Obesity - Nutrition

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Obesity

How we evaluate overweight and obesity Not all fat is the same Weight in the world: some data on the spread of obesity worldwide Risks of weight Causes of obesity Prevention of obesity Treatment of obesity Changing lifestyles Drug therapy The surgical therapy
  • How overweight and obesity are assessed
  • Not all fat is created equal
  • The weight in the world: some data on the spread of obesity worldwide
  • Weight risks
  • Causes of obesity
  • Obesity prevention
  • Obesity treatment
  • Change lifestyles
  • Pharmacological therapy
  • Surgical therapy

The increase in weight in the world population has been a constant known for many years, as it is an equally consolidated fact that excess weight leads to a deterioration in the quality of life and, when consistent, also a reduction in life expectancy. In the past, however, obesity has often been considered a morphological variant of the human body rather than a real disease, and until about 30 years ago doctors and researchers addressed it only marginally. Only in the last 25 years, thanks to numerous and important epidemiological studies, the international scientific community has defined it a real pathology.

In 1997, the World Health Organization considered that the prevalence of overweight and obesity was so wide that it deserved at least as much attention as other issues of public health concern, such as malnutrition and infectious diseases. In fact, obesity and overweight, as well as being progressively increasing in the western world, are also spreading in areas where they were traditionally absent. In 1998, the guidelines for the diagnosis and treatment of obesity, drawn up by the National Institute of Health, stated that this condition is the second most preventable cause of death after smoking in technologically advanced countries.

There is a general agreement on the health risks induced by excess weight: life expectancy decreases proportionally with the progressive increase in weight. It is not clear, however, if obesity is a risk factor in itself or if it is due to the complications and pathologies associated with it. What is certain is that the distribution of fat in some areas of the body involves higher risks: for example, the accumulation in the abdominal area is related to an increased risk of cardiovascular diseases, type 2 diabetes mellitus, premature death, breast and breast cancer uterine endometrium.

Unfortunately, the treatment of this condition, in addition to significantly affecting health expenditure, still leads to unsatisfactory results. However, we have some effective tools available: changing the lifestyle with food education and diet, increasing physical activity and, in selected cases, psychological support, pharmacological support, and surgery. However, it is necessary to use the various resources correctly and rationally.

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How overweight and obesity are assessed

Terms such as obesity, overweight and underweight appear more and more frequently in the media and there is no day when a message about weight problems is not addressed to the general public by television, magazines or newspapers. Whether it is an alarm for the global spread of obesity or the discovery of a gene involved in the onset of this disease, a possible remedy or a miraculous diet, it makes no difference; the weight issue is among the most accepted by the population.

Awareness of the public on these topics is important, but it often happens that the recipients of these messages are not reached because the perception of normal weight and obesity is extremely subjective and not infrequently some perceive themselves only of a robust constitution when they instead present already the pathology. What makes television and print messages sometimes inadequate is above all the fact that the images that accompany them usually represent "large obese" subjects, with volumes more similar to the characters of Botero's works, than to those of reality. So it happens that people who are already obese do not realize they are and indeed, given the message, they feel relieved not identifying themselves with the problem.

The characterization of the weight according to the different categories of underweight, normal, overweight and obese is instead very precise and can be calculated with a simple formula; this is the so-called body mass index or body mass index (BMI), now considered the best parameter for the evaluation of body weight as it has a high correlation with the presence of body fat, determined by reference methods.

This means that the higher the BMI, the higher the percentage of fat on the total weight. The importance of BMI lies above all in the fact that with the growth of the body mass index corresponds an increase in the risk of developing pathologies such as diabetes, hypertension, heart attack and stroke, but above all in the risk of mortality.

Although BMI is a very reliable parameter in establishing excess or defect in weight in most subjects, it is not a perfect formula; in particular circumstances it may in fact overestimate or underestimate the presence of fat.

For example, a bodybuilder or athlete who practices power sports such as weight jet, rugby, American football, may have a weight and therefore a high BMI due to the considerable development of the musculature, despite not having an excess of fat. On the contrary, an elderly person may not weigh sufficiently to enter the obesity belt, but may still have an excess of the fat component due to a lack of muscle component.

Therefore, the interpretation of the BMI cannot be separated from a clinical evaluation of the subject, as it does not provide information relating to body composition; in particular it should be associated with the measurement of the abdominal circumference and the evaluation of comorbidity and familiarity.

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