Obesity is a complex disease involving an excessive amount of body fat.

Obesity isn't
just a cosmetic concern. It's a medical problem that increases the risk of other diseases
and health problems, such as heart disease, diabetes, high blood pressure and certain
cancers. Usually, obesity results from inherited, physiological and environmental
factors, combined with diet, physical activity and exercise choices.

The good news is that even modest weight loss can improve or prevent the health
problems associated with obesity. A healthier diet, increased physical activity and
behavior changes can help you lose weight. Prescription medications and weight-loss
procedures are additional options for treating obesity.

Symptoms

Body mass index (BMI) is often used to diagnose obesity. To calculate BMI, multiply
weight in pounds by 703, divide by height in inches and then divide again by height in
inches. Or divide weight in kilograms by height in meters squared.

BMI Weight status

Below 18.5 Underweight

18.5-24.9 Normal

25.0-29.9 Overweight

30.0 and higher Obesity

Asians with BMI of 23 or higher may have an increased risk of health problems.

For most people, BMI provides a reasonable estimate of body fat.

However, BMI doesn't directly measure body fat, so some people, such as muscular
athletes, may have a BMI in the obesity category even though they don't have excess
body fat.

Many doctors also measure a person's waist circumference to help guide treatment
decisions. Weight-related health problems are more common in men with a waist
circumference over 40 inches (102 centimeters) and in women with a waist
measurement over 35 inches (89 centimeters).

Causes

Although there are genetic, behavioral, metabolic and hormonal influences on body
weight, obesity occurs when you take in more calories than you burn through normal
daily activities and exercise. Your body stores these excess calories as fat.

In the United States, most people's diets are too high in calories — often from fast food
and high-calorie beverages. People with obesity might eat more calories before feeling
full, feel hungry sooner, or eat more due to stress or anxiety.

Many people who live in Western countries now have jobs that are much less physically
demanding, so they don't tend to burn as many calories at work. Even daily activities
use fewer calories, courtesy of conveniences such as remote controls, escalators,
online shopping and drive-through banks.

Risk factors

Obesity usually results from a combination of causes and contributing factors:

Family inheritance and influences

The genes you inherit from your parents may affect the amount of body fat you store,
and where that fat is distributed. Genetics may also play a role in how efficiently your
body converts food into energy, how your body regulates your appetite and how your
body burns calories during exercise.

Obesity tends to run in families. That's not just because of the genes they share. Family
members also tend to share similar eating and activity habits.
Lifestyle choices

 Unhealthy diet. A diet that's high in calories, lacking in fruits and vegetables, full
of fast food, and laden with high-calorie beverages and oversized portions
contributes to weight gain.

 Liquid calories. People can drink many calories without feeling full, especially
calories from alcohol. Other high-calorie beverages, such as sugared soft drinks,
can contribute to significant weight gain.

 Inactivity. If you have a sedentary lifestyle, you can easily take in more calories
every day than you burn through exercise and routine daily activities. Looking at
computer, tablet and phone screens is a sedentary activity. The number of hours
spent in front of a screen is highly associated with weight gain.
Certain diseases and medications

In some people, obesity can be traced to a medical cause, such as Prader-Willi

syndrome, Cushing syndrome and other conditions. Medical problems, such as arthritis,
also can lead to decreased activity, which may result in weight gain.

Some medications can lead to weight gain if you don't compensate through diet or
activity. These medications include some antidepressants, anti-seizure medications,
diabetes medications, antipsychotic medications, steroids and beta blockers.

Social and economic issues

Social and economic factors are linked to obesity. Avoiding obesity is difficult if you don't
have safe areas to walk or exercise. Similarly, you may not have been taught healthy
ways of cooking, or you may not have access to healthier foods. In addition, the people
you spend time with may influence your weight — you're more likely to develop obesity
if you have friends or relatives with obesity.

Age

Obesity can occur at any age, even in young children. But as you age, hormonal
changes and a less active lifestyle increase your risk of obesity. In addition, the amount
of muscle in your body tends to decrease with age. Generally, lower muscle mass leads
to a decrease in metabolism. These changes also reduce calorie needs and can make it
harder to keep off excess weight. If you don't consciously control what you eat and
become more physically active as you age, you'll likely gain weight.

Other factors

 Pregnancy. Weight gain is common during pregnancy. Some women find this

weight difficult to lose after the baby is born. This weight gain may contribute to the
development of obesity in women.

 Quitting smoking. Quitting smoking is often associated with weight gain. And for
some, it can lead to enough weight gain to qualify as obesity. Often, this happens
as people use food to cope with smoking withdrawal. In the long run, however,
quitting smoking is still a greater benefit to your health than is continuing to smoke.
Your doctor can help you prevent weight gain after quitting smoking.

 Lack of sleep. Not getting enough sleep or getting too much sleep can cause
changes in hormones that increase appetite. You may also crave foods high in
calories and carbohydrates, which can contribute to weight gain.

 Stress. Many external factors that affect mood and well-being may contribute to
obesity. People often seek more high-calorie food when experiencing stressful
situations.

 Microbiome. Your gut bacteria are affected by what you eat and may contribute to
weight gain or difficulty losing weight.

Even if you have one or more of these risk factors, it doesn't mean that you're destined
to develop obesity. You can counteract most risk factors through diet, physical activity
and exercise, and behavior changes.

Complications

People with obesity are more likely to develop a number of potentially serious health
problems, including:

 Heart disease and strokes. Obesity makes you more likely to have high blood
pressure and abnormal cholesterol levels, which are risk factors for heart disease
and strokes.
  Type 2 diabetes. Obesity can affect the way the body uses insulin to control blood
sugar levels. This raises the risk of insulin resistance and diabetes.

 Certain cancers. Obesity may increase the risk of cancer of the uterus, cervix,
endometrium, ovary, breast, colon, rectum, esophagus, liver, gallbladder,
pancreas, kidney and prostate.

 Digestive problems. Obesity increases the likelihood of developing heartburn,

gallbladder disease and liver problems.

 Sleep apnea. People with obesity are more likely to have sleep apnea, a
potentially serious disorder in which breathing repeatedly stops and starts during
sleep.

 Osteoarthritis. Obesity increases the stress placed on weight-bearing joints, in

addition to promoting inflammation within the body. These factors may lead to
complications such as osteoarthritis.

 Severe COVID-19 symptoms. Obesity increases the risk of developing severe

symptoms if you become infected with the virus that causes coronavirus disease
2019 (COVID-19). People who have severe cases of COVID-19 may require
treatment in intensive care units or even mechanical assistance to breathe.
Quality of life

Obesity can diminish the overall quality of life. You may not be able to do physical
activities that you used to enjoy. You may avoid public places. People with obesity may
even encounter discrimination.

Other weight-related issues that may affect your quality of life include:

 Depression

 Disability

 Shame and guilt

 Social isolation

 Lower work achievement

What Is Constipation?
Constipation is a very common condition that affects people of all ages.
It means you are not passing stools (faeces) as often as you normally do, you
have to strain more than usual or you are unable to completely empty your
bowels.

Constipation can also cause your stools to be unusually hard, lumpy, large or
small. It can be either acute or chronic and many people only experience
problems for a short period of time with no lasting effects on their health.

Constipation symptoms and signs

You are likely be constipated if you are experiencing any of the following:

 Fewer bowel movements than normal

 Pain and straining when passing stools
 Stomach pain
 Stools are hard and dry, and may be large or small in size like pellets
 Sore bottom
 Unpleasant smell due to passing wind
 Leaking of liquid or loose stools
 Your bowels open less than three times a week
 There may be a bad taste in the mouth, bad breath, abdominal bloating,
decreased appetite, lethargy and, for some, the inability to function
normally.

Causes of Constipation

There are many triggers that can cause constipation and associated
symptoms which can include:
  Diet – not enough high fibre foods
 Pregnancy
 Lack of fluids
 Slow Transit Colon
 Lack of exercise
 Some medicines, especially pain killers
 Some people with neurological problems such as Parkinson’s
disease or Multiple Sclerosis are prone to constipation
 Surgery around the anus can sometimes be a cause of constipation
mainly due to pain when emptying the bowel afterwards
 Conditions such as Irritable Bowel Syndrome (IBS), Colitis and Crohns
Disease
 Ignoring the urge to open the bowels
 There is a strong connection between emotional feelings and how the
gut works. Feeling upset can make your bowel slow down or speed up.

How to Prevent Constipation

There are various things you can do to help keep your bowels healthy and
avoid becoming constipated. If you are in any doubt, consult your GP or
Healthcare Professional before making significant changes to your regular
diet. A dietitian will also be able to guide you.

 As a general rule, eating more high-fibre foods can prevent constipation.

However, if constipation is a result of Colitis or Crohns disease,
increasing fibre intake could have a detrimental effect
 There are two different types of fibre; soluble and insoluble. Soluble
fibre dissolves in the intestines to form a gel type substance. This helps
food move along the digestive tract. Insoluble fibre is not dissolvable
and moves through the intestines without being absorbed. This fibre
adds bulk to bowel movements and helps to reduce constipation
 Make sure you drink lots of fluids to keep the stools moist e.g. at least
1.5-2 litres ( 6-8 glasses) of water based drinks per day
 If you are taking any medicines (prescribed or bought from the chemist)
ask your doctor or chemist if they could be adding to your constipation.
If possible, try to remove constipating medications
  If really necessary, try using a fibre supplement such as fybogel and
possibly suppositories or mini-enemas to help regularise the bowels, but
they should not be used long term. Some foods can act as natural
laxative for some people, these include; prunes, figs, liquorice,
coffee/tea, spicy food
 If possible, increase your physical activity as this helps to increase
bowel activity

Diarrhoea is when you have frequent loose watery bowel motions. In most cases, the symptoms
resolve on their own within a couple of days without the need for medical treatment.
Diarrhoea that lasts one or two days and goes away on its own is known as acute diarrhoea, which
is a common condition that affects people of all ages. Diarrhoea lasting four weeks or more (whether
continuous or intermittent) is known as chronic diarrhoea and can be a symptom of an underlying
chronic disease or condition.

Causes
Acute (or brief) diarrhoea is usually caused by a bacterial (eg, salmonella), viral
(eg, norovirus or rotavirus), or parasitic (eg, giardia) infection of the bowels. Diarrhoea caused by
any of these infections is referred to as gastroenteritis.
Travel to places where the climate or sanitary practices differ form one's home country may cause
short-term gastroenteritis (eg from contaminated food or water) and is known as traveller's
diarrhoea.  Diarrhoea associated with jet lag will usually subside in a matter of days without
treatment.
The most common causes of chronic diarrhoea are underlying diseases or conditions, including: 

 Gluten intolerance (coeliac disease)

 Lactose intolerance (inability to properly digest lactose in dairy products)
 Irritable bowel syndrome
 Chronic bowel infection
 Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis
 Bowel cancer.

You should see your doctor if you are concerned that you might have any of these conditions.
Chronic diarrhoea can also occur when taking certain medications, e.g. some antibiotics and cancer
drugs. 
 Signs and symptoms
The main symptom of diarrhoea is loose, watery bowel motions (stools, faeces) three or more times
a day.
Accompanying signs and symptoms may include: 

 Urgent need to go to the toilet

 Abdominal pain and cramping
 Change in colour of your stools
 Mucous, pus, blood, or fat in your stools
 Vomiting
 General body weakness and tiredness.

Diagnosis
Diarrhoea is easily diagnosed by its symptoms.
If the diarrhoea lasts longer than two or three days, or is accompanied by symptoms such as fever or
bloody stools, your doctor may perform diagnostic tests to determine the cause.
These diagnostic tests could include: 

 Stool culture to test for infection

 Blood tests to rule out other diseases
 Fasting tests to reveal food intolerances
 Sigmoidoscopy or colonoscopy to look for signs of inflammatory bowel diseases (these tests involve
using a device with thin flexible tube and a camera and light at one end to look inside the bowel).

You should see a doctor if you or your baby / child develop any of the following signs: 

 Blood, pus, or mucous in stools

 A rash
 Diarrhoea lasting longer than one week or gets better and comes back
 New or worse symptoms.

Chronic or severe diarrhoea can lead to rapid dehydration, which is the excessive loss of fluids from
the body. Dehydration is particularly dangerous in infants and children, the elderly, and people with
weakened immune systems (e.g. people with HIV/AIDS or undergoing chemotherapy).
A doctor should also be seen if you, or a family member, becomes dehydrated. The signs and
symptoms of dehydration include: 

 Extreme thirst 
 Little or no urine passed in the last eight hours
 Urine is dark in colour and smelly
 Reduced saliva in the mouth, dry lips, no tears, sunken cheeks or eyes
 Infants may have dry nappies (for longer than 4-6 hours) and/or have a sunken fontanelle (the soft
spot on top of a baby’s head)
 Dizziness, lethargy, floppiness
 Rapid heart rate and breathing
 Cold hands and feet
 Skin that does not relax after being pinched.
 Treatment
Because most cases of diarrhoea resolve on their own within a day or two, self-care to relieve
symptoms is usually sufficient for treatment: 

 Avoid caffeine, dairy products, and greasy, high fibre, or sugary foods
 Placing a hot water bottle or wheat pack on your stomach, or taking paracetamol (e.g. Panadol),
may provide some relief from abdominal cramps
 Apply zinc and castor oil ointment or a barrier cream to affected areas if you, or your child, develops
a rash (like nappy rash) from the diarrhoea
 Avoid taking non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or
diclofenac, for pain relief as these medications can cause diarrhoea
 Anti-diarrhoeal medications that slow diarrhoea (e.g. Imodium) should be avoided as these drugs
prevent your body from getting rid of the bacteria or virus that may have caused the diarrhea.

To avoid dehydration, drink plenty of liquid every day, taking small, frequent sips. Ideal liquids are
clear thin broths or soups, diluted non-caffeinated sports drinks (e.g. Powerade or Gatorade), and
rehydration formulations (e.g. Gastrolyte) that are available without prescription from a pharmacy. 

Prevention
Hand washing is one of the most effective ways of preventing the spread of viruses and bacteria that
can cause diarrhoea. You should always wash your hands thoroughly after using the toilet, changing
nappies, and before meals.
The following rules when preparing food can also help prevent diarrhoea: 

 Always put foods that could spoil in the fridge

 Ensure that meat is cooked thoroughly
 Avoid eating raw meats, fish, and shellfish unless you are sure that they have been freshly prepared
and are from a reliable source
 Never place cooked meat on surfaces or plates that have held raw meat
 Disinfect bench tops, stove tops, and chopping boards with a diluted bleach solution.