Obesity is a chronic condition, related mainly to food and lifestyle, which is progressively increasing in developed countries. Correct treatment to overcome the problem is specialised and multidisciplinary.
Overweight and obesity are the most common metabolic conditions in developed countries. According to the World Health Organisation (WHO), it is one of the major epidemics of the 21st century. It is characterised by an increase in the body’s energy reserves as fat, resulting in an increase in the amount of body fat. It is frequently accompanied by an increase in weight, which affects the person’s health.
In this respect, obesity should not only be considered an esthetical problem but also a health problem, as, according to the Spanish Society for the Study of Obesity (SEEDO), it enhances the appearance of other conditions such as diabetes mellitus, high blood pressure, increased cholesterol, certain degenerative musculoskeletal diseases, cardiovascular diseases, psychological disorders (anxiety, depression, low self-esteem), sleep apnoea, gynaecological, digestive and liver disorders, and an increased chance of uterine cancer, bowel cancer, etc.
Being overweight is a condition that evolves into obesity, which is why its progress is important to prevent its progress during the phase in which it does not significantly affect the patient’s health.
Although the ultimate cause of obesity is unknown, a series of predisposing and precipitating factors have been detected:
Genetic: a genetic predisposition and rare chromosome-related disorders.
Social: today, a sedentary lifestyle and a lack of physical exercise are recognised as two important predisposing factors for obesity and being overweight, as they are found in the case of 95% of people with the condition. Other factors, such as giving up smoking (with a change in habit and the associated anxiety) are also predisposing factors as they can lead to increased appetite.
Psychological: certain states of anxiety, such when breastfeeding also contribute to an increase in appetite.
Conditions: certain primary conditions (thyroid, adrenal and pituitary changes) and surgical interventions produce a secondary increase in body fat mass. In addition, it is necessary to take into account that certain medication stimulates the appetite and can increase the level of obesity.
The most widely used method to assess whether an adult is overweight or obese is the Body Mass Index (BMI), which is calculated by dividing the weight (in kg) by the height (in metres).
In accordance with the criteria approved by the World Health Organisation (WHO), it is considered that a person is overweight when their BMI is higher than 25 kg/m2.
According to the BMI, we can classify the seriousness of obesity into the following categories:
|Overweight||25 – 29.9|
|Moderate obesity or type I||30 – 34.9|
|Severe obesity or type II||35 – 39.9|
|Morbid obesity or type III||40 – 49.9|
|Superobesity or type IV||50 – 60|
|Super-super obesity||> 60|
THE BMI FORMULA: WEIGHT in Kg / HEIGHT (in m2)
Example: A person that weighs 90 Kg with a height of 1.63m.
90 / (1.63 x 1.63) = 33.87
This person has moderate obesity.
The awareness and predisposition of the person and a good family environment is key for success against the condition.
Re-education in terms of food habits and a balanced diet that is low in calories (always advised by specialists in nutrition and dietetics), as well as physical exercise (also controlled by a medical professional), form the basis of the solution to the condition of obesity. Often this is not sufficient.
The different levels of obesity demand different levels of treatment, and need to be evaluated and treated in specialised, expert units in an integrated, multidisciplinary way, personalising each case in order to achieve patient motivation and collaboration.
Therefore, in accordance with the specialised healthcare personnel, different alternative therapies can be chosen, many of which are complementary: from personalised health and diet measures, pharmacological or psychological help, to different specific treatments, both digestive-endoscopic (intragastric balloon) and surgical (obesity-bariatric surgery).