Obesity

Overview of Obesity

Obesity is a complex health issue that affects millions of people worldwide. It’s associated with an increased risk of various health problems, including heart disease, diabetes, and certain types of cancer.

Fortunately, adopting a healthy diet and lifestyle can play a pivotal role in managing obesity and improving overall well-being.

In brief, Obesity is widely regarded as a pandemic, with potentially disastrous consequences for human health.

Demography

In developing countries, average national rates of heavier person are low, but these figures may disguise high rates of heavier person in urban communities; for example, nearly one quarter of women in urban India are  higher weight body. In detail, There is increasing public awareness of the health implications of obesity. Many patients will seek medical help for their obesity, on other hand others will present with one of the complications of obesity.

In countries like the USA also the UK, fat deposition is affecting almost the entire population. Additionally, The weight distribution of almost the whole population is shifting upwards – the slim are becoming less slim while the fat is getting fatter. Specifically, In the UK, this translates into a 1-kilogram increase in weight per adult per year (on average over the adult population).

Epidemiology

The epidemiology of obesity in India is complex and varies across different demographics.

Here are some key findings with their references:

Prevalence:

• A systematic review estimated the prevalence of obesity in India to range from 11.8% to 31.3% (Ahirwar et al., 2019). [5]
• The ICMR-INDIAB study 2015 found the prevalence of obesity and central obesity to vary from 11.8% to 31.3% and 16.9% to 36.3%, respectively (Ahirwar et al., 2019). [6]
• A nationally representative study with 698,286 participants found the prevalence of obesity to be 11.56% in males and 16.31% in females (Gupta et al., 2023). [7]
• The National Family Health Survey (NFHS-5) (2019-21) reported 6.4% of women and 4.0% of men aged 15-49 years are obesed (Government of India, 2022). [8]

Causes of Obesity

A continuous small daily positive energy balance of only 0.2–0.8 MJ (50–200 kcal; < 10% of intake) would lead to weight gain of 2–20 kg over a period of 4–10 years.

Age i.e.:

Basically; heavier person usually become higher weight body adults. In detail, Weight tends to increase throughout adult life, as BMR and physical activity decrease.

Socio-economic Factor i.e.:

Generally, India it is estimated that 5% of the population receives 40% of the available food energy, leading to obesity in the urban population in parallel with persisting under­nutrition in some rural communities

Energy dense foods i.e.:

For example; drinks with highly refined sugar content and salty snacks.

Sedentary life i.e.:

In brief, Decrease in physical activity levels in recent years correlated positively with the number of hours spent watching television. inversely with levels of physical activity (e.g. stair climbing).

Genetic role i.e.:

Twin also adoption studies confirm a genetic influence on obesity.

A few rare single gene disorders i.e.:

This disorders have been identified that lead to severe childhood obesity i.e. melanocortin­4 receptor (in other words; MC4R)

Defects in the enzymes processing proopiomelanocortin (POMC, the precursor for adrenocorticotrophic hormone (in other words; ACTH)) in the hypothalamus.

mutations in the leptin gene.

Additional genetic conditions i.e.:

like Prader– Willi also Lawrence–Moon–Biedl syndromes.

underlying disorder i.e.:

such as hypothyroidism or Cushing’s syndrome

Types

Classification based on Body Mass Index (BMI):

• Class I Obesity: BMI of 30.0 – 34.9 kg/m²
• Class II Obesity: BMI of 35.0 – 39.9 kg/m²
• Class III Obesity: BMI of 40.0 kg/m² or higher (also referred to as severe or morbid obesity) [9]

Other classifications:

• Central Obesity (or Abdominal Obesity): Excess fat accumulation around the abdomen. It is associated with a higher risk of metabolic complications.

• Peripheral Obesity (or Gluteal-femoral Obesity): Excess fat accumulation around the hips and thighs. It is considered less harmful compared to central obesity.

• Childhood Obesity: Obesity occurring in children and adolescents. It is associated with an increased risk of health problems in adulthood.

• Monogenic Obesity: Rare forms of obesity caused by mutations in single genes. [10]

Risk Factors for Obesity

• Availability of cheap also heavily marketed energy rich foods
• Increase in labour saving devices (e.g. lifts and remote controls)
• Increase in passive transport (for example, cars as opposed to walking, cycling, or walking to public transport hubs).

Body Fat Distribution

Increased intra abdominal  fat causes ‘central’ (for example; ‘abdominal’, ‘visceral’, ‘android’  or ‘apple shaped’) obesity, which contrasts with subcutaneous fat accumulation causing ‘generalised’ (either ‘gynoid’ or ‘pear-shaped’) obesity; the former is more common  in men and is more closely associated with type 2  diabetes, the metabolic syndrome also cardiovascular disease .

Besides this; The key difference between these depots of fat may lie in their vascular anatomy, with intra abdominal fat draining into the portal vein and thence directly to the liver.

Pathogenesis

• Genetic Predisposition: Discusses the role of genes in influencing body weight regulation, energy expenditure, and appetite control.
• Environmental Factors: Explores how lifestyle factors, such as diet and physical activity, interact with genetic predispositions to contribute to obesity.
• Neuroendocrine Dysregulation: Examines the complex interactions between the brain, hormones, and adipose tissue that can lead to energy imbalance and weight gain.
• Metabolic and Inflammatory Pathways: Details the role of metabolic dysfunction and chronic inflammation in the development and progression of obesity.
• Epigenetic Modifications: Investigates how environmental factors can alter gene expression and contribute to the development of obesity. [11]

Pathophysiology

• Energy Balance and Regulation: The delicate balance between energy intake and expenditure, highlighting the role of hormones, neurotransmitters, and metabolic pathways in regulating appetite, satiety, and energy utilization.
• Genetic Predisposition: The influence of genetic factors on obesity risk, including variations in genes involved in energy metabolism, adipogenesis, and appetite control.
• Environmental Factors: How environmental factors like diet, physical activity, and exposure to obesogenic chemicals can contribute to the development of obesity.
• Neuroendocrine Dysfunction: How alterations in the communication between the brain, hormones, and adipose tissue can disrupt energy homeostasis and promote weight gain.
• Metabolic and Inflammatory Processes: How metabolic dysfunction, insulin resistance, and chronic inflammation can contribute to the development and complications of obesity.
• Gut Microbiome: The gut microbiome to obesity, highlighting its potential role in influencing energy harvest, metabolism, and inflammation. [9]

Clinical Features

• Physical Findings:

  • Increased body weight and BMI: The most obvious clinical feature is an elevated body mass index (BMI), generally defined as ≥30 kg/m².
  • Increased waist circumference: Abdominal obesity, often measured by waist circumference, is associated with a higher risk of metabolic complications.
  • Fat distribution: Obesity can manifest with different fat distribution patterns, such as central (abdominal) or peripheral (gluteal-femoral).
  • Other physical signs: These might include acanthosis nigricans (darkened skin patches), striae (stretch marks), and signs of associated comorbidities like hypertension, diabetes, or sleep apnea.

• Symptoms and Functional Limitations:

  • Dyspnea (shortness of breath): Often exacerbated by exertion.
  • Sleep apnea: Breathing interruptions during sleep, leading to daytime fatigue.
  • Joint pain: Due to increased stress on weight-bearing joints.
  • Gastroesophageal reflux disease (GERD): Acid reflux and heartburn.
  • Impaired mobility: Difficulty with physical activities and reduced exercise tolerance.
  • Psychological impact: Obesity can be associated with depression, anxiety, low self-esteem, and social isolation. [10]

Sign & Symptoms of Obesity

• Fat appearance.
• Weight of 20% or more than ideal for height and body frame. In detail; Some heavier person have no physical symptoms but may have associated emotional problems and poor exercise tolerance.
• Others may possibly experience:
• Abdominal discomfort
• Aching
• Swollen ankles and joints
• Breathlessness
• Sweating
• Increased fatigue

Clinical Examination

• Anthropometric Measurements:

  • Body Mass Index (BMI): Calculation and interpretation based on weight and height.
  • Waist Circumference: Measurement and significance in assessing abdominal obesity and associated risks.
  • Other Measurements: May include hip circumference, waist-to-hip ratio, and skinfold thickness.

• Physical Examination:

  • General Appearance: Assessment of overall body habitus, fat distribution, and any signs of associated comorbidities.
  • Vital Signs: Measurement of blood pressure, heart rate, respiratory rate, and temperature.
  • Cardiovascular System: Examination for signs of hypertension, heart failure, or other cardiovascular complications.
  • Respiratory System: Assessment of lung function, particularly for signs of sleep apnea or obesity hypoventilation syndrome.
  • Musculoskeletal System: Evaluation of joint mobility, range of motion, and any signs of osteoarthritis or other musculoskeletal problems.
  • Skin: Examination for acanthosis nigricans, striae, or other skin changes associated with obesity.
  • Other Systems: May include examination of the endocrine, gastrointestinal, and neurological systems for signs of obesity-related complications.

• Focused Assessment:

  • Evaluation for comorbidities: Targeted assessment for common obesity-related conditions like diabetes, hypertension, dyslipidemia, and fatty liver disease.
  • Screening for mental health issues: Identification of potential psychological comorbidities such as depression or anxiety.
  • Assessment of lifestyle factors: Inquiry into dietary habits, physical activity levels, and other lifestyle factors that may contribute to or impact obesity. [12]

Diagnosis

• Body Mass Index (BMI):

  • Calculation: BMI is calculated as weight in kilograms divided by height in meters squared (kg/m²).
  • Classification:
    
    • Over-weight: BMI of 25.0 – 29.9 kg/m²
    • Obesity: BMI of 30.0 kg/m² or higher
    • Further Classification of Obesity:
      
      • Class I Obesity: BMI of 30.0 – 34.9 kg/m²
      • Class II Obesity: BMI of 35.0 – 39.9 kg/m²
      • Class III Obesity: BMI of 40.0 kg/m² or higher (also referred to as severe or morbid obesity)

• Waist Circumference:

  • Measurement: Measured at the level of the umbilicus.
  • Significance: A high waist circumference, even in individuals with a normal BMI, can indicate increased cardiometabolic risk.
  • Cut-off points: Vary depending on ethnicity and sex. Generally, a waist circumference of >90 cm in men and >80 cm in women is considered high risk.

• Assessment of Obesity-Related Comorbidities:

  • Medical History and Physical Examination: To identify the presence of conditions like hypertension, diabetes, dyslipidemia, sleep apnea, and others.
  • Laboratory Tests: May include blood glucose, lipid profile, liver function tests, and thyroid function tests. [9]

Differential Diagnosis

When a patient presents with obesity include:

1. Endocrine Disorders

• Hypothyroidism: Decreased thyroid hormone levels can lead to weight gain and fatigue.
• Cushing’s Syndrome: Excess cortisol production can cause central obesity, moon face, and buffalo hump.
• Polycystic Ovary Syndrome (PCOS): Hormonal imbalances can contribute to weight gain and difficulty losing weight.

2. Genetic Syndromes

• Prader-Willi Syndrome: A genetic disorder characterized by insatiable appetite, leading to excessive weight gain.
• Bardet-Biedl Syndrome: A rare genetic disorder that can cause obesity, vision problems, and other health issues.

3. Medications

• Certain antidepressants: Some medications, like tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), can cause weight gain as a side effect.
• Antipsychotics: These drugs, used to treat mental health conditions, can also contribute to weight gain.
• Corticosteroids: Long-term use of corticosteroids can lead to weight gain and changes in body fat distribution.

4. Other Conditions

• Depression: Can lead to changes in appetite and activity levels, potentially contributing to weight gain.
• Binge Eating Disorder: Characterized by recurrent episodes of uncontrolled overeating, often leading to obesity.
• Edema: Fluid retention can sometimes be mistaken for obesity, particularly in the legs and ankles.
• Muscle Mass: Bodybuilders or individuals with high muscle mass may have a high BMI but low body fat percentage. [13]

Complications of Obesity

Investigations

Clinical assessment

• quantify the problem
• exclude an underlying cause
• identify complications
• reach a management plan

Severity of obesity can be quantified using the BMI.

How to measure BMI i.e.:

• Body Mass Index is a simple calculation using a person’s height and weight. The formula is BMI = kg/m² where kg is a person’s weight in kilograms and m² is their height in metres squared.A BMI of 25.0 or more is higherweight, while the healthy range is 18.5 to 24.9. BMI applies to most adults 18-65 years.

Treatment

Therapeutic option for obesity

• 1^st level management i.e.:
  • ↑Exercise
  • Eating behaviour modification
  • including food selection, portion size control, avoidance of snacking, regular meals to encourage satiety, also substitution of sugar with artificial sweeteners. Regular support from a dietitian or attendance at a weight loss group may be helpful.
  • Treat cardiovascular risk factors
• 2^nd level management i.e.:
  • Supervised low-calorie diet
  • The composition of the diet should ensure a minimum of 50 g of protein each day for men and 40 g for women to minimise muscle degradation. Energy content should be a minimum of 1.65 MJ (in other words; 400 kcal) for women of height < 1.73 m, and 2.1 MJ (in other words; 500 kcal) for all men and for women taller than 1.73 m.
• 3^rd level management i.e.:
  • Drugs for example; sibutramine, rimonabant, orlistat
  • Drug therapy is usually reserved for patients with high risk of complications from obesity
• 4^th level management i.e.:
  • surgery i.e. laparoscopic bariatric surgical procedures (i.e. ‘Bariatric’ surgery)
  • Generally, Cosmetic surgical procedures may be considered in heavier person after successful weight loss. Besides this; This operation is of no value for long-term weight reduction if food intake remains unrestricted.

Prevention of Obesity

For preventing obesity, highlighting the following key points:

• Dietary Recommendations:

  • Focus on whole foods: Emphasize fruits, vegetables, whole grains, and lean protein sources.
  • Limit processed foods: Minimize intake of sugary drinks, refined carbohydrates, and unhealthy fats.
  • Portion control: Be mindful of portion sizes to avoid overeating.
  • Mindful eating: Pay attention to hunger cues and avoid eating when not hungry.

• Physical Activity:

  • Regular exercise: Aim for at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity per week.
  • Incorporate strength training: Include strength training exercises at least twice a week.
  • Increase daily activity: Find ways to be more active throughout the day, such as taking the stairs or walking instead of driving.

• Other Lifestyle Factors:

  • Adequate sleep: Aim for 7-8 hours of sleep per night.
  • Stress management: Practice stress-reducing techniques like meditation or yoga.
  • Limit screen time: Reduce time spent watching TV or using electronic devices.

• Early Intervention:

  • Childhood obesity prevention: Encourage healthy habits from a young age.
  • Regular checkups: Monitor weight and BMI regularly to identify any potential issues early on. [14]

Homeopathic Treatment for Obesity

Calcarea Carbonica:

This medicine is mainly given when there is excess fat in the abdomen and the metabolism is working at a very low pace, resulting in obesity and weight gain. A patient requiring this medicine is fatty and flabby. In order to be eligible to use this medicine to lose weight, the constitutional symptoms shown by the patient are given utmost importance. The eating habits include craving for boiled eggs, and strange things like chalk, clay, pencils, lime etc. Due to a sluggish metabolic activity, the patients are almost always constipated. This medicine can also be considered if the excess weight gain is due to thyroid problems.

Natrum Mur:

This medicine is recommended when there is an excess of fat mainly in the thighs and buttocks as compared to other parts of the body. This medicine gives wonderful results if the person has gained excess weight due to long continued stress or depression. The patients who require this medicine usually suffer from anaemia. Another important symptom seen in patients suited to this medicine is the craving for extra salts in diet. A person eligible for this medicine comes across as a person with weeping tendencies, especially when alone, worsens when someone consoles him / her and reserved nature.

Lycopodium

The patients who require Lycopodium are chronic sufferers of gastric troubles like flatulence and constipation. Lycopodium have a tendency to crave for sweet foods. They also indulge in hot drinks and hot food. They show a tendency to eat far beyond their capacity with resulting bloated abdomen and weight gain. Mentally, the person requiring this medicine very irritable and easily rouse to anger, especially on being contradicted.

Nux Vomica:

Homeopathic medicine Nux Vomica recommend for persons who have gained excess weight due to sedentary habits. The first important symptom in persons requiring this medicine is that they are chronic sufferers of the most obstinate constipation. most important symptom is the eating habit – a person in need of Nux Vomica homeopathic medicine for losing weight likes spicy food, fatty food and stimulants like coffee or alcoholic drinks. Mentally, the person is extremely sensitive to external impressions and gets angry to an extreme degree too.

Antimonium Crudum:

This mainly a homeopathic medicine prescribe for heavier person in order to help them lose weight. A suitable candidate for this medicine is a child who possesses extreme irritability, very cross nature, and an aversion to touch or look at. These children also have a marked aversion to cold bathing. The significant indicator for using this medicine to lose weight is a craving for acidic things like pickles in the child. The child’s tongue in this case is usually thickly white coated and the stomach is deranged with alternate diarrhoea and constipation due to a habit of overeating.

CAPSICUM:

Lax fibre, weak; diminished vital heat. Fat, indolent, opposed to physical exertion. In detail; General uncleanliness of body. Homesickness. Worse – while eating, especially from heat, On the other hand Better – open air, uncovering, draughts.

GRAPHITES:

Stout, fair complexion with tendency to skin affections and constipation, fat, chilly also costive. Additionally, Tendency to obesity. Aversion specifically to meat. Sweets nauseate. Besides this; Hot drinks disagree. Burning in stomach causing hunger. Worse – warmth, especially at night, during and after menstruation, whereas Better – dark, from wrapping up.

THYROIDINUM:

Thyroid exercise a general regulating influence over the mechanism of the organs of nutrition, growth also development. In detail; Thyroid weakness causes decided craving for large amounts of sweets. Excessive obesity. Best with pale patients. Weak; tachycardia; Palpitation especially from least exertion.

FUCUS VESICULOSUS:

"For obesity also non – toxic goitre." Digestion is furthered and flatulence is diminished. In addition; Obstinate constipation; forehead feels as if compressed by iron ring. All in all; Thyroid enlargement in heavier person.

Diet & Regimen

• making healthier food choices
• drink plenty of water
• limit intake of foods containing saturated fat, added salt, added sugars and alcohol
• Avoid junk food such as burgers cheese fries
• Avoid fad diets such as meat, fish, wheat or dairy products

Certainly! Here’s a diet and regimen suggestion for obesity, along with a book reference that provides detailed information:

Dietary and Lifestyle Recommendations:

Dietary Guidelines

• Calorie Control: Creating a calorie deficit is key to weight loss. Aim to consume fewer calories than you burn through daily activities and exercise. Focus on portion control and choose nutrient-dense foods over calorie-dense options.
• Balanced Diet: Emphasize whole, unprocessed foods, including:
  • Fruits and Vegetables: These provide essential vitamins, minerals, and fiber while being low in calories. Aim for at least 5 servings a day.
  • Lean Protein: Include sources like poultry, fish, beans, lentils, and tofu in your meals. Protein helps you feel full and satisfied, reducing the likelihood of overeating.
  • Whole Grains: Opt for whole-grain bread, pasta, and brown rice over refined grains. These provide more fiber and nutrients.
  • Healthy Fats: Include moderate amounts of healthy fats from sources like avocados, nuts, seeds, and olive oil. These fats contribute to satiety and support overall health.
• Limit Processed Foods, Sugary Drinks, and Unhealthy Fats: These tend to be high in calories, added sugars, and unhealthy fats, contributing to weight gain and health problems.

Lifestyle Recommendations

• Regular Exercise: Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity activity per week, along with muscle-strengthening exercises at least two days a week. Exercise not only burns calories but also improves cardiovascular health, boosts mood, and helps maintain muscle mass. 
   
• Behavioral Changes: Sustainable weight loss often involves making lasting changes to your habits. Consider:
  • Keeping a food diary to track your intake and identify areas for improvement
  • Setting realistic goals and celebrating your achievements
  • Seeking support from a registered dietitian or healthcare professional
  • Practicing mindful eating to develop a healthier relationship with food [15]

Book Reference:

• Title: The Obesity Code: Unlocking the Secrets of Weight Loss
• Author: Dr. Jason Fung
• Year of Publication: 2016
• Publisher: Greystone Books
• Edition: First Edition

Key Points from "The Obesity Code"

• Hormonal Imbalance: The book challenges the traditional calorie-in, calorie-out model of weight loss and emphasizes the role of hormonal imbalances, particularly insulin resistance, in obesity.
• Intermittent Fasting: Dr. Fung advocates for intermittent fasting as a powerful tool to improve insulin sensitivity and promote weight loss.
• Dietary Recommendations: The book recommends a low-carbohydrate, high-fat diet to reduce insulin levels and support fat burning.

Disclaimer:

It’s important to consult with your doctor or a registered dietitian before making any significant changes to your diet or exercise routine, especially if you have any underlying health conditions. They can help create a personalized plan that meets your specific needs and goals.

Remember that achieving and maintaining a healthy weight requires a long-term commitment to healthy lifestyle habits. Patience, consistency, and a positive mindset are key to success.

Do’s:

• Do consult a healthcare professional: Get a comprehensive evaluation, including assessment for comorbidities and personalized advice on diet, exercise, and potential medications or surgery.
• Do focus on a balanced diet: Prioritize whole foods, fruits, vegetables, lean protein, and whole grains. Limit processed foods, sugary drinks, and unhealthy fats.
• Do engage in regular physical activity: Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. Find activities you enjoy and incorporate them into your routine.
• Do practice mindful eating: Pay attention to hunger and fullness cues. Eat slowly and savor your food. Avoid distractions during meals.
• Do prioritize sleep: Aim for 7-8 hours of quality sleep per night.
• Do manage stress: Find healthy ways to manage stress, such as exercise, meditation, or spending time in nature.
• Do seek support: Join support groups or connect with others who are also working to manage their weight.
• Do celebrate small victories: Focus on progress, not perfection. Celebrate every step toward your goals.

Don’ts:

• Don’t crash diet: Avoid restrictive diets that promise rapid weight loss. These diets are often unsustainable and can lead to nutrient deficiencies and rebound weight gain.
• Don’t skip meals: Skipping meals can lead to overeating later in the day and can slow down your metabolism.
• Don’t rely on supplements or fad diets: There’s no magic pill for weight loss. Focus on healthy lifestyle changes.
• Don’t compare yourself to others: Everyone’s journey is different. Focus on your own progress.
• Don’t give up: Weight loss takes time and effort. There will be setbacks, but don’t let them discourage you. Keep going and stay committed to your goals.
• Don’t engage in negative self-talk: Be kind to yourself and avoid self-criticism. Positive self-talk can help you stay motivated.

Terminology

• Obesity: A chronic medical condition characterized by excessive body fat accumulation that can lead to various health problems.

• Body Mass Index (BMI): A numerical value calculated using a person’s weight and height. It serves as an indicator of body fatness and helps categorize individuals into different weight categories (e.g., underweight, normal weight, over-weight).

• Waist Circumference: A measurement taken around the abdomen at the level of the navel. It is used as an indicator of abdominal fat, which is associated with a higher risk of health problems.

• Over-weight: A weight category where a person’s BMI is higher than normal but not yet obesity.

• Morbid Obesity: A severe form of obesity where a person’s BMI is 40 or higher. It significantly increases the risk of serious health complications.

• Comorbidities: Health conditions that occur alongside obesity, such as type 2 diabetes, heart disease, hypertension, and sleep apnea.

• Energy Balance: The balance between the number of calories consumed (energy intake) and the number of calories expended (energy expenditure).

• Sedentary Lifestyle: A lifestyle characterized by low levels of physical activity.

• Obesogenic Environment: An environment that promotes weight gain and makes it difficult to maintain a healthy weight.

• Weight Stigma: Negative attitudes and beliefs about over-weight people, often leading to discrimination and prejudice.

• Bariatric Surgery: Surgical procedures performed to help individuals with severe obesity lose weight.
• Lifestyle Interventions: Non-surgical approaches to managing obesity, including dietary modifications, increased physical activity, and behavioral counseling.

In Homoeopathy 

Additional Terminologies:

• Calcarea carbonica: A common homeopathic remedy for obesity, especially in individuals with a tendency towards slow metabolism, fatigue, and cravings for sweets.
• Graphites: Often used for obesity associated with constipation, skin problems, and a tendency towards feeling chilly.
• Lycopodium: May be indicated for obesity with digestive problems, bloating, and a craving for sweets.
• Antimonium crudum: May be helpful for obesity in children and individuals with a thick, white coating on the tongue.

1. Davidson’s Principles and Practice of Medicine (22nd edition)
2. Department of Health (Obesity Guidelines)
3. https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199736362.001.0001/oxfordhb-9780199736362-e-003
4. https://www.emedicinehealth.com/obesity/article_em.htm
5. Ahirwar, R., Mondal, P. R., & Daima, P. K. (2019). Prevalence of obesity in India: A systematic review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(1), 318-329.
6. Chellaiyan, V., Niruban, S., & Surendiran, B. (2022). Obesity Epidemiology: A Serious Public Health Concern in India. Chettinad Health City Medical Journal, 11(1), 21-28
7. Government of India. (2022). Prevalence of Obesity. Lok Sabha Unstarred Question No. 3780.
8. Gupta, R., et al. (2023). Obesity and Abdominal Obesity in Indian Population: Findings from a Nationally Representative Study of 698286 Participants. International Journal of Environmental Research and Public Health, 20(5), 4168.
9. Williams Textbook of Endocrinology (14th edition), by Shlomo Melmed et al., 2020. Published by Elsevier.
10. Harrison’s Principles of Internal Medicine (21st edition), by Dennis L. Kasper et al., 2022. Published by McGraw Hill.
11. Pediatric Obesity: Etiology, Pathogenesis, and Treatment (2nd edition), by Michael S. Freemark., 2018. Published by Springer.
12. Obesity: Clinical, Surgical and Practical Guide (2nd edition), by Shamim I. Ahmad, W. Timothy Garvey, Lee M. Kaplan, Arya M. Sharma., 2024. Published by Springer.
13. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease (11th Edition), by Mark Feldman, Lawrence S. Friedman, Lawrence J. Brandt. 2021. Published by Elsevier
14. Nutrition and Diet Therapy (12th edition), by Sue Rodwell Williams. 2017. Published by Elsevier
15. Title: The Obesity Code: Unlocking the Secrets of Weight Loss. Author: Dr. Jason Fung. Year of Publication: 2016. Publisher: Greystone Books. Edition: First Edition.

Also Search As

People can search for homeopathic articles on obesity using various methods:

1. Online Search Engines:

• Use specific keywords:
  
  • "homeopathy for obesity"
  • "homeopathic treatment for weight loss"
  • "homeopathic remedies for obesity"
  • Combine these with specific remedy names like "Calcarea carbonica for obesity" or "Graphites for weight loss"
• Use advanced search operators:
  
  • Use quotation marks to search for an exact phrase (e.g., "homeopathic treatment of obesity")
  • Use the minus sign to exclude certain terms (e.g., homeopathy obesity -conventional medicine)
• Utilize scholarly search engines like Google Scholar or PubMed to find peer-reviewed research articles.

2. Homeopathic Websites & Databases:

• Visit websites of reputable homeopathic organizations or clinics: These often have resources and articles on various health conditions, including obesity.
• Search specialized homeopathic databases: Some online databases focus specifically on homeopathic research and literature.

3. Homeopathic Journals & Publications:

• Browse through homeopathic journals: Many journals publish research articles and case studies on homeopathic treatments for different ailments, including obesity.
• Check libraries or online archives for access to these publications.

4. Consult Homeopathic Practitioners:

• Ask your homeopath for recommendations: They can provide you with relevant articles or direct you to reliable sources of information.

There are several ways to search for information about obesity, each with its own advantages:

1. Online Search Engines (e.g., Google, Bing, DuckDuckGo):

• Pros: Easy to access, provides a wide range of results, allows for quick searches.
• Cons: Can yield overwhelming amounts of information, may include unreliable sources, requires filtering for quality.
• Tips:
  
  • Use specific keywords: "obesity causes," "obesity treatment," "childhood obesity," etc.
  • Add location to your query: "obesity statistics in India"
  • Use quotation marks for exact phrases: "obesity prevention programs"
  • Utilize advanced search options (e.g., date range, file type).

2. Scholarly Databases (e.g., PubMed, Google Scholar):

• Pros: Focuses on peer-reviewed scientific literature, ensures quality and reliability of information.
  
   
• Cons: Can be more complex to navigate, may require access to academic institutions or subscriptions.
• Tips:
  
  • Refine searches using medical subject headings (MeSH terms).
  • Filter by publication date for recent research.  
    
     
  • Consider using advanced search features (e.g., author, journal).

3. Medical Websites & Organizations:

• Pros: Provides credible information from health professionals and reputable organizations.
• Cons: Can be biased towards specific treatments or viewpoints, may not be as comprehensive as scholarly databases.
• Examples:
  
  • World Health Organization (WHO) – Obesity and over-weight
  • Centers for Disease Control and Prevention (CDC) – Obesity
  • Mayo Clinic – Obesity

4. Books and E-books:

• Pros: In-depth coverage of specific aspects of obesity, can offer different perspectives and expert opinions.
• Cons: May require purchasing or borrowing from a library, information may not be as up-to-date as online sources.
• Tips:
  
  • Search library catalogs or online book retailers.
  • Look for books written by experts in the field of obesity research or medicine.

5. Social Media & Online Communities:

• Pros: Provides access to personal experiences and support from others with obesity.
• Cons: Information may not be reliable or evidence-based, can expose individuals to misinformation and harmful advice.
• Tips:
  
  • Follow reputable organizations and experts on social media.
  • Be cautious about information shared in online communities.
  • Verify information with credible sources.