Obesity is an abnormal accumulation of body fat, usually 20% or more over an individul

s idealbody weight. Obesity is associated with increased risk of illness, disability, and death.The
branch of medicine that deals with the study and treatment of obesity is known asbariatrics. As o
besity has become a major health problem in the United States, bariatrics hasbecome a separate
medical and surgical specialty.
Obesity means having too much body fat. It is different from being overweight, which
means weighing too much. The weight may come from muscle, bone, fat, and/or body water.
Both terms mean that a person's weight is greater than what's considered healthy for his or her
height.Overweight and obesity are defined as abnormal or excessive fat accumulation that may
impair health.Body mass index (BMI) is a simple index of weight-for-height that is commonly
used to classify overweight and obesity in adults. It is defined as a person's weight in kilograms
divided by the square of his height in meters (kg/m2).
Obesity occurs over time when you eat more calories than you use. The balance between
calories-in and calories-out differs for each person. Factors that might affect your weight include
your genetic makeup, overeating, eating high-fat foods, and not being physically active. Being
obese increases your risk of diabetes.
Diabetes mellitus is a disorder in which the level of blood glucose is persistently raised
above the normal range. Diabetes mellitus is a syndrome with disordered metabolism and
inappropriate hyperglycemia due to either a deficiency of insulin secretion or to a combination of
insulin resistance and inadequate insulin secretion to compensate. Diabetes mellitus occurs in
two primary forms:
 type 1, characterized by absolute insufficiency, and the more prevalent
 type 2, characterized by insulin resistance with varying degrees of insulin secretory
defects.

Diabetes mellitus is a group of metabolic diseases characterized by elevated levels of

glucose in the blood (hyperglycemia) resulting from defects in insulin secretion, insulin action,
or both (ADA), Expert Committee on the Diagnosis and Classification of Diabetes Mellitus,
2003.Classification of Diabetes Mellitus :

 Type 1 diabetes (insulin dependent diabetes mellitus) is caused by B-cell destruction,

usually leading to absolute insulin deficiency
  Type 2 diabetes (previously referred to as non insulin dependent diabetes mellitus) ranges
from those with predominant insulin resistance associated with relative insulin
deficiency, to those with a predominantly insulin secretory defect with insulin resistance

Besides Obesity is also a risk factor for hypertension, because more and more weight
gain, the more blood you need to supply oxygen and nutrients to tissues. so that the volume of
blood in the blood vessels also increases, so does the pressure on the walls arteripiun will
increase.

Hypertension is high blood pressure. Blood pressure is the force of blood pushing agains
t thewalls of arteries as it flows through them. Arteries are the blood vessels that carry oxygenate
dblood from the heart to the body's tissues.

Hypertension is a major health problem, especially because it has no symptoms. Many pe

oplehave hypertension without knowing it. In the United States, about 50 million people age six
andolder have high blood pressure. Hypertension is more common in men than women and inpeo
ple over the age of 65 than in younger persons. More than half of all Americans over the ageof 6
5 have hypertension. It also is more common in African-Americans than in white Americans.

Hypertension is serious because people with the condition have a higher risk for heart dis
easeand other medical problems than people with normal blood pressure. Serious complications
canbe avoided by getting regular blood pressure checks and treating hypertension as soon as it is
diagnosed.

There is no cure for primary hypertension, but blood pressure can almost always be lower
ed withthe correct treatment. The goal of treatment is to lower blood pressure to levels that will p
reventheart disease and other complications of hypertension. In secondary hypertension, the dise
asethat is responsible for the hypertension is treated in addition to the hypertension itself.Success
ful treatment of the underlying disorder may cure the secondary hypertension.

Guidelines advise that clinicians work with patients to agree on blood pressure goals and
develop a treatment plan for the individual patient. Actual combinations of medications andlifest
yle changes will vary from one person to the next. Treatment to lower blood pressure mayinclude
changes in diet, getting regular exercise, and taking antihypertensive medications.Patients fallin
g into the prehypertension range who don't have damage to the heart or kidneysoften are advised
to make needed lifestyle changes only. A 2003 report of a clinical trial showedthat adults with el
evated blood pressures lowered them as mush as 38% by making lifestylechanges and participati
ng in the DASH diet, which encourages eating more fruit and vegetables.

Lifestyle changes that may reduce blood pressure by about 5 to 10 mm Hg include:

 Reducing salt intake

 Reducing fat intake
 Losing weight
 Getting regular exercise
 Quitting smoking
 Reducing alcohol consumption
 Managing stress

In addition to causing diabetes and hypertension, obesity can also cause heartburn. One
of the biggest risk of the occurrence of heartburn is obesity. The more a person's weight, then the
chances of suffering from heartburn will be even greater. Excess fat in the belly as well as
chemical compounds released by body fat as a possible cause. A study conducted in 2003 that
was published in the journal of the American Medical Association found that the risk of having
symptoms of gastric acid Akkan increased with increasing BMI us.

Heartburn is the main symptom of the disease GERD (Gastroesophageal Reflux

Disease), which occurs when stomach contents back up into the esophagus (esophagus). The
burning sensation usually occurs after eating food triggers heartburn and will be more so when
the body lying down or bending over.

Heartburn is a burning sensation in the chest that can extend to the neck, throat, and face;
it isworsened by bending or lying down. It is the primary symptom of gastroesophageal reflux, w
hichis the movement of stomach acid into the esophagus. On rare occasions, it is due to gastritis(
stomach lining inflammation).

Heartburn itself is a symptom. Other symptoms also caused by gastroesophageal reflux c

an beassociated with heartburn. Often heartburn sufferers salivate excessively or regurgitate stom
achcontents into their mouths, leaving a sour or bitter taste. Frequent gastroesophageal reflux lea
dsto additional complications including difficult or painful swallowing, sore throat, hoarseness,c
oughing, laryngitis, wheezing, asthma, pneumonia, gingivitis, bad breath, and earache.

Heartburn Causes by acid refluxing back into the esophagus. Risk factors include those
that increase the production of acid in the stomach, as well as structural problems that allow acid
reflux into the esophagus.

 Some common foods that we eat and drink, stimulate increased stomach acid secretion setting
the stage for heartburn. Over-the-counter medications also may precipitate heartburn.
Examples of these irritants include:
o alcohol,
o caffeine,
o aspirin (Bayer, etc.),
o buprofen (Motrin, Advil, Nuprin, etc.)
o Naproxen (Naprosyn, Aleve)
o carbonated beverages,
o acidic juices (grapefruit, orange, pineapple)
o acidic foods (tomatoes, grapefruit, and oranges), and
o chocolate.
 Smoking and the consumption of high-fat content foods tend to affect function of the lower
esophageal sphincter (LES), causing it to relax from the stomach and allow acid to reflux into the
esophagus.
 A hiatal hernia where a portion of the stomach lies within the chest instead of the in abdomen,
can affect the way the LES works and is a risk factor for reflux. Hiatal hernias by themselves
cause no symptoms. It is only when the LES fails that heartburn occurs.

Hernias are most common in the abdomen, but they can also appear in the upper
thigh, belly button, and groin areas. Most hernias are not immediately life threatening,
but they don’t go away on their own and can require surgery to prevent potentially
dangerous complications.

Hernias are caused by a combination of muscle weakness and strain. Depending

on its cause, a hernia can develop quickly or over a long period of time.

Common causes of muscle weakness include:

 failure of the abdominal wall to close properly in the womb, which is a congenital defect
 age
 chronic coughing
 damage from injury or surgery

Factors that strain your body and may cause a hernia, especially if your muscles
are weak, include:

 being pregnant, which puts pressure on your abdomen

 being constipated, which causes you to strain when having a bowel movement
 heavy weight lifting
 fluid in the abdomen, or ascites
 suddenly gaining weight
 persistent coughing or sneezing