Obesity is one of the biggest public health problems facing the world. According to the World Health Organization (WHO), the rate of obesity worldwide has tripled since 1975. It seems that it has become one of the most important causes of becoming seriously ill from COVID-19.
What is obesity?
In 2013 it was officially recognized as a disease. Obesity is truly a disease state that involves an excessive amount of body fat, and it also increases the risk of other diseases.
It is generally defined by numbers, such as body mass index (BMI) and waist circumference . BMI is your weight in kilograms divided by the square of your height in meters. It is an imperfect measure of obesity, but it is the best we have at the moment. Sometimes doctors also measure your waist size to determine if you are at risk for a medical condition.
Causes and risk factors of obesity
Many different factors affect whether a person is obese. It’s not just about how much you eat and how much you exercise. We have moved away from the old myth of calories in and calories out. You also have to think about hormones and genetics and a variety of environmental and social factors.
Genetics
About a third of a person’s BMI is entirely due to genetics. If both parents are obese, there is an 80 percent chance that you are.
Certain genetic syndromes, when genes are altered in some way in a person, are also linked to obesity. These include Prader-Willi syndrome, Bardet-Biedl syndrome, Alstrom syndrome, and Cohen syndrome.
Endocrine (hormonal) disorders
Problems with hormones involved in eating, metabolism, and satiety (feeling full) can also contribute to weight gain.
An example is hypothyroidism (low thyroid hormone levels), which slows down your metabolism. Another is Cushing’s syndrome, which occurs when you have too many stress hormones circulating. People with polycystic ovary syndrome (PCOS) are also more likely to be overweight or obese.
Certain medications
Some medications can cause weight gain, including some antidepressants, antipsychotics, and medications to treat epilepsy. If you think this is what is happening to you, ask your doctor to see if there are alternatives, but do not stop taking the medications on your own.
Age
You are more likely to gain weight as you age. That said, many young people are now obese. According to experts, 18.5% of children between the ages of 2 and 19 have the disease.
Lifestyle problems
For many people, unhealthy eating, being sedentary, not getting enough sleep, and stress (which can affect hormones) can all contribute to weight gain.
Social and environmental factors
This could be anything from being poor to being exposed to chemicals. It could also mean living in a “food desert” where healthy food is not readily available or in neighborhoods where it is not safe to walk.
Race, ethnicity, and gender
Blacks have the highest obesity rates, followed by Latinos, then whites, and finally Asians. Black or Latina women are more obese than men.
Psychological problems
Some people eat to bury their feelings (also known as emotional hunger), perhaps due to childhood trauma. Other emotional problems could also come into play.
Symptoms and complications of obesity
The main symptom of obesity is excess body fat , verified by BMI and waist circumference.
Obesity can contribute to several health complications, some of them life-threatening. Between 300,000 and 350,000 deaths a year are due to obesity and obesity-related problems, with higher death rates for people with a higher BMI.
Type 2 diabetes
This condition is closely related to obesity. According to a November 2017 article in Diabetes Spectrum, 90 percent of people with type 2 diabetes have a BMI of 25 or higher. Excess fat also leads to insulin resistance , which is a major risk factor for diabetes and heart disease.
The prevalence of type 2 diabetes has increased in the last 50 years in line with obesity. It is clear that we could greatly eradicate type 2 diabetes if we cure obesity.
Cardiovascular disease
Uncontrolled diabetes can lead to heart disease and stroke. Excess fat can also raise blood pressure and LDL (“bad”) cholesterol levels while lowering HDL (“good”) cholesterol levels. Cholesterol and blood pressure are key risk factors for heart disease.
Sleep apnea
About half of the people with sleep apnea are overweight. This happens when the airways become blocked at night, causing you to repeatedly start and stop breathing.
Being overweight or obese causes fat to accumulate in the neck area, obstructing the airways.
Acid reflux
Experts believe that excess fat around the abdomen increases pressure on the stomach, making it easier for acid to splash up into the esophagus. Not only does this cause burning and irritation in the moment, it can also increase the risk of ulcers and Barrett’s esophagus, which is the main risk factor for esophageal cancer.
Osteoarthritis
More weight means your joints have to work harder to stay awake and moving. 5 kilos of extra weight actually adds 7 to 25 kilos of pressure to the knees.
Cancer
Being obese increases your risk for certain types of cancer, including kidney, ovarian, endometrial, pancreas, colorectal, liver, and breast . This may be because obesity increases inflammation, which can contribute to cancer, or because fat tissue produces extra estrogen. Estrogen has been linked to several cancers.
Nonalcoholic fatty liver disease
It is estimated that 65 percent or more of people with obesity have fat in the liver. That is never good. Twenty percent of those people will end up with steatosis, and about 20 percent of them will develop cirrhosis, possibly requiring a liver transplant.
Metabolic syndrome
Metabolic syndrome is a cluster of conditions (including hypertension, high blood sugar, abdominal fat, and abnormal levels of cholesterol and triglycerides) that increase the risk of heart disease, stroke, and type 2 diabetes.
Psychological effects
This includes low self-esteem and bad moods, as well as body image issues, according to a September 2016 study in the Endocrinology and Metabolism Clinics of North America.
Treatments for obesity
There is no simple formula for treating obesity. There are many actors that we should talk about and it depends on the person.
Changes in lifestyle
Lifestyle is the core of everything. Even if you are receiving other obesity treatments, such as medications or surgery, experts recommend eating healthy foods, exercising more, getting good sleep, reducing stress, and controlling the amount of alcohol you drink .
Medicines
Some medications help you lose weight by affecting the satiety centers of your brain and making you feel full on less food. These include the diabetes medicine semaglutide . This drug is pushing the envelope of weight loss. It is an injection once a week. Another drug, orlistat, reduces fat absorption from the intestines.
Bariatric surgery
Bariatric surgery can facilitate weight loss through several different avenues. After surgery, your hunger hormones decrease and satiety increases, which is why it works so well. With an average weight loss of 33 percent, Roux-En-Y ( gastric bypass ) surgery appears to be the most effective.
Gastric sleeve surgery (gastrectomy) removes a part of your stomach, while a gastric band (lap band) mechanically reduces the size of your stomach by placing a band around the top of the organ.
