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Why certain individuals continue to eat despite obesity is now being questioned as a behavioural disorder. Other factors, which would determine eating patterns, depend on availability and attractiveness of food and physiological indicators of hunger and satiety. The emotional factor may determine these, and may trigger or modulate the control of food intake.

Chemicals like serotonin have emerged as key mediators determining food intake. These are known to affect the receptors in the hypothalamus in the brain, which primarily controls appetite. Based on the current information about these neurotransmitters, research is being aimed to evolve substances, which would influence the appetite centres. However till date, only a few drugs have been introduced in the market. Their usefulness and safety continue to be debatable. Most endocrinologists feel that these are rather desperate methods. Nevertheless a wide area of research is still open and what mediates hunger and satiety and why some achieve satiety with small amounts of food is a million-dollar question.

Genetics factors
Obesity often runs in families. This suggests a genetic predisposition, but at the same time common eating patterns, attitudes towards food cannot discount the environmental factors. Preventive measures should be initiated at early ages to prevent obesity in offsprings.

Endocrine obesity
A small percentage of the obese suffer from hormonal disorders. In such cases consultation with an endocrinologist may be warranted. In children, hypothalamic lesions i.e. non-functional tissues in the hypothalamus are commonly found. Craniophary-giomas i.e. a brain tumour derived from remnants of an embryonic structure, is sometimes present in children and the symptoms are obesity associated with growth retardation and visual abnormalities. Disorders of the thyroid gland leading to reduced functioning of the gland is also fairly common

Fat is fattening because

1. it is a "Calorie Dense" Food. As opposed to 4 calories per gramme of carbohydrates, fat provides 9 calories per gramme i.e., 2.2 times more calories than carbohydrates;
2. fats are consumed faster, they require less chewing and are digested more efficiently. Fats also don't decrease the inter-meal hunger time,
3. they are efficiently stored. Our body spends only 3 per cent of the ingested calories to digest, absorb and store fat as compared to carbohydrates where it costs the body 7 per cent of the ingested calories.

Hence fat is the most fattening food substance because the majority of its calories can be preserved (97% of net calories).

High dietary fat is

• calories dense 9 cal/gm v/s for carbohydrates
• produces slow satiety
• efficiently digested and stored
• decreases inter-meal hunger time

Fibre facts
Fibre is derived from foods of plant origin. It is that portion of plant cells which are not digested by human enzymes the soluble fibre from gel when mixed with liquids. It slows gastric transit time, improves blood sugar control in diabetes and also decreases blood cholesterol. Rich sources of this type of fibre are peas, beans lentils and oats. The insoluble fibre is derived from wheat bran, vegetable and whole grain. They are also called "roughage" in diet they are forming agents and have shown to decrease incidence of diverticuloses and coloric cancers.
A fibre rich diet helps in weight management in many ways. They are "Calorie Poor" foods and bulk forming. Hence they give a sensation of fullness of stomach, early satiety and very few calories. They also delay gastric emptying, increase the inter-meal hunger interval and decrease insulin (appetite stimulant) levels.

High dietary fibre

• Calorie poor
• Delays gastric emptying
• Early satiety with few calories
• Increases Inter-Meal hunger time.

Hence, a high fibre diet along with a low fat diet provides the ideal nutrition plan for sustained weight loss. The doctors should educate the patient that only restricting calories is not the solution to obesity. It is the quality of food that translates into avoiding fatty food stuffs like butter, cheese spreads, animal foods, chips etc. and increase in low fat foods such as vegetables, fruits, beans, peas, whole fruits and whole grain cereals and breads. A high-fibre and low-fat diet with regular exercise is the key to weight reduction and good health.

Power Plants
The following are 8 of the most nutritious vegetables one is likely to eat regularly.

• Broccoli-Contains more than twice the vitamin C of oranges and is high in B vitamins and calcium.
• Spinach-Lots of iron, calcium, potassium and vitamin A.
• Sprouts-Packed with vitamin C and iron and rich in B vitamins and potassium.
• Beans-Best vegetable source of potassium and high in iron, B vitamins and calcium.
• Peas-High in B vitamins and rich in iron.
• Asparagus-High in B vitamins and contains good amounts of iron and vitamins A and C
• Cauliflower-Rich in vitamin C.
• Carrots-Has the most vitamin A, potassium, calcium.

If you look down at your lithe body and think the problem of excess weight has nothing to do with you, hold on a minute. Fat is a sneaky culprit, and it can be killing you without leaving a single stretch mark. Remember Jim Fixx, the guru of the running world who dropped dead mid-stride with barely an ounce of visible fat on his body? The problem was that although his body was fat-free, his arteries were probably loaded with soluble fat of the kind caused by eating animal fats, high saturated fats and the new trans fats contained in products with partially hydrogenated oils.

Determining whether you're at risk due to too much dietary fat is not achieved by looking in the mirror, at the bathroom scale or the height-age-weight charts. The only way to accurately and objectively evaluate your body fat is to have a body composition test. The only way to evaluate the fat in your arteries is to have a blood serum test.

There are a variety of tests available today. For body fat, there are electrical impedance tests and the tried-and-true calipers. If you use calipers, make sure the test is performed at different points of your body (triceps, chest, back, abdomen, and legs) and performed twice to ensure an accurate reading. On the average, the ideal percentage of body fat for men is between 16 and 19; for women it is between 22-25. Generally, as we age we tend to carry more body fat than in our youth. Men carry 3 per cent essential fat. The ideal optimum for athletes has often been cited as 12-20 per cent for women, 7-12 per cent for men. Bodybuilders, however, strive for even lower body fat.

A number of tests are available for blood serum too. The best test will be one performed by your physician, where he or she can interpret the results for you. Most probably these tests will give you a single number reading. In general, under 200 means you're fine. If you test over 200, you will need to follow up with you physician for a test which can determine the LDL (bad cholesterol) and HDL (good cholesterol) in your blood.

Taking the fat out of your diet is going to require label reading and some math. Presently, most authorities recommend a diet that contains 30 per cent or fewer calories from fat. For athletes and the truly health-conscious, 10-20 per cent fat calories is the target range most sought today.

In order to find the percentage of fat calories in any given food, you need to do some math. Each fat gram gives you nine calories. To determine the percentage of fat calories, multiply the fat grams by nine, and then divide by the total number of calories. For example, if one serving contains 100 calories, and five grams of fat, your per cent of fat calories is 45 (5 grams X Calories = 45 fat calories, divided by 100 = 45). If this is too complicated, several companies now offer slide-rule or wheel devices that give you this figure without computation. Although less accurate, you can try counting grams. A rough average is 22-30 grams of dietary fat per day. Over 30 grams and you are probably eating too much.

Due to the epidemic of heart disease in India, you should definitely have a blood serum test. If one or more of the following risk factors apply to you:

Too much of anything makes you fat
Fat is the worse culprit in our diets, but don't think that counting fat calories clears the road for you to eat all the carbohydrates or protein calories you want. Carbohydrates, simple or complex, and protein can all store themselves as fat when eaten in quantities over and above what you require to fuel your daily activity.

Alcohol is another deceptive fat maker. If you read nutrition books, you'll see that most alcohol contains no fat. But the simple sugars convert in your body and the calorie count skyrockets!
Good nutrition requires you to limit fat, avoid saturated and trans fats, and keep your total calories consumed in line with your caloric expenditure.

Role of Dietary Fat and Fibre in Weight Management
Several epidemiological studies have shown that overweight individuals eat less or as much as normal individuals. We are consuming less calories compared to our intake at the turn of this century. Even then the incidence of obesity is increasing. Hence we cannot view obesity solely as being due to consuming too many calories.

In the last five decades a changing trend is emerging in industrialized nations and affluent societies in developing countries. The total fat consumption is increasing and that of carbohydrates is creasing. There are well documented studies to show that as the per cent of fat increases in the diet, there is an increase in the tendency for obesity even if the total calorie intake remains the same, i.e., if the same number of calories are taken as carbohydrates and fats then an individual with the carbohydrate intake is less likely to develop obesity.

Obesity in simple terms means accumulation of excess of fat in the body, usually in the absence of an underlying disease. However, in a small percentage of cases hormonal disturbances are responsible for it. Obesity is a worldwide phenomenon, which afflicts the rich and the affluent. It is one of the most common nutritional disorders of our times

Fat: The Most Deadly Enemy
Obesity and high cholesterol are responsible for more deaths in America than car accidents or cancer. It's time to declare war and to de-grease.

It's a fact that fat is killing us. Heart disease, exacerbated by a diet too high in cholesterol, is a high killer. Dietary fat contributes to diabetes, high blood pressure, kidney dysfunction and gall bladder disorders, as well as cancer of the colon, uterus, prostate and breast. If that isn't enough to scare you, consider the fact that obesity with its multilayers of midriff, cottage-cheese thighs and turkey-gobbler necks is ugly.

Ever since the liberalization of Indian economy, more and more Indians have been exposed to the glamorous consumerist society of the west and a progressively higher number to gullible people are falling prey to the fast food culture. This, coupled with the comfort loving lifestyle of the upper and upper middle class, has led to a whole generation of chubby people. Still harbouring the image of the jolly fat man? Well, blubber not only makes you physically ugly, but also psychologically disadvantaged. Studies have shown that fat people on an average drop out of school sooner and earn less money than their thinner counterparts. Fat women are less likely to marry.

For an athlete, fat are not only a health risk, but also a serious deterrent to performance. Excess weight contributes to joint problems, slows a person down and dramatically lowers endurance. Even in sports such as weightlifting, where it has long been believed that bodyweight provides a leverage advantage, new studies show that pound-for-pound, leaner weightlifters are stronger than heavyweights.