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Prevention and treatment of obesity

  • DEFINITION AND EPIDEMIOLOGY

    Obesity can be defined as a disease of the modern age, and its considered one of the biggest public health problems today, with an exponential increase rate and pandemic proportions.

    Professionally, we define it as a chronic endocrine-metabolic disorder characterized by excessive accumulation of fatty tissue due to excessive energy intake, which over certain time period causes complications in proper function of other organic systems.

    Simply, excessive body mass and obesity are defined as “abnormal” or excessive accumulation of fat tissue puts ones nutritional and health status at risk.

    Obesity is usually caused by a combination of excessive energy intake and lack of physical activity, meaning that total energy intake per day is greater than its expenditure. A person gains weight because excess energy is stored in body reserves as extra fat. There is also a genetic predisposition to obesity development, but very few cases of obesity are primarily caused by genes.

    Vital importance to a healthy lifestyle and psychophysical balance is implementing healthy eating habits as well as the continuous, everyday physical activity. Recent studies have shown that excess body mass inhibits about 620 genes and creates the basis for the development of various health disorders.

    The well known fact is that excessive body mass or obesity itself disrupts health. Medical intervention is often required in solving the problem of weight loss and maintenance of ideal body mass.

    By regulating body mass and weight loss, and maintaining an ideal body mass, the person converts acquired knowledge into lifestyle with a drastically reduced health risk.

    It is estimated that around 60% of the population in the Republic of Croatia has excessive body mass and about 20% of the adult population is obese, equally affecting both genders It is estimated that a new researches currently being carried out will show much more alarming figures – 30% of obese adults.

  • OBESITY COMPLICATIONS

    Obesity is not just an aesthetic problem, but a serious public health problem that is a vicious circle of inadequate functioning of almost every system in our body. If the problem of obesity is not treated on time, the complications become much more serious.

    Considering the BMI criteria (Body Mass Index, BMI), the obesity is directly associated with increased risk of developing cardiovascular diseases including occlusive disease of the arteries, hypertension, hyperlipidemia, heart attack, cerebrovascular disease and stroke.

    Studies have shown that obesity is the cause of one third of all cases of hypertension.

    Obesity can also lead to development of type 2 diabetes. Namely, continuous high calorie intake, usually high in carbohydrates (sugars) and fat, weakens the cell response to insulin, which gradually leads to weaker pancreas functioning. It is estimated that about 6 million people die on an annual basis, as a result of diabetes.

    Diseases that occur as a result of obesity include:

    • gastrointestinal diseases (eg. GERB, gastritis, Chron’s disease, irritable bowel syndrome)
    • degenerative joint diseases; musculoskeletal diseases (eg. osteoarthritis, osteoporosis)
    • gynecological problems (eg. polycystic ovaries)
    • endocrinological disorders (eg. hormonal disorders such as hypothyroidism or diabetes)
    • malignant diseases (eg. breast, cervical, pancreatic, colon, prostate, liver and kidney tumors)
    • breathing disorders during sleep (apnea) and psychological problems, mostly lack of self-confidence, phobias, complexes and depression.
  • DIAGNOSIS OF OBESITY

    Obesity is defined by person’s weight in kilograms (kg) divided by his or her height in meters squared, but the key factor is to define the relationship between the lean body mass and body fat.

    ClassificationBMI (kg/m2)
    underweight≤ 18,5
    normal (healthy weight)18,5 – 24,9
    overweight25 – 29,9
    obese class 1 (moderately obese)30 – 34,9
    obese class 2 (severely obese)35 – 39,9
    obese class 3 (very severely obese)≥ 40

    Another criteria for assessment is the waist circumference (cm) measured in the height of the navel. Centimeters obtained by measuring are equivalent to the health risks.

    WOMENMENRISK STATUS
    > 80 cm> 94 cmhigh risk of metabolic complications
    > 88 cm> 102 cmsevere risk of metabolic complications

    Weighing and measured centimeters are just the beginning. Specifically, if you are overweight, especially if we’re talking about obesity II ° or III ° there is a high possibility that obesity has already damaged your health to the extent that you require medical attention.

  • ABDOMINAL OBESITY

    A special problem is the inadequate distribution of fat tissue. Patients with excessive body mass can have evenly distributed fat throughout the body: in the hands, body, buttocks, legs, or they can have concentrated fatty tissue in the abdomen. Fatty tissue concentrated in the abdomen area is a much bigger health problem. That type of obesity is called abdominal obesity and it’s more common in men than in women.

    There are different methods of determining abdominal obesity.

    One of the key indicators, apart from the waist circumference (the area of ​​the navel), is the percentage of visceral fat. Visceral fat is not subcutaneous fatty tissue, but fatty tissue surrounding internal organs such as liver, kidney, pancreas. In average, in terms of male patients up to 20% of total body fat should be visceral fat, while the share of visceral fat in women should be lower, around 5-8%.

    Differences between genders are due to a different hormonal profile. A dominant female sex hormone is estrogen that stores fat mainly in the buttocks and hips, preventing accumulation of fat in the form of visceral fat in the abdomen. During menopause hormonal changes occur, estrogen decreases, and thus leads to increased tendency to accumulate fat tissue in the form of visceral fat in the abdomen. If a person doesn’t exercise regularly and doesn’t have balanced diet, fat accumulation is faster and increases the risk of many health complications!

    There is an unquestionable importance of physical activity and proper diet with a lower carbohydrate content (especially refined carbohydrates) to solve the problem of visceral fat.

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