Obesity or overweight are chronic conditions of excess fat in the body. Almost 70% of South African women and 39% of South African men are obese.
The clinical diagnosis is made according to the Body Mass Index (BMI) as follows:
Normal weight: BMI 18.5 – 24.9 kg/m²
Overweight: BMI 25 – 29.9 kg/m²
Obesity: BMI ≥ 30kg/m²
Obesity and overweight are associated with many co-morbidities, especially diabetes, hypertension, sleep apnoea, heart disease, cancer, and arthritis. There are also many reasons a person may become obese ranging from factors that cannot be changed such as genetics and age to more modifiable problems such as an unhealthy lifestyle.
The key factors in managing patients with overweight or obesity are:
Comprehensive assessment including all medical conditions, medication use and history of previous weight loss management
Full dietary assessment with a registered dietician
Full fitness assessment for patients not exercising regularly or who have specific problems, e.g., painful knees or back
Psychological assessment – this may be done during consultation with Dr Murphy or with referral to a psychologist or psychiatrist. Untreated or poorly treated depression, anxiety, PTSD, burnout causes chronically elevated stress hormones which in turn make it very difficult to lose weight. This is often the reason other weight loss interventions seem to fail!
Prescription of appropriate weight loss medication timeously.
Referral for Bariatric Surgery for appropriate candidates.
The most important part of management is ongoing follow-up. The body will always resist attempts at weight loss, and this is why weight regain is the real challenge to deal with. It is so important to try intervening at the point this regain occurs. Obesity and overweight, as chronic conditions, need to be managed life-long.
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