What is obesity?
Obesity is a condition of excess body fat Overweight and obesity are defined as excess body weight for height. Men have a body fat percentage of 15-20%, and women have approximately 25-30%, but the body mass index (BMI) is used much more often than the body fat percentage to determine obesity.
The BMI of adults with normal weight is between 20.0 and 24.9. If someone is overweight, the BMI will be between 25.0 and 29.9. Obesity is defined as a BMI between 30.0 and 39.9. Severe (or painful) obesity is defined as a BMI greater than or equal to 40.
What causes obesity?
Overeating and lack of physical activity are the two main causes of obesity. An important factor is the hormonal imbalance.
The hormones leptin and insulin, male and female sex hormones and growth hormones affect appetite, metabolism and body fat distribution. Obese women and men usually have unbalanced levels of these hormones and this imbalance alters the metabolism, causing it to accumulate excess body fat.
Menopause in women, as well as andropause in men, are responsible for changes in hormone levels that can lead to weight gain. In many cases, diet and nutrition are not enough to prevent weight gain when you are struggling with hormonal problems that affect metabolism, muscle mass and hunger.
For most women, weight gain occurs gradually over the years. On average, between 5 kg and 7 kg from perimenopause to postmenopause, with a typical increase of about half a kilogram per year.
For women who undergo a hysterectomy, weight gain is accelerated. Too much cortisol or too little progesterone in the body is a common culprit for weight gain, and increased or decreased levels of testosterone or estrogen can also lead to increased weight gain, which can occur during menopause.
In men, high levels of cortisol usually contribute to weight gain, because increased cortisol reduces testosterone levels, which are already decreasing during andropause. As a result, decreased testosterone reduces energy, which means less physical activity and subsequent weight gain. In addition, thyroid disorders that affect the pituitary gland, as well as low levels of human growth hormone (HGH), often lead to weight gain in men, reducing metabolism in the body.
Among the many factors to consider are the combination of genes, environment and behavior.
What are the signs and symptoms of obesity?
The most obvious symptoms are if someone is overweight and their body mass index (BMI) is greater than 30. Other non-specific symptoms may include fatigue and tiredness.
Depression can be a consequence or cause of excessive food intake and reduced activity. Almost 30% of obese patients have eating disorders such as overeating or a constant urge to look for food.
BMI and waist and hip circumference are useful ways to estimate weight. Skin changes can also occur – they include excess hair and darker and thicker skin around the armpits and neck. Osteoarthritis of the knee and spine are also more common in obesity.
How common is obesity?
Obesity is becoming more common, having tripled in the UK over the last 25 years, for example. In England, the percentage of overweight men increased from 14% in 1994 to 25% in 2006 and for women from 19% in 1994 to 29% in 2006
These increases in obesity are also seen in children. Between 1995 and 2006, the obesity rate among English boys increased from 11% to 17% and from 12% to 15% among English girls.
Is obesity hereditary?
Given that many children of obese parents are obese themselves, there seems to be a genetic cause for obesity. The same conclusion can be drawn from the observation of identical twins – both are found to be obese instead of just one. However, as mentioned above, although genetic factors can determine an individual’s tendency to gain weight in a particular environment, the environment itself has a greater impact.
How is obesity diagnosed?
The World Health Organization’s criteria for obesity are based on BMI. Body mass index is calculated by your weight in kilograms divided by height in meters squared (kg / m2).
For adults, overweight is BMI of 25.0-29.9. Obesity is BMI of 30,039.9 kg / m 2. Severe or painful obesity is defined as BMI greater than or equal to 40 kg / m2.
X-ray of the upper gastroduodenal tract of a 26-year-old patient showing resection (removal) of two-thirds of the stomach after bariatric surgery to treat obesity. The arrow shows the new junction between the esophagus and the reduced stomach.
How is obesity treated?
There are many different strategies for treating obesity and people can find it very difficult to lose weight. Losing weight is a long-term commitment and everyone needs to find a way to work for them that they can maintain over time. Before making any significant lifestyle changes, it is advisable to visit your GP.
Obesity is treated in different ways:
- Diet programs – Achieving calorie reduction is still the most important way to achieve long-term weight loss.
- Exercise programs – aerobic exercise (such as brisk walking or swimming) are of the greatest value for obese people. The ultimate minimum goal should be to achieve 30-60 minutes of continuous aerobic exercise at least five times a week.
- Exercise is vital to any weight management program because it helps build * muscle mass, increase metabolic activity and improve overall health.
- Social policy – Although managing obesity in the individual is important, obesity is also a public health problem. Educating the public about healthy eating, as well as encouraging regular participation in outdoor exercises and activities, is particularly important.
- Very low calorie diets – these include reducing calorie intake to 800 calories a day or less. They are suitable for the treatment of severely obese people and should only be performed under medical supervision.
When used in the right conditions, they can achieve weight loss of 1.5-2.5 kg per week, with a total loss of up to 20 kg in 12 weeks. Although these diets can lead to significant short-term weight loss. weight, it is extremely difficult to maintain the diet after a few weeks. Strict supervision is needed to avoid disrupting the diet. Most people often regain all their weight quickly and often gain more weight.
- Behavioral changes – this requires a trained professional to have an in-depth discussion with the person about the necessary changes, such as eating and breakfast. Success depends on both a highly * motivated person * and a dedicated advisor who is willing to maintain long-term follow-up.
- Medications – Not many medications are available to treat obesity, and those that are available have minimal long-term effectiveness. The most common are those that block the action of pancreatic enzymes, reducing the absorption of fat from the intestines.
- Studies show weight loss of 9-10% in two years, although this often recovers when the drug is stopped (unless there are changes in lifestyle – such as increased exercise and reduced food intake).
- Surgery – Surgical therapy for obesity (bariatric surgery) has been shown to be associated only with prolonged weight loss in people with unhealthy severe obesity or obesity associated with other conditions.
- The data show that well-performed bariatric surgery in carefully selected patients with good multidisciplinary support (support from a team of specialists) significantly improves the problems associated with severe obesity. Therefore, although bariatric surgery is the only therapeutic method associated with proven prolonged weight loss, it is not suitable for all overweight patients.
Are there any side effects from the treatment?
Many methods of treating obesity include a healthy, balanced and active lifestyle, all of which have a positive effect on health.
Bariatric surgery has a risk associated with it, between 0.2% and 1.0% mortality, depending on the type of procedure performed.
What are the long-term consequences of obesity?
Obesity is associated with many long-term consequences that have a negative impact on quality and life expectancy.
- diabetes type 2;
- limited mobility;
- high blood pressure, heart disease and stroke;
- cancers of the endometrium, prostate, gallbladder, breast, colon and pancreas;
- obstructive sleep apnea;
- reduced possibility of conception;
- fatty liver and reflux esophagitis.
If you experience unexplained weight gain, ask your doctor about your specific needs and goals for weight loss.
The following lifestyle changes are a good start:
- Reduce portions of foods rich in fat or sugar.
- Eat more fruits, vegetables and whole grains.
- Spend 30 minutes a day in moderate physical activity (e.g. Fast walking).
- Eat three times a day, including breakfast.
- Find opportunities to be more physically active: do not use an elevator if possible, park your car further away in the parking lot, etc.
And don’t expect results overnight! Aim for 5-10% weight loss to get started. Weight loss takes time and changes in diet and activity will have to last for the rest of your life.