Overweight

What is obesity?

Obesity is an increase in body fat that exceeds normal levels. Body weight is estimated using the body mass index, which relates height to weight. A BMI over 25 kg/m^2 is considered overweight. A BMI over 30 is considered obese. Overweight and obesity are chronic diseases that increase your risk of death and the likelihood of complications.

How can you calculate your BMI?

BMI (Body Mass Index) is the most common method of estimating body weight. Since the height of a person has an influence on the body weight, the quotient of the body weight in kilograms and the square of the height in meters is formed. Although body composition, i.e. the distribution of fat, muscles and bones, also influences weight, it is difficult to determine this precisely. In practice, therefore, the BMI is used.

To calculate your BMI, you can use the BMI calculator from the German Obesity Society, for example.

Depending on the BMI, three large weight groups are formed, each of which has a different risk of obesity-associated comorbidities:

• Underweight: BMI < 18.5
• Normal weight: BMI 18.5-24.9
• Overweight: BMI ≥ 25
• Präadipositas: BMI 25 – 29,9
• Adiposity Grad 1: BMI 30 – 34.9
• Grad 2 adiposity: BMI 35 – 39.9
• Grade 3 Adiposity: BMI ≥ 40

The risk of obesity-associated comorbidities increases with increasing BMI. While the risk is only slightly increased in so-called pre-obesity, it is already high in grade 2 obesity and very high in grade 3 obesity.

Unfortunately, the BMI is only a rough guide for estimating your body weight. Since your height is squared in the calculation, the smallest measurement errors can lead to large changes in the calculated BMI.

Fat distribution pattern also has a major impact on obesity health risk. Fat that is carried in the stomach, so-called visceral fat, has a higher impact on the cardiovascular system and thus leads to more complications of obesity. In contrast to the fat directly under the skin, the subcutaneous fat, it releases hormones that have an effect on a wide variety of organs.

To account for this factor, your waist circumference is also measured to assess the risk of obesity-related diseases. It is considered a good indicator of the amount of visceral fat and is classified according to gender.

• Increased risk of cardiovascular disease:
• women ≥ 80cm; Men ≥ 94cm
• Abdominal obesity (obesity of the abdomen):
• women ≥ 88cm; Men ≥ 102cm

Causes of obesity

Many factors influence the development of overweight and obesity. An important factor is the imbalance between energy intake and energy expenditure. This can have different causes:

• genetic factors
• Lifestyle: lack of exercise and malnutrition
• “Seduction” through constantly accessible food
• Lack of sleep and stress: Both factors can not only lead to increased eating, but also have an impact on the hormone balance.
• Depressive illnesses can lead to a lack of exercise and increased food intake.
• Low social status: It has been shown that people with a lower income and level of education are more likely to be overweight.
• Eating disorders: frequent binge eating (binge eating disorder), frequent night eating (night eating disorder)
• Hormone imbalances: hypothyroidism or abnormally high cortisol levels (Cushing’s syndrome)
• Medication: Some medications can cause weight gain.

Metabolic Syndrome

Next to smoking, the so-called metabolic syndrome has the greatest influence on the risk of cardiovascular diseases . It is a combination of four different components that often result from overeating and lack of physical activity.

1. Abdominal obesity
2. high blood pressure
3. Disorders of lipid metabolism (elevated blood lipid levels)
4. Impaired regulation of blood sugar

What are the risks of being overweight?

Obesity contributes to increased mortality. This is higher, the higher the BMI and the younger the person who is overweight. A person with a BMI of 22.5 – 24.9 has the lowest risk of death. If you are in the obesity grade 1 weight class, then your life expectancy is 2-4 years less than it would be if you were a normal weight. In the case of grade 3 obesity, it would even be 8-10 years less. This increased risk of death has many different causes, which can be explained primarily by the changed hormonal balance in obesity.

Some of the complications of obesity include:

• Diabetes mellitus (diabetes)
• gallstones
• fatty liver
• sleep apnea syndrome
• cardiovascular disease and stroke
• high blood pressure
• Joint problems: mainly knee and hip problems
• gout
• esophagitis
• Some cancers
• Polyzystisches Ovarialsyndrom
• back pain
• hormonal imbalances and infertility
• Increased risk in pregnancy
• Increased risk of surgery and scars
• dementia

It is important to realize that obesity is not just a medical or physical problem. Being overweight can cause many problems in everyday life. People who are overweight are often discriminated against and suffer from negative stigma. They are often seen as lazy or weak-willed, which can even lead to problems when looking for a job. Obese people also have an increased risk of developing depression.

diagnosis of obesity

In order to make the diagnosis of obesity, your doctor does not only have the scales at his disposal. It is important to learn more about the history of weight change and previous attempts to lose weight. Although it can be difficult to answer questions about your weight, it’s important that you answer your doctor’s questions honestly. He is a person of trust whose priority is to offer you the best possible therapy and to accompany you on your way to losing weight. To investigate the comorbidities of obesity, some of the possible tests are blood pressure measurement, examination of the heart with an electrocardiogram (ECG) or ultrasound (heart echo). Blood and/or urine samples can also be taken to get an overview of your hormone balance.

When should I go to the doctor?

Your doctor should be the first point of contact if you feel you have an issue with your weight. Since the complications of obesity can have a major impact on your health, they should be treated as soon as possible. Your doctor can help you plan your next steps and, for example, draw your attention to specialized nutritional advice.

What can you do yourself?

Many patients report that the exchange with others means a lot to them. In self-help groups you can find tips on how to deal with obesity and talk to other people who are affected. Internet sites where you can look for self-help groups in your area are, for example, those of the Adipositas Association or at Adiposita.de .

Nutrition plays a very important role in the treatment of obesity. You can get help from a nutritionist or a nutritionist, but there are also many things you can start incorporating into your daily routine right now. Before you change your entire diet all at once, it can help to become aware of what you eat on average during the day. The best way to do this is with a food log. By writing down everything you eat in a day, you’ll get a feeling for which screws you can tweak the easiest over a longer period of time. Some changes you can make include:

• Reduce energy intake: High-calorie foods, such as “fast food”, very greasy food or carbohydrate-heavy food, often do not fill you up for long. Short-chain carbohydrates like sugar and white wheat flour are digested quickly and contain few nutrients.
• Eat slowly: The eyes are often larger than the stomach. By avoiding large portions on the plate and eating slowly, you give your body a chance to let you know when you’ve eaten enough.
• Eat colorful: A varied diet is important for a balanced diet. You should eat at least 3 servings of vegetables and 2 servings of fruit a day. These contain vitamins and fiber, which not only contribute to satiety, but are also important for healthy digestion. One principle to keep in mind is that your diet should be based on plant-based foods, which you can supplement with animal products.
• Whole grain instead of light wheat flour: Whole grain flour has more nutritional value than so-called extracted flour (light flour) because the shell and the germ contain the most fiber, vitamins, healthy oils and minerals.
• Drink water: It is recommended to drink at least 1.5 L of liquid per day. However, this does not mean sugary soft drinks. They contain a lot of calories without bringing any nutritional value with them. Water, unsweetened tea, or coffee are better choices. Alcohol also has a very high calorie density. In order to lose weight, it makes sense to reduce your alcohol consumption.
• Find your sport: Regular physical exercise is not only good for losing weight, but also trains your cardiovascular system and promotes digestion. Not everyone needs to run. Once you find a sport that you like, it’s easier to stick with it long-term.

These are just a few tips to get you started. It’s hard to sustain change over time. It might help to set goals with a friend or partner so you can support each other.

therapy for obesity

The therapy for obesity is based on a basic program of nutritional therapy, movement therapy and behavioral therapy. The goal is to lose weight and maintain that weight loss over the long term. You can discuss the easiest way to start with with your doctor. In the case of extreme obesity and failure of the basic therapy, an operative solution can be considered. Before you decide whether this path would be a good choice for you, you should carefully weigh up the benefits and risks of such an operation with your doctor.

Obesity in childhood and adolescence

Obesity is the most common diet-related health disorder in children and adolescents in Germany. The number of overweight children has increased significantly. For children and adolescents, the increased weight not only leads to problems at school, but it can also lead to long-term health problems. Since children are still growing, adult values ​​cannot be used to diagnose obesity. Diet plays a major role in development at this age. In a conversation with a pediatrician, the BMI can be compared to that of children of the same age and the best nutritional therapy can be discussed.

Here’s how Med-Healths can help

Via Med-Healths you can speak to a doctor about your problems with being overweight and how to proceed in a personal consultation. He can not only draw up a therapy plan for you, but also issue you with a referral to a resident doctor or a nutritionist, so that a physical examination is also possible.