Obesity and Immunity - Aastha Bariatrics

Obesity and Overweight is a complex disorder involving an excessive amount of body fat. It is a medical condition that increases the risk of other diseases and health problems such as heart disease, diabetes, high blood pressure and certain cancers.

Treatment for obesity is decided based on the BMI a person falls under.

Formula for BMI Calculation:

BMI = WEIGHT (in kgs) / HEIGHT (m²)

Classification of obesity

Nutritional status	Asian criteria
Normal	< 25
Overweight	25 – 29.9
Obese 1(obese)	30 – 34.9
Obese 2(morbid obese)	35 – 39.9
Obese 3 (super obese)	40 and above

What causes obesity?

Food and Activity
Environment
Genetics
Health Conditions and Medications
Stress, Emotional Factors and Poor Sleep

What are its Complications?

Type 2 diabetes
Heart disease and stroke
Sleep apnea
Certain cancers
Digestive problems
Severe COVID-19 symptoms

How can obesity be treated?

Diet and exercise are vital parts of the weight loss journey. The changes to diet and exercise can result in weight loss, but more than half of those people will gain their weight back.

Bariatric surgery is a well-established surgery treatment strategy for obesity after failure of behavioral and pharmacologic weight loss therapies and associated with improved comorbidities, quality of life, and survival in severe obesity.

Anybody with BMI above 30 with or without any comorbidities can undergo bariatric surgery.
Comorbidities include type 2 diabetes, hypertension, dyslipidemia, PCOD, hypothyroidism, OSA and more are benefited from Bariatric surgery.

How can obesity be treated?

Immunity refers to the body’s ability to prevent the invasion of pathogens. Pathogens are foreign disease-causing substances, such as bacteria and viruses, and people are exposed to them every day.

Immunity is a complex biological system that can recognize and tolerate whatever belongs to the self, and to recognize and reject what is foreign (non-self).

The immune system has two types of components:- innate and adaptive.

Innate immunity: Innate immunity is present in all metazoans. The innate component of the immunity system involves the recognition of certain foreign (non-self) molecules to generate one of two types of innate immune responses: inflammatory responses and phagocytosis.

Innate immunity, also known as native immunity, is a semi-specific and widely distributed form of immunity. It is defined as the first line of defense against pathogens.

Adaptive immunity: Adaptive immunity occurs only in vertebrates. The adaptive component involves more advanced lymphatic cells that can distinguish between specific “non-self” substances in the presence of “self”.

Adaptive immunity can be acquired either ‘naturally’ (by infection) or ‘artificially’ (through deliberate actions such as vaccination). Adaptive immunity can also be classified as ‘active’ or ‘passive’.

Nutrition and Immune function:

Eating a diet that is high in fiber and antioxidants (fruits and vegetables) and has enough protein helps to keep your immune system working properly. Specific micronutrients such as iron, selenium, zinc, copper, as well as vitamins C, A, E, B-6 and folic acid have important roles in the body’s immune response.

If you have too little protein intake, you are also at risk for protein-energy malnutrition. This has also been associated with significant impairments of immunity.

How can obesity be treated?

If you are affected by obesity, decrease your calories to help facilitate weight-loss.
Decrease simple carbohydrates such as sweets, baked goods, sugar-sweetened beverages, sugar, honey, jams, jelly, etc.
Decrease excess bad fat commonly found in commercial baked goods, processed or fried foods, cheese, ice-cream, butter etc.
Drink at least 2 to 2.5 liters of water each day.

Exercise and Immune function:

Exercise and health go hand-in-hand. Exercise helps fight against many diseases such as high blood pressure and cholesterol, cancer, sleep disturbances, mood and obesity itself. Exercise does improve immune function and seems to increase the number of certain immune cells that help to boost immune activity.

Moderate exercise also increases certain immune cells, reducing the risk of infection.

Exercise and Immune function:

A person affected by obesity that eats healthy and exercises is still at risk for decreasing immune function. Obesity itself impairs immunity. Some of these specific findings include:

Decreased cytokine production
Altered monocyte and lymphocyte function
Natural killer cell dysfunction
Reduced macrophage and dendritic cell function
Decreased response to antigen/mitogen stimulation

Obesity is an extremely complex disease and many processes and pathways are altered, any of which could affect the immune system. Obesity may increase the risk for bacterial and viral infections. Those affected by obesity may also be at risk for viruses like H1N1 because of less of an immune response to vaccinations.

Vaccines and Obesity:

Vaccines work by introducing a killed or weakened form of the disease to the immune system. The killed or weakened disease is not strong enough to produce symptoms or signs of the disease, but the vaccine does stimulate production of antibodies to protect against the disease if you come in contact with it in the future.

A lot of work has been done regarding hepatitis B vaccines in regards to obesity, in which it is shown that individuals affected by obesity have a very high non-response rate to vaccination. This means after the introduction of the “non-active virus” to the individual’s immune systems, the disease-fighting antibodies are not produced to the extent they need to be to protect against the disease.

Vaccines and Obesity:

Eating healthier and incorporating moderate exercise can help to increase your immune function. However now it is known that obesity itself (diet or genetic induced) decreases immunity leading to increased risk of bacterial and viral infection as well as decreased responsiveness to some vaccinations. The good news is that several studies have shown an increase in immune responsiveness and improvements after weight-loss or following dietary restriction.

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