What is obesity? Answers Alessandra Dei Cas, director of the simple departmental structure of Nutrition and Metabolism Sciences of the University Hospital of Parma and director of the specialty school in Nutrition Sciences of our University. «Obesity is a chronic multifactorial disease characterized by an excessive accumulation of fat mass in the body that has a negative impact on health. This is a real pandemic, according to Istat data in Italy a third of the adult population is overweight, while one in ten is obese, with alarming numbers even in the pediatric population. In the Emilia Romagna Region, 30% of people aged 18-69 are overweight and 12% suffer from obesity ».
When can you say you are obese?
«Obesity, according to the World Health Organization, is classified into three degrees of severity based on the body mass index (BMI), a formula that expresses the adequacy of weight based on a person’s height. As the BMI increases, in the transition from mild to severe obesity, the risk of developing cardio-metabolic diseases and mortality increases proportionally. The quantity of adipose tissue is not, however, the only variable to be evaluated; a distribution of the abdominal adipose tissue (measurable with the waist circumference) confers a higher metabolic and cardiovascular risk than a prevalently peripheral (or subcutaneous) localization “.
What are the health problems for the obese?
“Obesity is not an aesthetic problem, but is associated with an increase in all causes of death and the risk of developing further diseases closely associated with it, or with comorbidities such as type 2 diabetes, hypertension, dyslipidemias, cardiovascular diseases but also sleep and respiratory diseases, some forms of cancer, representing an important public health and economic problem for health systems “.
What are the causes of this disease?
«In about 95% of cases obesity is attributable to an imbalance between the intake and energy expenditure in favor of the former, therefore between the calories we consume with food and those consumed mainly with physical activity. Recent studies have, however, highlighted that there is an individual genetic predisposition that can contribute up to 40-50% and, in severe obesity, up to 60-80% to weight gain. This is one of the reasons why each of us responds differently to environmental stimuli that favor weight gain such as a sedentary lifestyle and an increase in calorie intake linked to the availability of foods with a high energy content ».
How to prevent it?
“This question implies a very complex answer. Obesity must be fought since childhood with the implementation of school programs of nutrition education and the promotion of physical activity that must find support in the institutions. The National Prevention Plan 2020-2025, adopted with the State-Regions Agreement of 6 August 2020, in order to prevent and combat obesity / overweight, especially in childhood, provides for an integrated intervention that combines community strategies (oriented to the promotion of health in different areas such as school, workplace, city) with those centered on individuals at risk of disease (e.g. individual support on lifestyles), in order to reduce individual risk factors and remove the causes that prevent citizens healthy lifestyle choices “.
Cures and goals
The therapeutic goal is the decrease in fat mass necessary to improve the state of health and the diseases associated with obesity itself, so the extent of the weight loss to be obtained and maintained over time must be shared with the patient, realistic It is customized. Studies indicate that a weight loss of 5-10% is sufficient to reduce cardiovascular risk factors while a weight loss of 10-15% is necessary to be effective on most comorbidities such as obstructive sleep apnea, steatopathy. non-alcoholic and metabolic improvement in type 2 diabetes. Therapeutic strategies must also take into account the degree of severity of obesity. In the mild one, a lifestyle approach is indicated in terms of caloric restriction to be obtained with a varied and balanced diet and the promotion of physical activity by reducing sedentary lifestyle. Weight loss must be gradual, using caution in following “trendy” diets and in taking food supplements that are not supported by scientific studies.
The performance of aerobic physical exercise of moderate intensity (at least 150 minutes / week) such as walking is able to promote greater weight loss, to preserve muscle tissue and increase the probability of maintaining any weight loss in the long period. In mild and moderate obesity, especially if associated pathologies are present, pharmacological approaches for limited periods under prescription and medical supervision may be considered in addition to lifestyle modifications. In severe obesity accompanying pathologies that negatively affect quality and life expectancy, bariatric surgery, in the context of a multidisciplinary path, currently represents the most effective treatment for long-term weight loss “.
© All rights reserved