15^th International Conference on Obesity Medicine October 30- 31, 2017 Bangkok, Thailand

Genes can directly cause obesity disorders such as Bardet-Biedl syndrome and Prader-Willi syndrome. Obesity is a complex disease resulting from the interactions of a wide variety of hereditary and environmental factors. The advancement in quantitative genetics, genomics and bioinformatics has attributed to a better understanding of the genetic and molecular basis of obesity. Clustering the cases within a family, the congruence of body weight for Monozygotic twins, and the discovery of genes associated with obesity are key points that offering interest regarding the genetic dimension of obesity. Heritability of obesity vary depending on the phenotype studied, however it tends to be higher for phenotypes linked to adipose tissue distribution (40-55%) and for weight or body fat excess (5-40%). Weight gain and adiposity increase with age, an effect also influenced by heredity. Occurrences of monogenic types of obesity are evidence that it may be caused by Genetic Mutations, as only 78 cases worldwide have been attributed to mutations of seven distinct genes.

Patients with type 2 diabetes are obese, and the global epidemic of obesity, its incidence and prevalence of type 2 diabetes over the past 20 years has given glance of diabetes in recent times. Excess weight is the main risk factor for type 2 diabetes, most of the obese individuals do not develop type 2 diabetes. Recent studies have identified relation between obesity and type 2 diabetes as it involves proinflammatory cytokines (tumor necrosis factor and interleukin-6), insulin resistance, deranged fatty acid metabolism, and cellular processes such as mitochondrial dysfunction and endoplasmic reticulum stress. These interactions are complex, and each of the are unclearly defined. Further genetic studies may elucidate additional  pathophysiological pathways for obesity and diabetes and identify promising new treatment targets. As physicians frequently prescribe glucose lowering medications associated with weight gain, as it results in  glycemic control and body weight and  current therapeutic options need more consideration. The issue is particularly concentrating on the evidence that even modest weight reduction whether through lifestyle or behavioral interventions, obesity medications, or bariatric surgery can improve glycemic control and reduce diabetes risk.

Obesity is becoming a major complication in recent  generation. It is associated with numerous comorbidities such as Cardiovascular diseases (CVD), type 2 diabetes, hypertension, Breast cancers, and sleep apnea/sleep-disordered breathing. Other important element of obesity is that, it is the only independent risk factor for CVD, and it is also documented in obese children. Obesity is associated with an increased risk of Morbidity and Mortality. Health service use and medical costs associated with obesity and related diseases have increased  and are expected to rise. Besides an altered metabolic profile, a variety of adaptations or alterations in cardiac structure and function occur in the individual as adipose tissue accumulates in excess amounts of fat also enhances the Cardiac dysfunction. Hence, obesity may affect the heart through its influence on known risk factors such as Dyslipidemia, hypertension, glucose intolerance, Inflammatory markers, obstructive sleep apnea and the prothrombic state. Osteoarthritis is the another disorder with unrecognized mechanisms. On the whole, overweight and obesity predispose to or are associated with numerous cardiac complications such as coronary heart disease, heart failure.

Obesity associated factors that occur more frequently in children and adolescents, adults. In  this regard adverse effects of obesity in children and adolescents have attempted to outline areas for future research. Obesity referred  as body mass index, greater than the 95th percentile for children of the same age and gender. It  affects one in five children globally. Discrimination against overweight children begins early in childhood and becomes progressively institutionalized. Because obese children tend to be taller than their nonoverweight peers, they are apt to be viewed as more mature.  In  the inappropriate expectations that result may have an adverse effect on their socialization. Many of the Cardiovascular consequences that characterize adult onset of obesity are preceded by abnormalities that begin in childhood.  Hyper lipidemia, hypertension, and abnormal glucose tolerance occur with increased frequency in obese children and adolescents. The relationship of cardiac risk factors to visceral organs in body are independent of total body weight, fat remains unclear. Some of the complications like Sleep apnea, Pseudotumor cerebri, Behavioral & Environmental Factors,Insomnia and Blount's disease represent major sources of morbidity for which rapid and sustained weight reduction is necessary. Although several periods of increased risk appear in childhood, it is not clear whether obesity with onset early in childhood carries the risk of adult morbidity and mortality.

Obesity has wide-ranging effects on both reproductive health and chronic medical conditions in women. Being overweight or obese, woman are at higher risk of diabetes, Coronary artery disease, back pain and knee Osteoarthritis. Obesity negatively affects both contraception and fertility. Maternal obesity is linked with higher rates of cesarean section as well as higher rates of high risk obstetrical conditions such as diabetes and hypertension. Pregnancy outcomes are negatively affected by maternal obesity , increased risk of Neonatal mortality and malformations. Maternal obesity is associated with a decreased intention to breastfeed, decreased initiation of breastfeeding, and decreased duration of breastfeeding. There seems to be an association between obesity and depression in women, though cultural factors may influence this association. Obese women are at higher risk for multiple cancers, including endometrial cancer, cervical cancer, breast cancer, and perhaps ovarian Cancer.

Obesity is associated with several endocrine diseases, including hypothyroidism and polycystic ovarian syndrome & rare ones as Cushing's syndrome, central hypothyroidism and hypothalamic disorders. The mechanisms for the development of obesity vary in according to the endocrine condition. Hypothyroidism is associated with accumulation of hyaluronic acid within various tissues, additional fluid retention due to reduced cardiac output and reduced thermogenesis. The pathophysiology of obesity associated with Polycystic Ovarian Syndrome remains complex as obesity, itself may simultaneously be the cause. Net excess of androgen appears to be pivotal in the development of central obesity. In Cushing's syndrome, an interaction with thyroid and growth hormones plays an important role in addition to an increased adipocyte differentiation and Adipogenesis.

Bariatric surgery   which is also known as weight loss surgery includes a variety of procedures performed to Obese people. In this, Weight loss is achieved by reducing the size of the Stomach with a gastric band or through removal of a portion of the stomach sleeve referred as Gastrectomy or Bilio-pancreatic  that may duodenal switch or by resecting and re- directing the small intestine to a small stomach pouch and it is termed as, Gastric pouch surgery. Bariatric surgical, includes procedures cause weight loss by restricting the amount of food the stomach can hold, causing  Mal-absorption of nutrients, or by a combination of both gastric restriction and Mal absorption. Bariatric procedures also often cause hormonal changes that may lead other complications as Hyperthyroidism and Insomnia. Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic surgery) which is also disadvantageous to mankind as it involves high energy radiations. However, research is emerging that suggests bariatric surgery could be appropriate for those with a BMI of 35 to 40 with no comorbidities or a BMI of 30 to 35 with significant comorbidities.

The goal of obesity treatment is to reach and stay at a healthy weight. It needs to work with a team of health professionals including a dietician, behavior counselor or an obesity specialist to help out and make changes in your eating and activity habits. The initial treatment goal is usually a modest weight loss  3 to 5 percent of your total weight. All weight-loss programs require change in eating habits and increased physical activity. The treatment methods that are right for you depend on level of obesity, overall health and your willingness to participate in your weight-loss plan. Other treatments include -Dietary changes, Exercise and activity, Behavior change, Prescription weight-loss medications, Weight-loss surgery.

Current research on Obesity is based on identify genetic, Behavioural, & environmental causes of obesity; to understand that how obesity leads to diabetes and cardiovascular diseases other health problems and to build on basic & Clinical research findings and study innovative prevention and treatment strategies. The research institutes, other agencies, private and public organizations all will play important roles in reducing the epidemic of obesity. Clinical Studies on Obesity, Biomarkers for Assessing Obesity, Obesity Surgery- Risks and Challenges, Bioinformatic Tools: Next-Generation Obesity, Remote Technologies and Telemedicine.In terms of our remit, obesity’s consequences for health are the dominant cause for concern. As, obesity results in a substantial increase in risk of type 2 diabetes and it  reveal  that a balance between approaches, reducing or preventing obesity and breaking the link between obesity and related diseases is necessary. An intermediate approach, targeting common points such as insulin resistance is also possible.