Obesity (obesity, severe overweight) often affects not only the quality of life, but in the long term very often also health. Diabetes and the increased risk of cardiovascular diseases come first.

Synonyms

Obesity, morbid overweight

Definition

Overweight man

Overweight or not? This is not just a question of who goes on the scales. There has also been some movement in the expert discussion about obesity. Slight obesity is no longer a cause for concern for many medical professionals. On the other hand, the widespread strong overweight is dangerous to health, especially as obesity or obesity.

More than half of Germans are so overweight that health suffers and life expectancy is shortened. Obesity is the most common cause of lifestyle diseases such as cardiovascular disease , diabetes or orthopedic complaints.

Frequency

In Germany, more than 50 percent of people are considered too fat. At 62 percent, men are significantly more overweight than women.

Symptoms

Obesity and body mass index

Overweight is determined according to international agreement using the so-called body mass index. The BMI is calculated as follows: body weight in kilograms divided by height in meters squared. For a 1.65 m tall person with 80 kg, the calculation looks like this: 80: 2.72 = BMI 29.4. Values ​​between 18.5 and 24.9 are then considered normal weight. From a BMI of 25, doctors speak of overweight, with a BMI of 30 from obesity or obesity.

Waist-to-hip ratio

To put it simply: Fat close to organs, the so-called visceral fat, is more harmful to health than fat on the buttocks or legs. When most of the body fat is around the waist, one speaks of the apple type. With an apple-shaped body fat distribution, the risk of high blood pressure, diabetes, heart disease and stroke is significantly increased. The risk of the diseases is higher because the fat cells are often not only under the skin, but also in the liver, for example. Being overweight with the pear type entails fewer risks on average than with the apple type. The explanation: The fat cells mainly accumulate in the region remote from the organ, for example on the buttocks and thighs.

The fat distribution can be measured in the form of the waist-hip ratio. A healthy TH ratio in women is equal to or less than 0.8. In men, a healthy TH ratio of 0.9 and less is assumed.

Causes

The main cause of obesity is roughly simplified, that the body receives more energy from the food than it consumes. The organism stores the excess energy as fat under the skin or in organs.

Medical professionals distinguish between primary and secondary causes of overweight and obesity. Above all, the primary causes are incorrect eating habits and a lack of exercise; secondary causes of overweight are diseases that can be associated with weight gain. A typical example of this is the underactive thyroid. Hyperfunction of the adrenal cortex (Cushing’s syndrome), brain tumors, surgery or radiation can also promote obesity.

Treatment

In order to avoid serious complications such as diabetes, heart attack or stroke, excess weight should be reduced as early as possible. The first means of choice for this are a fresh, varied and low-fat diet and lots of exercise. If overweight cannot be reduced, you should seek professional help. Your doctor will be happy to work with you to develop a concept for a concept that will help you permanently lose excess weight. If you want to lose weight, there are only two options:

  1. Limit energy intake in the form of food
  2. Increase energy consumption

Experts recommend combining both for the purpose of sustainable weight reduction. So eat less or less energy and exercise more. Light endurance sports such as walking, Nordic walking or cycling, for example, consume about 600 kcal per hour. So if you do light exercise 3 hours a week, you burn the equivalent of two average lunches.

Change of diet

In fact, the answer after healthy weight loss is very simple. There is only one way that you can permanently lose excess weight: with a sustainable diet that consumes fewer calories than you consume. The linchpin of this change in diet: The nutritional behavior must suit you. Only then can you lose excess weight and maintain the desired weight. Because a change in diet in the sense of any kind of one-sided diet almost certainly brings with it the yo-yo effect: you lose weight – and gain more or less after the diet. And often more than you lost weight before.

The most important pillar of losing weight is the change in diet. And it is easier than many media want us to believe. Forget everything you’ve ever read about one-sided diets or powders. For a sustainable change in diet, it is basically completely sufficient if you eat a fresh and varied diet that is low in sugar and fat. Simply by foregoing fast food such as burgers, pizza and fries, sugary lemonades and breakfast cereals and sweets will save you thousands of calories. Replace fast food with salads, fruits and vegetables, and low-fat meat (poultry) or fish. Juice spritzers are better than soda, water is even better.

If you want to lose weight sustainably healthy, it is best not to use diet products. This applies to reduced-fat foods and sweets from the supermarket as well as to so-called formula diets in the form of powders, granules or beverages with a precisely defined nutrient, vitamin and mineral content. These diets are only suitable for short diets, to lose 2 to 3 kilos or to replace some meals as part of a diet. In the long term, however, you will only avoid being overweight and the yo-yo effect if you change your eating habits for everyday use.

Overweight medication

Over the counter medications have been on the market for some time that inhibit the absorption of fat in the intestine. As a result, approx. 30% of the dietary fats are no longer absorbed by the intestine, but are directly excreted in the stool. One of the side effects: At the same time, the absorption of fat-soluble vitamins A, E, D and K is reduced. The use of such active ingredients as Orlistat also has some side effects and side effects that should be monitored by a doctor.

In the interest of your own health, you should not use any anti-obesity medication that comes from the group of laxatives (e.g. senna leaves), dehydrating agents (e.g. birch leaves, pineapple enzyme) or detox teas (e.g. senna leaves and birch leaves) are. These only lead to a short-term, increased water excretion. Important minerals can be lost in the long run. In addition, regular use of laxatives leads to constipation. Abuse of laxatives is the main cause of chronic constipation.

So-called fat blockers from the USA do not contain any fundamentally new substances for weight loss, but mainly vitamins. And even vitamins can harm if too much is taken.

Appetite suppressant with side effects

Appetite suppressants with chemical agents have an appetite-suppressing effect on the brain. Because of the side effects, many patients cannot take these medications (e.g. blood pressure in the pulmonary circulation rises with hypertension). Side effects can also occur in healthy patients. Nervousness and restlessness are among the harmless complaints. Worse is a physical or psychological addiction to appetite suppressants and their risk of heart valve defects. That is why most chemically active appetite suppressants are no longer sold today. In order to curb the appetite in a natural way, herbal preparations such as goat-lozenge, mate or peppermint tea as well as meals made from the Jerusalem artichoke bulb or oatmeal are suitable. The effect of homeopathic medicines (e.g.

Nutritional counseling and support groups

Losing weight with others can strengthen your will to lose weight. However, you should consider for yourself whether you want to join a commercial organization. It is better to get support, for example, in health centers, from independent nutritionists or in self-help groups. If you are overweight or obese, a cure or an inpatient admission to a specialized clinic can help you get off to a good start in the fight against the extra pounds.

Medical treatment for overweight

Medical treatment for obesity can basically be limited to

  • diagnose obesity. It is not uncommon for people with normal weight to lose weight. In this context, special attention should be paid to eating disorders such as anorexia.
  • Exclude organic causes of obesity, such as hormonal disorders, metabolic disorders, water retention in the tissues (edema) or an unnoticed pregnancy.
  • Treating concomitant diseases and accompanying the progress of the weight loss medically
  • Prescribe medications that help to reduce excess weight (from a BMI of 30). This includes, in particular, vegetable guar to suppress the feeling of hunger as well as alginic acid and amfepramone to facilitate dietary measures, cathine and phenylpropanolamine reduce appetite and orlistat reduce fat intake. It must be said that all active substances only support weight-reducing measures. As a rule, they alone do not help you lose weight – especially long-term and sustainably. In addition, the intake must be made exactly according to medical prescription, in addition to the diet plan and exercise program.

Operatively reduce the size of the stomach

In extreme cases of obesity, gastric surgery can make you feel full even with small amounts of food. With such an operation, the stomach is reduced in size. This surgery can only be the last resort. The statutory health insurers will only reimburse the costs after a very narrow pre-selection.

Forecast

Complications from obesity

The symptoms and consequences of being overweight or obese are extremely diverse and affect the entire organism. For example, being overweight is considered the strongest risk factor for cardiovascular diseases such as heart attack, angina pectoris, high blood pressure, arteriosclerosis or stroke. A connection can also be made between metabolic diseases such as diabetes, high cholesterol or gout. Furthermore, being overweight is a significant burden on the skeletal and muscular systems and is often responsible for back problems such as herniated discs. Overall, overweight and obesity weaken physical performance. Most experts assume

Study location

Being overweight shortens life expectancy

For the European Prospective Investigation into Cancer and Nutrition (EPIC), researchers from the University of Cambridge evaluated the data from more than 300,000 participants over an average of 12 years. According to this, obesity with a body mass index (BMI) greater than 30 is the cause of around 337,000 deaths. The number of deaths caused by a lack of exercise is almost twice as high (676,000).

Body mass index in criticism

For some time now, the BMI has been criticized as a yardstick for overweight. Background: When calculating the BMI, only weight and height are used. However, many experts believe that this is not enough to determine the health risk of being overweight or obese. Rather, the fat distribution on the body must also be taken into account for a meaningful result. In fact, studies show that fat distribution has a significant impact on the health risk from being overweight.


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