Obesity is a condition characterised by excess deposition of fat to the extent that it may have an adverse effect on health.

Not only is obesity an epidemic and a public health problem, but as defined by The Obesity Society, is also a severely debilitating condition in its own right.

It is caused by overeating, lack of physical activity, genetic susceptibility, hormonal imbalance and psychological issues. Obesity is associated with adverse health effects such as diabetes mellitus, high blood pressure, stroke, joint damage and excess cholesterol, which eventually leads to cardiovascular disease (heart attack).

This highlights the importance of knowledge of obesity and recent advances in its management for the general public.

Obesity is measured by body mass index (BMI), which is calculated using the formula: weight in kilogrammes divided by the square of the height in metres (kg/m2).

There are numerous online BMI calculators, which will help to get the BMI value in seconds.

The World Health Organization recommends a BMI of 18.5 to 24.9 as normal for the adult population; 25-29.9 as pre-obese; and more than 30 as obese.

For the East Asian population, a lower BMI is recommended to determine obesity because the mean BMI is lesser than in the European population.

So, in addition to BMI, waist circumference (males 94cm and females 80cm) is also used to determine the central obesity in the Asian population.

The management of obesity mainly involves the restriction of calorie intake and enhancing physical activity. This will work for a majority of the pre-obese and obese individuals, who strictly comply with it.

In individuals with specific associated conditions, along with diet and exercise, underlying hormonal and psychological diseases have to be treated to overcome obesity.

Those who do not benefit from diet and exercise are treated with medications which either reduce the calorie intake by suppressing appetite or increasing energy consumption. Some medications prevent the intestinal absorption of nutrients.

If the methods above dont work, there is an option of a gastric balloon or a surgical procedure to limit the volume of the stomach or reduce the length of intestines. However, they are invasive and are associated with complications.

New treatment modality

Recently, the United States Food and Drug Administration approved a non-invasive oral hydrogel-based weight loss pill.

These pills are expected to be available in 2021 in the US, and possibly in other parts of the world.

The prescription pills, intended for individuals with a BMI of 25-40, have to be taken twice daily with water, about 20 minutes before lunch and dinner.

How it works: This oral pill is made up of a super-absorbent hydrogel, which is not absorbed into the blood.

Instead, it is eliminated from the gut, just like food particles.

The pill contains multiple small particles composed of two natural components, cellulose and citric acid, which create a complex structure having the ability to absorb and retain huge amounts of water.

The capsule particles can swell up to 100 times more than its original size when consumed and gain an elasticity similar to ingested food.

Multiple particles from the capsule can fill the stomach, and the individual does not feel hungry, thus leading to smaller food consumption.

This will help to reduce the overall calorie intake by the consumer and consequently, promote weight loss. The hydrated particles undergo degradation in the large intestine with the reabsorption of water and excretion of the degraded particles in the stool.

While the pill is easy to pop into the mouth, it does come with some minor side effects such as abdominal pain, constipation, diarrhoea and flatulence.

It is not advised for pregnant ladies and individuals having an allergy to cellulose or citric acid.

Also, this pill should be used with precaution in individuals with gastrointestinal disorders (GI) such as Crohns disease, diverticula, history of GI surgery, adhesions and GI ulcers.

Considering the ill effects of obesity, one should always practise a healthy lifestyle to prevent the onset. But one should not worry if he is unsuccessful in preventing obesity due to various factors as there are many modalities of management.

Oral hydrogen-based capsules will be an addition to the list of existing treatment modalities with an expectation to treat obesity and prevent obesity-related complications.

Associate Professor Dr Jeevan K.K. Shetty and Assoc Prof Dr Venkatesh R. Naik are the academic leads in biochemistry and pathology respectively at the Perdana University-Royal College of Surgeons in Ireland School of Medicine. This article is courtesy of Perdana University. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the readers own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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