes are apparent – generalized obesity (pear shape) and abdominal obesity (apple shape). Abdominal obesity is recognized by measuring waist circumference or waist: hip ratio. Abdominal obesity is strongly associated with the development of coronary artery diseases, with insulin resistance and the development of type-2 diabetes mellitus. In few cases the specific factors have been identified to cause obesity. However, the etiology of obesity arises from a complex interplay of behavioural and genetic factors.
Food habits: Consumption of high-fat diet often causes obesity and most is stored in the body tissue. Snacking and loss of formalized meal patterns, which reduce the conscious recognition of foods eaten (canine hunger) often causes weight gain. Alcohol consumption promotes weight gain by providing substantial energy which also stimulates appetite.
Lack of Exercise: The leading factor to cause obesity is seemed to be an overall decrease in physical activity levels, and is very commoner to a person who leads a sedentary life.
Genetic factors: Obesity has a hereditary tendency and is transmitted to the nest generations. In Prader-Willi Syndrome. Laurence-Moon-Biedl syndrome, obesity develops. Overall estimates of the contribution of genetic factors to weight gain ranges from 25-70%.
Endocrinal disorders: There are certain specific endocrinal factors which causes obesity are – hypothyroidism, Cushing’s syndrome, Hypothalamic tumour or injury, Insulinoma etc.
Pregnancy: During pregnancy few women develop weight gain (about 4-5 kg.) and may go on increasing in the subsequent pregnancies.
Psychological status: As a result of emotional unstability, overeating may develop as a habit which may lead to obesity.
Socio-Economic background: The person who belongs to high-socioeconomic group consumes lots of protein, fat and carbohydrates which lead to the development of obesity.
How to diagnose Obesity and Overweight?
1) Body Weight more than 20% above the ideal body weight (Height – weight Chart) is considered as obesity.
2) Body Mass Index (BMI) is the most authentic parameter to describe weight gain or obesity. This is calculated by measuring a person’s weight in kilograms and then dividing by that person’s height in metres squared (kg/m2).
1) Ponderal Index in a person less than 12 is considered as obese (less commonly used parameter).
Height in inches
Ponderal Index (PI) =
3 Weight in lb
2) Skin fold thickness (fat fold thickness) more than 2.5 cm at the tip of scapula in males or mild tricep region in females is considered as obese.
Impact of Obesity and Weight gain on Health:
Overweight and obesity lead to adverse metabolic effects on blood pressure, cholesterol, triglycerides and insulin resistance. The non-fatal, but debilitating health problems associated with obesity include respiratory difficulties, chronic musculoskeletal problems, skin problems and infertility. The more life-threatening problems fall into four main areas: cardiovascular problems; conditions associated with insulin resistance such as type 2 diabetes; certain types of cancers, especially the hormonally related and large-bowel cancers; and gallbladder disease.
Obesity has effects on both mortality and morbidity rate which varies depending upon various etiological factors. However, it is clear that the lowest mortality rates are seen in individuals with a BMI of 18.5-24. Moreover Coronary Heart Disease is the major cause of death in obese person but Cancer rates are also increased in overweight individuals. Problem of morbidity increases steadily as the BMI increases above 25. Many of the obese people develop psychological consequences and also the society suffers from obesity related disabilities.
Ø Depression: Depression is very common after repeated failure with dieting and disapproval from family, friends, and the public.
Ø Diabetes: Obese individuals develop a resistance to insulin, which regulates blood sugar levels. Over time, high blood sugar can cause type 2 diabetes that can lead to serious damage to the body.
Ø Hypertension and Heart Disease: Excess body weight strains the heart. This may lead to high blood pressure, which can cause strokes as well as heart and kidney damage.
Ø Incontinence: A heavy abdomen may cause the valve on the urinary bladder to weaken, leading to urinary stress incontinence or the leakage of urine with coughing, sneezing or laughing.
Ø Infertility: Obese women may experience infertility.
Ø Menstrual Irregularities: Morbidly obese women may experience disruptions of menstrual cycles as well as abnormal flow and increased pain.
Ø Osteoarthritis: The weight exerted on joints, particularly knees and hips, results in rapid wear and tear of joints as well as pain, called osteoarthritis. Excess weight puts a strain on bones and muscles of the back, which can cause disk problems, pain and decreased mobility.
Ø Sleep Apnea and Respiratory Problems: Fat deposits in the tongue and neck can cause intermittent obstruction of air passage, called sleep apnoea. The obstruction is more severe when sleeping on back, so there is frequent change of position causing loss of sleep leading to headaches.
How to manage Obesity?
Obesity is a very common problem in many individual either hereditary or developed afterwards. Many obese individual undergoes strict dietary restrictions alone without taking any medical advice which is also injurious to health. Moreover obesity can not be treated in isolation and other risk factors are also to be taken into consideration e.g. smoking, consumption of alcohol, presence of hypertension or hyperlipidaemia etc. Calculation of BMI together with assessment of other risk factors will identify the patients who need to undergo a weight reduction programme and in all the cases of obesity, smoking should be stopped with a strict dietary restriction as stopping of smoking increases appetite and decreases metabolic rate.
Ø Adequate exercise: Promotion of increased physical activity is to be encouraged among the patients. Walking briskly for about 30 min. each day can result in an additional reduction in weight of 1 kg per month.
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Daily Energy Requirement |
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Circumstances |
Requirements |
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Healthy adult females |
Healthy adult males |
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|
At rest Light work Heavy work |
6.7 MJ (1600 kcal) 8.4 MJ (2000 kcal) 9.4 MJ (2250 kcal) |
8.4 MJ (2000 kcal) 11.3 MJ (2700 kcal) 14.9 MJ (3500 kcal) |
Ø Diet control: A balance diet suitable for the expected weight of the patient should be advised which aims at negative balance of some of the calories. The diet should contain adequate protein but less fat and carbohydrate. A diet consisting of a moderate reduction in energy intake of about 2.5 MJ (600 kcal) less than expenditure (assessed on weight, sex and age), produces a greater weight loss than strict diets (e.g. 4.2 MJ/1000 kcal) due to improved compliance.
Ø Behavioural modification: This is designed to support a process of change in the individual’s attitude, perception and behaviour as regards food intake, life style and physical activity.
Ø Health awareness programme: A large number of people can be given proper guidance regarding risk factors, complications of obesity and at the same time to be encouraged for proper management and prevention of weight gain so as to save the society from physical disabilities among the suffering humanity.
Ø Medicinal intervention: There are considerable numbers of homoeopathic medicine which helps to prevent and control obesity or weight gain along with proper dietary management and adequate physical activity is to be maintained.
Repertorial Approach to Obesity:
DR. ROBIN MURPHY: Obesity: acon., adon., agar., ail., alco., all-s., am-br., am-c., ambr., am-m., ang., ant-c., ant-t., apis., aran-i., arist-cl., arn., ars., asaf., aur., bac., bar-c., bell., blatta., bor., brom., bry., bufo., calad., CALC., calc-ac., calc-ar., calc-caust., calo., camph., canth., CAPS., carb-v., casut., cham., chin., chlorpr., cic., clem., coc-c., coca., cocc., coloc., con., cortiso., croc., cupr., dig., euph., euphr., FERR., fuc., GRAPH., guai., hura., hyos., iod., ip., KALI-BI., kali-br., KALI-C., lac-d., lach., laur., lith., lob., lyc., lycpr., mag-c., mag-p., mang., merc., merc-d., mur-ac., nat-a., nat-c., nat-m., nux-m., olnd., op., phos., PHYT., plat., plb., puls., rheum., rhus-t., rumx., sabad., sabal., sars., sel., seneg., sep., sil., spig., spong., stram., stront-c., sulph., thuj., thyr., tus-f., valer., verat., viol-o.
DR. C. M. BOGER: Obesity, corpulence: Acon., agar., amb., am-c., amm-m., ang., Ant-c., ant-t., ap., arn., asaf., aur., bar-c., bell., bor., bry., CALC-C., cam., canth., CAPS., carb-v., caus., cham., chin., cic., clem., cocl., colo., con., croc., Cup., dig., euphor., FER., Graph., guai., hell., hyo., iod., ip., kali-bi., kali-c., lach., lau., Lyc., mag-c., merc., mur-ac., nat-c., nux-m., old., op., pho., plat., plb., Pul., Phyt., rhus-t., saba., sars., sele., Seng., sep., sil., spi., spo., stram, stro., Sul., thu., val., ver-a., vio-o.
DR. J. T. KENT: Obesity: Agar., ambr., am-m., ant-c., asaf., aur., bar-c., bor., bry., Calc., calc-ar., camph., canth., Caps., chin., cocc., con., cupr., euph., Ferr., Graph., guaj., iod., ip., kali-bi., kali-c., lac-d., lach., laur., lyc., mag-c., merc., mur-ac., nat-c., nux-m., olnd., op., plat., plb., puls., sabad., sars., seneg., sep., sil., spig., spong., sulph., thuj., vert.
Body fat but legs thin: am-m., ant-c., lyc. ; Children in: ant-c., bad., bar-c., bell., CALC., caps., ferr., kali-bi., sac-l., seneg.; Elderly people: am-c., AUR., bar-c., CALC., caps., fl-ac., KALI-C., op., sec.; Menopause, during: calc., calc-ar., GRAPH., sep.; Pregnancy after: calc., kali-c., sep.; Stout and robust: ail., calc.; Uterine complaints, with: calc., graph., kali-c, sep.; Young people in: ant-c., CALC., calc-ac., lach.; Body fat, but legs thin: Am-m.; Old people: Kali-c.
Leading Homoeopathic Remedies for Obesity:
According to Dr. J. H. Clarke: Phytolocca berry θ / tablets ii gtt. 8 hr. If this fails to do good after a month’s trial give (1) Amm. brom. 3x, 8h (2) Calc. c 3, gr. v-6, 8g (3) Calc. ars. 3x, gr. ii 8h. A table spoon of lemon-juice in a little water, sweetened, may be taken three times a day if it does not disagree. Thyroidinum tablets, gr.v may be given once or twice a day.
Ø Ammonium carbonicum: Obese patients with weak heart; particularly suited to stout women who are always tired and weary, take cold easily, suffer from cholera-like symptoms before menses, lead a sedentary life; delicate women who always have the “smelling bottle” at hand.
Ø Ammonium muriaticum: Fat and sluggish patient who have respiratory troubles; body large and fat, but legs too thin; tendency to irregular circulation; many complaints accompanied by cough, profuse glairy secretion; tendency to suffer from obstinate constipation and haemorrhoid.
Ø Antimonium crudum: For children and young people inclined to grow fat; have excessive hunger, eats beyond the capacity for digestion; very sensitive to cold < after taking cold; disposition to abnormal growths of skin; old people with morning diarrhea or suddenly become constipated or alternate diarrhea and constipation.
Ø Calcarea arsenicosa: Suited to lymphatic, scrofulous and tubercular constitution; overweigh women approaching to menopause; obese persons, complaints of alcoholics after leaving off alcohol; violent palpitation from slightest emotion.
Ø Calcarea carbonica: Children who grow fat, are large-bellied with large head, pale skin, chalky look, scrofulous diathesis; fat, flabby children rather bloated than solid, pale but flushing easily; fattiness, flabbiness but without fitness; disposed to grow fat, corpulent, unwieldy, who sweat easily, takes cold readily, habitually constipated, belongs to lymphatic constitution.
Ø Capsicum: Fatty people who are easily exhausted, phlegmatic diathesis, lack of reactive force, indolent, dreads any kind of exercise; persons with light hair, blue eyes, nervous but stout and plethoric, awkward and of unclean habits.
Ø Graphites: Suited to women inclined to obesity, who suffer from habitual constipation; with history of delayed menstruation; it is suited to persons who have a tendency to put on unhealthy fat; very chilly patient and unhealthy skin.
Ø Kali bichromicum: Adapted to fat, fair, fleshy, light complexioned persons; subject to catarrhal or with syphilitic or scrofulous history; fat, chubby children, sluggish people, over weight persons subject to suppressed catarrh; fat, chubby, short necked children disposed to croup or croupy affections.
Ø Pulsatilla: Women inclined to be fleshy, with scanty and protracted menstruation; suited to indecisive, slow, phlegmatic temperament, sandy hair, blue eyes, pale face, easily moved to laughter or ters; thirstless patient; never well since some previous illness.
Ø Thuja ccidentalis: Fleshy persons, dark complexion, black hair, lymphatic temperament, unhealthy skin; sycotic or hydrogenoid constitution; chilly patient who takes cold easily; oily face, coarse skin, looks like ‘Ganeshji’; bad effects of vaccination in past, disposed to morning diarrhea.
Conclusion:
Obesity is not a self-limiting phenomenon and progressively increases if left uncured leading to some life threatening systemic disorders. Medicine alone can not treat or control the case of overweight unless strict dietary measurement is taken care of. However the homeopathic medicines named here shows a remarkable result to treat the cases of obesity with variable opinion. In my clinic I have observed good control over weight gain by prescribing Phytolocca berry θ and Fucus vesiculosus θ in 10 drops every day. This observation needs further confirmation from wise homoeopaths.
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