Obesity

General

Obesity (Obesity) describes a condition that is associated with very overweight goes hand in hand. This disease has various causes and consequences, which are examined in more detail below.

definition

According to the World Health Organization (WHO), one speaks of obesity if the Body mass index (BMI) over 30 kg / m² lies.

The BMI generally describes the relationship between body weight and height and is calculated as follows: Body weight in kg / body height in m².

From Normal weight one speaks at a BMI between 18.5-24.9 kg / m²while a BMI is between 25-29.9 kg / m² as Overweight or pre-obesity is defined.

The obesity will turn in 3 degrees of severity divided according to the height of the BMI:

• Grade I from 30kg / m²
• Grade II from 35kg / m²
• Grade III from 40kg / m².

However, this classification is not without controversy, as the fat distribution in the body is not included.
It is known that a increased waist size (for women taller than 80 cm, for men taller than 92 cm) with a higher risk of cardiovascular disease and Diabetes mellitus (Diabetes).
If, on the other hand, the fat is predominantly found Thighs and hip, the risk of such secondary diseases is significantly lower.
One too increased muscle mass (such as with Bodybuilders) does not do justice to the BMI as a basis for classifying obesity.

Nevertheless, this classification is currently common in the German health system.

Please also read our topic on this Consequences of being overweight.

frequency

According to statistics from recent years, approx. 25% of adults in Germany were obese, in the age group between 3 and 17 years 6% of children and adolescents obese.

Worldwide, the proportion of obese people in a society (prevalence) is highest in the industrialized countries (USA, Alaska, Canada, Mexico, Australia, Germany, Great Britain, Finland, etc.).

Overall, it can be stated that the prevalence of obesity has increased significantly in the last few decades, but currently the number seems to be stabilizing.

causes

The Causes of Overweight and Obesity are diverse. In addition, various factors play a role, such as Education, income, etc. play a crucial role in the risk of obesity.

• Unfavorable energy balance due to excessive calorie intake with insufficient energy consumption:
  Of the daily calorie requirement depends on many factors. Already the Basal metabolic rate (Energy requirement when resting) varies depending on gender, age, body type and much more Turnover through additional energy-consuming processes, such as sporting activity, mental activity, changed ambient temperatures, etc.
  Overweight or obesity always arises when the body over a long period of time more energy is supplied than it consumes.

• Genetic factors:
  There is evidence that the Fat distribution and the Genetically influenced food utilization become. Also Lipid metabolism disorders, such as. hypercholesterolemia) can be genetic. However, they always play a role in the development of obesity Environmental factors a role.
  Certain factors in the pregnancy, such as. a Mother's diabetes mellitus increase the child's risk of obesity.
  

• Obesity as a result of other diseases:
  There are certain Metabolic diseasesthat with a decreased basal metabolic rate (Basic need for energy without physical exertion) and therefore to one Increase in body weight all the way to obesity. These include the Hypothyroidism, Disturbances in the cortisol balance and Sugar metabolism disorders with an increased secretion of insulin.
  Also psychiatric illness in the form of eating disorder can be associated with obesity, e.g. Binge eating disorder (uncontrolled binge eating), bulimia (Bulimia nervosa).

• Side effects of drugs:
  Certain Medication lead to weight gain when taken (e.g. certain Antidepressants). Therefore, they should not be prescribed to overweight patients.

Symptoms and secondary diseases

The increased body weight often leads to the following symptoms and secondary diseases:

• Sleep apnea syndrome: nocturnal breathing pauses of more than 10 seconds, which are associated with daytime sleepiness and sleep attacks during the day

• Reflux disease: backflow of gastric acid into the esophagus due to a decreased closure at the junction from esophagus to stomach

• Damage to the musculoskeletal system: osteoarthritis (joint wear), especially on the hips and knees, diseases of the spine (e.g. slipped discs), gout

• Cardiovascular diseases: Obesity increases the risk of developing high blood pressure (arterial hypertension), Arteriosclerosis (calcification of arteries) up to myocardial infarction or cerebral infarction and vascular occlusions or changes in the legs (intermittent claudication) or eyes (deterioration of vision due to retinal changes).

• Metabolic disorders: Obese patients suffer more often from diabetes mellitus (diabetes) with all diabetic secondary diseases (chronic kidney damage, chronic nerve damage, wound healing disorders, etc.). Blood lipids are also often increased in obese people, which in turn influences the risk of certain secondary diseases.

• Mental disorders: The cerebral vessels can also be damaged by excessive body weight, which can lead to certain forms of dementia. In addition, mental illnesses such as depression occurs more often.

If obesity (especially increased belly fat), high blood pressure, increased blood lipid values ​​and a disturbed sugar metabolism occur together, one speaks of the metabolic syndrome. This combination leads to an extremely high risk of cardiovascular disease.

Read more about this at:

• Osteoarthritis and obesity
• Consequences of being overweight

diagnosis

The diagnosis of obesity is often made when the patient presents to the general practitioner or specialist for a check-up or because of other symptoms. That is enough Determination of body size and weight. In addition, a Measurement of the waist circumference.

If the diagnosis of obesity is made, further examinations should follow in order to identify and treat possible secondary diseases at an early stage. The diagnosis should also be an occasion for advice on how the patient can reduce their weight or what other therapy options are available.

therapy

The goal of any therapy is always weight loss.

The cause of the obesity should always be clarified first in order to find out the most sensible therapy method for the respective patient. Therefore, the eating habits and movement patterns must first be precisely analyzed, certain preliminary examinations with regard to other causes of the disease must be carried out and the therapy goals must be defined. According to some professional associations, it is advisable to reduce body weight by 5-30%, depending on the degree of obesity.

The therapy always includes a permanent change in diet and exercise, often together with psychotherapy and always together with the partner or the family.

• Weight loss diet (reduction diet):
  Body weight only decreases when the energy consumed is higher than the energy consumed through food. It is recommended to eat at least 500 kcal less than is consumed. In addition, you should drink enough and move at least 3 times a week for half an hour.
  It is also important to permanently and sustainably change diet and exercise patterns in order to prevent the yo-yo effect. In this case, due to insufficient calorie intake during the diet, there is a change to the so-called starvation metabolism, which in turn can lead to weight gain.

• Weight Loss Drugs:
  The drug options for weight loss include 3 groups of substances: appetite suppressants, bulking agents and fat blockers.
  Appetite suppressants are supposed to suppress the feeling of hunger and thus slow down food intake. However, they are very controversial, because their unspecific effect in the entire body also interferes with other systems (e.g. blood pressure regulation) and can thus cause serious side effects. A doctor should therefore always be consulted before using appetite suppressants.
  Swelling substances such as with cellulose or collagen, spread in the gastrointestinal tract and thus reduce the volume for the intake of food. A possible side effect is the intestinal obstruction, which is why it is essential to ensure sufficient fluid intake.
  Fat blockers inhibit the absorption of fats from food, which is why these are excreted undigested in the form of fatty stools. The problem is the lack of absorption of the fat-soluble vitamins A, D, E and K, which then have to be replaced with medication.

Read more on the subject at: Diet pills

You might also be interested in: Belly Away Diet

• Surgical intervention options:
  The field of bariatric surgery deals with operations on the gastrointestinal tract, which are supposed to help in weight loss in obese patients.
  Since these are major surgical interventions with certain operational risks, all conservative therapy attempts for weight loss should always be exhausted first. In addition, the patient must be aware that surgical therapy alone is not sufficient, but must always be accompanied by a change in diet. The professional societies have also defined precise requirements as to when a patient is suitable for such measures and when success appears likely.
  The aim of all interventions is either to restrict the capacity of the stomach in order to limit the amount of food consumed or to reduce the absorption of certain food components (e.g. fats) in order to limit the number of calories consumed.