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Obesity is a complicated chronic disease. It arises for many different reasons and does not go away on its own without treatment. There is no one "miracle cure" for obesity. Treatment of obesity is difficult, long and requires the use of various methods tailored individually to each patient. Check what are the causes of obesity and how it is safely treated.

Obesityis one of the most dangerous and complicated chronic diseases. It is caused by many factors, the so-called environmental (e.g. improper nutrition, low physical activity), psychological, genetic and hormonal.

Obesity - definition of obesity disease

Obesitywas recognized as a disease more than 50 years ago. The World He alth Organization (WHO) entered it on the International List of Diseases and He alth Problems (the so-called ICD10 classification) under the code E66. In Poland, this list has been in force since 1996 and every doctor has it in his desk. When making a diagnosis for a patient, he must enter the appropriate disease code on the card.

The causes of obesityare really many and they are varied. Each patient may have several or even a dozen or so. Determining the factor (s) causingobesityis a long process and requires individual diagnostics for each patient, and then effective treatment of personalized methods and tools. What's more, research on obesity continues to reveal new causes that may lead to the emergence of this disease.

Obesity - what is overweight?

Obesitystarts withoverweight . That is why specialists call it:pre-obesity , orpre-obesity .

Overweight is a state in which we provide the body with much more energy than it needs for proper functioning, including basic metabolism, heat production and physical activity.

Our "economical" and "economical" organism starts to store it in the form of adipose tissue in order not to waste this extra energy. He plans to use it in "worse" times, when he will not have access to food. And if those don't come, the fat "stores" just build up. This additional "composition" of adipose tissue accumulates in different parts of the body. In men, it is most often on the abdomen. Hence the name of the so-called obesityabdominal, apple-type obesity. In women, adipose tissue is usually located around the lower abdomen, on the buttocks and on the thighs. That is why it is also referred to as gluteal-femoral obesity, pear-type obesity.

Remember, however, that in each type of obesity, this "reserve" of adipose tissue is a visible symptom of the disease, not its cause. Being overweight is a state in which a red alarm light should go on:something is wrong with the body ! If we do not start treatment on time, overweight may develop into obesity - I, II and III degree disease, i.e. morbid obesity.

Obesity can lead to death

In Poland,overweightandobesitysuffers from around 70 percent society. Among people with stage III obesity, there are more and more people with a BMI (body mass index) of 50 and more. This stage of the disease is commonly referred to as extremely morbid obesity. It leads to full motor disability and addiction to the help of other people, and often to death.

Obesity or overweight - how to check it?

Three methods are used to determine the stage of development of the obesity disease:1. Determining the body mass index, i.e. BMI (Body Mass Index).

BMI is the amount of body fat in your body. To calculate BMI, divide your weight - in kilograms, by your height squared - in meters.

Example:if you weigh 65 kg and you are 1.70 m, your BMI is - 65: (1.70 x 1.70)=22.4.

But beware - BMI is unreliable in pregnant women, athletes, people with extensive muscle tissue, growing children, or the elderly who have difficulty determining their height correctly.

Full BMI classification according to the World He alth Organization (WHO):

  • less than 18.5 - underweight
  • from 18.5 to 24.9 - correct weight
  • from 25 to 29.0 - overweight
  • from 30.0 to 34.9 - 1st degree obesity
  • from 35.0 to 39.9 - 2nd degree obesity
  • over 40 - grade III obesity, also known as severe or malignant.

Check your BMI - use our calculator!

2. Body Fat Measurement

It can be made only with the use of special scales or similar devices, which are more and more often available in medical and dietary offices. Overweight is diagnosed when the body fat content is 20-25% in men and 30-35% in women. Indications above these norms mean obesity.

3. Waist measurement

Waist circumferenceit is simply the widest part of your belly. With a large accumulation of body fat, it is often difficult to find and measure correctly. You can ask your doctor for help and learning how to measure.

If your waist is between 80-87 cm (men 90-94) - you are overweight, when it is equal to or greater than 88 cm (men 94) - you are already obese.

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Obesity - Environmental Causes

Diagnosing the factor that triggered improper food consumption is the basis of effective obesity treatment. Environmental factors that can lead to obesity are those related to our everyday life - including family, private and work life. So it's not just about eating foods that have too much fat or avoiding exercise, but many other reasons that can lead to overweight and obesity that we often don't even realize. Their list is quite long, so we've broken it down into several sections.

1 / Incorrect nutrition as well as family habits of preparing and eating meals, including:

  • eating too much food,
  • eating foods with too high energy density (food that 1 g contains a large amount of calories, most often due to high fat and sugar content),
  • eating meals too often without 3-4 hour breaks between them,
  • irregularly eating meals and eating them up in between, e.g. sweet or s alty snacks,
  • disruptions at eating times,
  • not eating breakfast,
  • eating one meal a day - e.g. after finishing work,
  • eating dinner too late - it should be eaten no later than 2 hours before bedtime,
  • drinking sweetened beverages,
  • not eating vegetables,
  • reluctance to try new products.

2 / Abnormal food purchases, including:

  • highly processed products that provide a large amount of calories in small amounts,
  • products with preservatives, "enhancers", artificial dyes,
  • fruits and vegetables, the development of which was supported by chemicals,
  • being guided when choosing a product by its price - not always, but often the cheapestthe products contain the most fats and sugars that are detrimental to he alth, and little he althy dietary fiber,
  • succumbing to false information in slogans advertising food.

3 / Low physical activity

The development of civilization, including food production, sales methods and new technologies, has meant that we are also less and less moving to "get" food. We no longer have to hunt for it (also the one in the store), bake, collect, and even drive to the store for it.

All we need to do is turn on the appropriate application on the tablet or phone, choose the right products and order them, and they will bring them home. And this way, instead of a few hundred or thousand steps, which would allow the body to use energy, we make a few "clicks" or "touches" with a finger that have nothing to do with physical activity.

4 / Stress

Fast pace of life, competition at work or the need to "develop" an appropriate standard on which our remuneration depends, the willingness to provide for the family, meet the requirements of oneself and others, as well as possessing an increasing number of items that, in our opinion, are necessary for us to live.

These and many other factors make us live in more and more stress. In order to "eat" it, we often reach for products that give us a deceptive sense of peace and better well-being.

Remember, however, that what drives us when we start to "eat" stress is nothunger , butappetite . Hunger is the physiological need for food intake to keep the body alive. And the appetite is the desire to eat something that, as our experience shows, brings us relief and gives us pleasure.

  • Obesity and stress - how do they affect each other?
  • Slimming - how to reduce appetite and hunger?

Obesity - psychological causes

Emotional or mental he alth problems can be both the cause and the consequence of obesity. In those patients in whom obesity is associated with psychological factors, the most common diagnosis is:

  • low self-esteem and lack of self-acceptance,
  • depressed mood ordepression- in order to improve their well-being, patients reach for sweets or alcohol, which provide additional calories,
  • replacing important emotional needs with food - e.g. love, friendship, security, recognition, respect,
  • night eating syndrome , which manifests itself, inter alia, in not eating meals in the morning, eating more than half of the food in the evening and at night, difficulty falling asleep or insomnia, andalso sleepwalking - when the patient is not aware that he / she gets up at night to eat something,
  • compulsive eating syndrome , when a patient eats large amounts of food due to nervousness, anxiety, sadness, loneliness or boredom, and the quantity and quality of the eaten food do not matter to him,
  • food addictionwhich symptoms are:
    • feeling an internal compulsion to eat a lot of food,
    • no control over food,
    • physical signs of the so-called withdrawal when the patient does not eat, e.g. muscle tremors, denying that he or she does not control eating, eating food despite knowing that it is harmful to him in too large portions.

The risk of developing food addiction is greater in people who see it as a "tool" for reducing stress and are prone to various addictions in general.

Obesity - hormonal causes

The most common of them are the so-called Cushing's syndrome, in which excess cortisol, which is called the stress hormone, causes your body to produce more food. Weight gain can also cause hypothyroidism, but only if it is advanced and untreated.

Listing the hormonal factors that cause obesity, researchers of this disease and doctors also point to disturbances in the functioning of hormones that send a hunger signal to the brain (ghrelin - "commands": eat!) And satiety (GLP1 - "orders": stop, stop eating!).

Obesity - genetic causes

Some time ago, scientists reported that they discovered a gene called FTO that increases the risk of obesity. However, if we see the causes of obesity in genetics, it should be noted that up to 100 genes can be responsible for its formation, and the FTO is one of them.

Experts emphasize, however, that in "inheriting" obesity it is more about duplicating the wrong eating habits and inactive ways of spending free time, noticed by grandparents and parents. Worldwide, there have been only 200 cases in which damage to the function of a single gene was the cause of obesity.

Who is an obesitologist?

Obesitologistis a specialist in the treatment of overweight and obesity (from Englishobesity- obesity). Are you looking for obesitologists? Go to www.jakleczycotylosc.pl

Obesity - conservative treatment

The truth is brutal, get rid of your delusions - no "miracle diet" for 2-3 weeks or even a few months will not help in the effective treatment of overweight and obesity. For this it is necessarypermanent, lifelong change of eating habitscombined with sustained increase in physical activity . This is calledconservative treatment .

To lose weight, you need to consume fewer calories than your body needs. But these amounts can vary greatly from person to person. They depend, inter alia, on from his age, physical fitness, type of work, severity of obesity and other diseases.

Therefore, the correct amount of calories that a specific overweight or obese person may eat daily should be determined by a doctor in consultation with a dietitian to obtain a beneficial therapeutic effect.

The same applies to physical activity. Its type and "dosage" should be adjusted to the he alth condition, physical condition and severity of obesity in each patient separately. Such recommendations should also be established by the doctor together with the physiotherapist.

Worth knowing

Activities and sports are SAFE for all overweight and obese people:

  • simple exercises in water,
  • aqua aerobics,
  • swimming,
  • nordic walking,
  • some pilates exercises,
  • cycling - stationary and off-road.

Activities and sports are DANGEROUS for people with obesity (especially so-called obesity):

  • step,
  • zumba,
  • tabata,
  • exercises on trampolines and hanging machines (e.g. trx),
  • exercises with elements of acrobatics,
  • jumping,
  • circuit training,
  • climbing,
  • skiing,
  • fast or long distance running.

Obesity - drug treatment

It is used primarily in overweight people and obesity of the 1st and 2nd degree. Sometimes, taking prescription drugs to support weight loss is recommended to patients so-called bariatric patients, i.e. those who are either preparing for obesity surgery (bariatric surgery) and need to reduce their weight to a certain level prior to surgery, or have already undergone bariatric surgery but have gained weight again.

There are two prescription drugs available in Poland for the treatment of obesity. The former increases the time you feel full after a meal and reduces your appetite, while the latter inhibits the intestinal absorption of fat consumed with food.

The doctor always decides about the inclusion of drugs in the treatment of overweight and obesity, as well as about their dosage and duration of use. Unfortunately, these drugs are not reimbursed by the National He alth Fund, so the patient bears the full cost of their purchase.

Obesity - surgical treatment (bariatric surgery)

Bariatric surgery isa method of treatment that is used in patients with advanced obesity. Patients with obesity of the third degree (BMI 40+) or obesity of the second degree (BMI 35.0 - 39.9), who have suffered complications from obesity, are qualified for the operation, e.g.

  • type 2 diabetes,
  • hypertension
  • or osteoarthritis.

Currently, three types of bariatric surgeries are performed in Poland:

  • sleeve gastrectomy,
  • gastric by-pass (the so-called gastric by-pass and its type mini gastric by-pass)
  • and - less and less - putting on a gastric band.

The goal of each of these operations is not only to reduce the volume of the stomach so that the patient can eat smaller portions, but above all to exclude the part of the stomach where ghrelin is produced, i.e. hunger hormone. All three treatments are reimbursed by the National He alth Fund.

An indirect method is the implantation of the so-called gastric balloon. It is used primarily in patients with extremely morbid obesity (BMI 50+) who, in preparation for the main bariatric surgery, must reduce their body weight by up to several dozen kilograms.

Worth knowing

Slimming treatments are not bariatric surgery!Lipo-suction, i.e. liposuction, GUAM, lymphatic massage, thermal slimming GOLF and other treatments contribute to the reduction of body fat, but They work mainly with overweight, because their task is to shape the body, firm the muscles, make the skin more elastic, and not treat overweight and obesity.

Obesity - psychological support for treatment

The methods supporting the treatment of overweight and obesity include the so-calledbehavioral therapy . It helps the patient to modify eating behavior, teaches the techniques of controlling the eating process, but also strengthens his motivation to treat and helps to understand what the obesity disease itself is and what its consequences are. On the other hand, for patients whose obesity treatment is hindered by, among others, low self-esteem, depressive disorders, compulsive eating syndrome, it is recommended to usepsychotherapy .

Overweight and obesity are treated gradually. The best weight loss at the beginning of treatment is 1 kg, then 0.5 kg per week.

Obesity - the consequences of not treating obesity

Obesity is not only a disease in itself, but also causes the development of about 50 other diseases. It can also increase the risk of more severe diseases such as the flu, COVID-19 and whooping cough.

Weight reduction as low as 5 to 10 percent. being overweight reduces the risk of developing complicationsobesity, and if it has already occurred, it reduces their intensity.

1 / Metabolic complications due to excess intra-abdominal fat:

  • insulin resistance,
  • pre-diabetes that may progress to type 2 diabetes
  • nonalcoholic fatty liver disease,
  • lipid disorders,
  • hypertension,
  • hormonal disorders,
  • damage to kidney function,
  • cancers - e.g. of the breast, uterus, pancreas, colon, kidney, liver, anus, prostate and blood.

2 / Diseases resulting from excessive fat tissue load on the body:

  • degenerative changes in the spine and knee joints,
  • varicose veins and venous thromboembolism,
  • gastroesophageal reflux,
  • lung disorders (hypoventilation syndrome),
  • hiatal hernia,
  • sleep apnea syndrome.

3 / Emotional changes affecting the patient's quality of life:

  • low self-esteem and lack of self-acceptance,
  • disturbances in the perception of size, body parameters,
  • isolation from loved ones and society,
  • sleep disorders,
  • fears,
  • depression.

4 / Other disorders in the body's work:

  • gallbladder stones,
  • increased risk of complications during anesthesia for surgery,
  • postoperative and perinatal complications,
  • abnormalities in the structure and development of the fetus.
  • Surgical treatment of obesity: types of bariatric surgery
  • Child obesity - causes, treatment, prevention
  • Weightism, so I hate you because you're fat
This will be useful to you

If you want to successfully treat overweight and obesity, you must realize and accept that:

  • obesity is a disease and you need to treat it, not "fight" it or "lose weight" from time to time with successive "miracle diets",
  • the earlier you learn the cause of obesity and start treatment - preferably already at the overweight stage - the greater the chance that you will not develop the disease, but …
  • … it is never too late to treat obesity,
  • obesity treatment is a long, difficult process and requires an individual approach to each patient, not standard recipes such as " eat less, move more ",
  • obesity treatment should be carried out by an interdisciplinary team consisting of a doctor, dietitian, psychologist andphysiotherapist,
  • the basis of obesity treatment is receiving help from professionals and sincere, systematic cooperation with them,
  • if you are already overweight or have become obese, you can reduce weight thanks to various methods, but you will not cure yourself of this disease until the end - it is enough to return to the lifestyle before treatment, and you will soon have to gain weight again,
  • if you want to be successful in obesity treatment, do not measure it by the rate of weight loss or the number of pounds lost, but by the durability of these effects and the improvement in your he alth and quality of life.
Important

Poradnikzdrowie.pl supports safe treatment and a dignified life of people suffering from obesity. This article does not contain discriminatory and stigmatizing content of people suffering from obesity.

About the authorMagdalena Gajda A specialist in obesity disease and obesity discrimination of people with diseases. President of the OD-WAGA Foundation of People with Obesity, Social Ombudsman for the Rights of People with Obesity in Poland and a representative of Poland in the European Coalition for People Living with Obesity. By profession - a journalist specializing in he alth issues, as well as a PR, social communication, storytelling and CSR specialist. Privately - obesity since childhood, after bariatric surgery in 2010. Starting weight - 136 kg, current weight - 78 kg.

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