Overweight | Obesity | Obesity | obesity

The World Health Organization (WHO) describes obesity as the greatest chronic health problem of the future. In some Western industrialized countries, more than 30 percent of people are overweight. Depending on the country, obesity and associated diseases account for five to ten percent of total health care costs. In the United States, about 280,000 deaths per year are attributed to obesity and its complications.

Obesity is the second leading cause of death after smoking. Even in Germany, only about a third of the adult population has a healthy body weight. What is particularly worrying is that obesity is also increasing among children and young people.

Obesity is defined as an increase in body fat that exceeds normal levels. The basis for calculating weight classification is the body mass index. [Body Mass Index (BMI)]. BMI is the ratio of weight to height squared. Overweight is defined as BMI > 25 kg/m², obesity as BMI > 30 kg/m² (according to the WHO). In addition to the extent of excess weight, which is measured by BMI, the pattern of fat distribution determines metabolic and cardiovascular health risk. Visceral fat mass is particularly correlated with cardiovascular risk factors and complications. A simple and widely available measure to assess visceral fat deposits is to measure waist circumference. If waist circumference is ≥ 88 cm in women or ≥ 102 cm in men, abdominal obesity is present. For people with a BMI ≥ 25 kg/m², waist circumference should always be measured.

Overweight or obesity is a chronic disease that significantly reduces the quality of life and can lead to serious health problems. Basically, body weight increases when the body receives more energy in the form of calories than it can use. In this case, we are talking about a positive energy balance. The development of obesity can certainly be attributed to a multifactorial genesis. Family disposition, genetic causes, modern lifestyle (lack of exercise, malnutrition, e.g. fast food, sugary soft drinks, alcoholic beverages), stress, eating disorders, endocrine diseases (e.g. hypothyroidism, Cushing’s syndrome), medications (e.g. some antidepressants, neuroleptics, antidiabetics, glucocorticoids, beta-blockers) and other causes (e.g. immobilization, pregnancy, operations on the hypothalamus region, nicotine withdrawal) contribute to its development.

Being overweight or obese is associated with a high risk of developing a variety of diseases and thus a significantly reduced life expectancy. Carbohydrate metabolism disorders (e.g. insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus), dyslipoproteinemia, gout, high blood pressure (arterial hypertension), cardiovascular diseases (e.g. coronary heart disease, stroke, heart failure), tumors or carcinomas, hormonal disorders (e.g. restricted fertility) as well as pulmonary complications (e.g. dyspnea, restrictive ventilation disorders, hypoventilation and sleep apnea syndrome). Severe obesity can also result in gastrointestinal diseases (e.g. gallstone disease, fatty liver disease, non-alcoholic fatty liver hepatitis (NASH), reflux disease), degenerative diseases of the musculoskeletal system (e.g. coxarthrosis, gonarthrosis, spinal syndromes) as well as an increased risk of surgery and anesthesia. General complaints (e.g. increased sweating, joint problems, exertional dyspnea) as well as weight-related restrictions in activities of daily living lead to a reduction in quality of life, with psychosocial consequences such as increased depression and anxiety, social discrimination, reduced self-esteem and social isolation.