Obesity

What is obesity?

 

Obesity is defined by the World Health Organisation (WHO) as a chronic disease in which the main symptom is excess weight caused by excessive fat accumulation.

 

Why does obesity occur?

 

Although we don’t fully understand what mechanisms bring about obesity,it is widely believed that it occurs due to a combination of:

 

-     Individual factors (genetic and metabolic).

 

-     Factors relating to our modern way of life (environmental factors).

 

In particular,obesity is greatly influenced by lifestyles or environmental influences,and an individual’s capacity to respond to them; in other words,the attitude and behaviour each individual adopts when faced with environmental pressure.

 

Diet and sedentariness are two environmental factors that have a notable influence on obesity.

 

The difference between caloric intake and expenditure determines whether an individual’s energy balance is positive or negative.The human body stores excess calories as fat.When ingestion exceeds expenditure the excess is stored as body fat.

Diet

 

Diet is one of the environmental factors that has the greatest influence on weight variation:

 

-     Nowadays, food is more abundant and widely-available than ever beforein so-called developed countries.People have access to an unprecedented array of both natural and industrial or manufactured foods.

 

-     There is almost little sense in talking about seasonal or local fruit and vegetables anymore,as now we can grow any variety anywhere,and at any time of the year.

 

-      Protein-rich foods,such as meat,eggs or fish,that in the past were almost solely the preserve of the wealthy,are now intensively produced and available to everyone.

 

-     The food industry has developed to such an extent that it is now possible to preserve almost all foods.

 

However,despite the incredibly wide range of foods available,people’s diets generally tend strongly towards foods and drinks that contain a lot of calories in a small volume (this is referred to as energy density).These foods have to be consumed in large quantities in order for people to feel full.In addition, portion sizes are growing ever bigger,while food prices are constantly falling; thus consumers eat more and choose high density foods instead of lower density ones.

 

Other foods in high demand in our modern society that have a significant influence on obesity,above all childhood obesity,include:

 

-      Baked goods

 

-     Savoury snacks such as crisps,etc.

 

These products are high in calories and contain saturated fats.

 

Soft drinks also have a big influence on obesity,as they contain a large amount of sugar.Many people drink soft drinks at mealtimes,often in large quantities.They presume that soft drinks are innocuous,and are unaware of the fact that they are adding a large amount of calories to their diet.

 

Sedentariness

 

Sedentariness is also a factor that contributes to obesity,as it reduces caloric expenditure.

 

The inhabitants of developed countries have very sedentary lifestyles.They rarely undertake any physical activity,as their jobs are more sedentary and their leisure time does not involve any energy expenditure (television,cinema,computer,video games...).Indeed, eating foods such as popcorn,nachos,soft drinks,etc.,while at the cinema or in front of the television is becoming more and more widespread.In addition,due to advances in technology,domestic chores no longer require intense physical effort.

 

How is obesity classified?

 

Nowadays,obesity is classified by BMI (Body Mass Index),which compares weight in kilograms with height squared.The formula for this calculation is as follows:

Example:a person who weighs 90 kg and measures 1.65 m in height would have a BMI of:

 

Classification of obesity and overweight according to BMI (Spanish Society for the Study of Obesity,SEEDO 2007):

 

 

In other words,the patient in the example above would be classified as having grade I obesity.

 

Is obesity equally as common in men and women?

 

-      According to some studies, the percentage of obese people in Spain is 15.5% among adults between 25 and 60 years of age.

-    The percentage of people who are overweight is 39.2%

-     If we add these two figures together,we find that 54.7% of adults in Spain weigh more than is considered normal.

-     If we divide the figures by sex we can see that:

-    The percentage of men suffering from obesity is 13.2%.

-     The percentage of women suffering from obesity is 17.5%.

-     46.4% of men are overweight,in comparison with 32.9% of women.

Childhood obesity figures show that:

-     The percentage of children suffering from obesity is 13.9%.

-     The percentage of overweight children is 12.4%.

-     The total percentage of children with excess weight is 26.3%.

 

Why is obesity a medical problem?

 

Although obesity may not be a recent problem,the epidemic level it is reaching at the moment in developed countries certainly is.

 

Moreover,obesity is accompanied by a number of chronic illnesses,such as diabetes,dyslipidemia (e.g.,an increase in cholesterol), arterial hypertension, arthritis, psychiatric disorders,some types of tumours,etc.These associated illnesses exacerbate the obesity problem,making it one of our principal Public Health problems,and closely link it to the cardiovascular diseases that continue to be the primary cause of death in Spain and our neighbouring countries.

 

Why is obesity a social problem?

Obesity and its associated diseases reduce life expectancy and quality of life and place an enormous financial burden on the health system.They can also affect a person’s work life and interpersonal relationships.Thus,obesity is a socio-health problem.

 

How is obesity treated?

Obesity is treated in two ways:

-     Diet.

-     Physical activity.

Therapy can also be undertaken in order to bring about changes in life styles.

In a secondary phase,pharmaceuticals can be prescribed if necessary.

 

Improve your diet:

 

-      Eat in a more balanced and varied way through dietary planning.

-     Reduce your intake of food,taking into account portion size and the different food groups.

-     Eat foods that do not have a high energy density,such as cereals,pulses,fruit or vegetables.

-      Don’t snack.

-      Don’t drink alcohol or soft drinks on a regular basis.

 

Increase physical activity:

 

-     Increase your amount of daily exercise.

-     Walk instead of taking the car.

-     Take the stairs instead of the lift.

-     Spend a few minutes on the exercise bike.

-     Play a sport.

 

Should you go on any type of diet in order to lose weight?

 

The objective of obesity treatment is to lose weight by losing fatty tissue.Therefore, when an obese person loses weight,what they should really be losing is fat,and above all,abdominal fat.Thus,an obese person should not have a hypercaloric or unbalanced diet.

When an individual loses weight very rapidly they may be losing muscle and water.Weight loss must be gradual – between 2 kg and 4 kg a month – to ensure the loss of fatty tissue.

In very severe and unbalanced diets,like the majority of “miracle” diets,muscle tissue is lost,its higher water content making it easier to lose than fat.The results of these diets,can,at first,seem spectacular.However,when the dieter finishes the diet,they experience the “rebound effect”,whereby all the weight lost is put back on,and not as muscle,but as fat,making it increasingly difficult to lose.