Obesity

PCOS and Weight Gain

Polycystic ovarian syndrome (PCOS) is a heterogenous disorder that is characterized by a state of increased androgen levels (measured either clinically or through laboratory tests), a dysregulation of ovulatory functioning, and polycystic ovarian morphology.

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Although patients may remain without symptoms, most notable characteristics are a state of clinical hyperandrogenism particularly hirsutism (presence of hair overgrowth), menstrual irregularities (often leading to difficulty conceiving), and elevated testosterone levels in the blood.

The cause of PCOS is still unknown but is thought to develop from an interplay of factors from heredity, fetal development, environment, and metabolism.

It because of this relative hormonal and biochemical imbalance that PCOS is associated with a high prevalence of weight gain and obesity. Women with this condition range from 30-70% depending on which part of the world they are. Other conditions in which PCOS is associated with are: metabolic complications (such as type 2 diabetes), pregnancy complications, anxiety and depression, endometrial cancer, and obstructive sleep disorder.

Most medical societies advocate lifestyle modification measures as an important facet in the management of PCOS. Increasing physical activity and exercise together with a sensible diet has been shown to lower the risk of diabetes and improve ovulatory cycles among women with PCOS.

Weight loss may further be achieved by lessening caloric intake by 500 Calories per day. Consuming foods with low glycemic indices may help stave off cravings during the day and help stabilize blood glucose levels. Monitoring water intake to 2 liters per day may also help reduce food cravings. As with any weight loss measure, a daily multivitamin supplement may be necessary to supply nutrients from the restrictive diet.

References:

ACOG Practice Bulletin No. 194: Polycystic Ovary Syndrome. (2018). Obstetrics & Gynecology, 131(6), e157–e171. https://doi.org/10.1097/AOG.0000000000002656

Australian National Health and Medical Research Council/American Society for Reproductive Medicine/European Society of Human Reproduction and Embryology (NHMRC/ASRM/ESHRE). (n.d.). International evidence-based guideline on assessment and management of polycystic ovary syndrome.

Legro, R. S., Arslanian, S. A., Ehrmann, D. A., Hoeger, K. M., Murad, M. H., Pasquali, R., & Welt, C. K. (2013). Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 98(12), 4565–4592. https://doi.org/10.1210/jc.2013-2350

Ricardo Azziz, Enrico Carmina, ZiJiang Chen, Andrea Dunaif, Joop S. E. Laven, Richard S. Legro, Daria Lizneva, Barbara Natterson-Horowtiz, Helena J. Teede & Bulent O. Yildiz. (2016). Polycystic Ovary Syndrome. Nature Reviews Disease Primers, 2(16057). Retrieved from https://www.nature.com/articles/nrdp201657

What happens to the body in obesity?

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The body may bear the brunt when one’s weight increases over time.  This is the reason that obesity is often associated with many illnesses.

Blood pressure may often become elevated among people with weight issues. Blood sugar levels start to shoot up.  A person may also experience symptoms of diabetes such as increased urination and/or thirstiness, blurring of vision, pins and needles sensation in the toes and feet, darkening of the skin, etc.)

Persistent increase in weight may also affect heart functioning leading to an increase in size of the heart muscle and disturbance in the diastolic pressure.

Pain and swelling in the joints particularly in the hips and kneed are common in individuals who are obese.  This is because the lower parts of the body suffer the undue heaviness.

Start engaging in weight loss measures the soonest if you feel these symptoms alongside an increasing body weight.

 

Reference:

Ferri’s Clinical Advisor 2018, 906-909.e8

How Fat is Fat?

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Back in the days, people who were “hefty” or “plump” are said to have been blessed by graces and blessings from above.  They were widely accepted in society as those who are more than able to provide for their means.

Nowadays, being “heavy” carries an uncertainty with the way one’s health goes.  As more and more research is done, this has been associated with a number of medical illnesses.  A handful of experts even include this state as a medical illness itself.  Organizations like the World Health Organization have even labeled obesity as an epidemic.

The term obesity is referred to when one’s body mass index (BMI) is equal to or more than 30kg/m2.  Special considerations are given to elite resistance athletes and body builders.  In order to know one’s BMI, you just have to take your height in meters and  weight in kilograms.  Dividing the weight by the square of the height gives the BMI.  The normal BMI is between 18.5 and 25.

Some experts believe that the real measure of obesity lies in the amount of visceral fat mainly deposited in the abdomen.  Precise measurements of this would need specialized imaging such as computed tomography or magnetic imaging resonance scans which may be impractical in some parts of the world.  A practical way of estimating this is by measuring the abdominal circumference.  Abdominal obesity is present if the waist measurement is more than 102 cm (40 inches) in men, and 88 cm (35 inches) in women.  This is important because an increasing abdominal girth predisposes a person more to certain chronic illnesses and even mortality, despite a normal BMI.

Take charge of your health beginning today.  Take your body mass index and waist circumference regularly to monitor your progress to healthy living.

 

References:

Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894: pp. i-xii

National Institutes of Health : Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. Obes Res 1998; 6: pp. 51S-209S