TRIGGER WARNING: BMI, WEIGHT GAIN/LOSS

‘You just need to burn more calories than you consume’, or ‘Just eat less and move more’, are sentences that probably almost every obese person can recall hearing at least once in their lifetime. Since these recommendations sound very straightforward, it should be easy to realize them. Yet, we are witnessing a worldwide increase in the prevalence of obesity, and it is becoming a major global health concern. Learn more about the prevalence, causes, and complications of obesity in this post!

What is Obesity and Who is Considered Obese?

Obesity is a chronic medical condition in which access fat has accumulated in the body which increases obesity-related health-complications. A person is commonly considered obese with a body mass index (BMI) equal to or above 30. Furthermore, it is split into three classes: class I (BMI 30-35), class II (BMI 35-40), and class III (BMI > 40). However, this classification is not perfect, as it does not account for fat- and muscle mass.

BMI = mass (kg)/ height (cm)2

How Many People Are Affected by Obesity?

Accoding to the World Health Organization, the prevalence of obesity has nearly tripled since 1975. 13% of adults were obese in 2016. And sadly 38.2 million children worldwide under the age of 5 were underweight or obese in 2019.

What are the Causes for Developing Obesity?

To overly simplify it: obesity is caused by consuming more energy than we spend. The excess energy is stored in fat cells, so-called adipocytes. However, this is not the end of the story. The susceptibility to obesity is different among individuals and depends on the combination of several factors, for example genetics, physical activity, diet, mental health status, stress, and socio-economic status.

Individuals can be genetically and epi-genetically predisposed to develop obesity, meaning that the body could be ‘programmed’ to eat more, to store fat more easily, and to burn less energy. This does not necessarily mean that a person with this genetic program will become obese, but could become obese in combination with a high-calorie diet and reduced physical activity. In our today-lifestyle we are naturally moving less because we often depend on cars, public transport, sit at a desk at work, and on the couch at home. Furthermore, for many people food is almost constantly available, and healthy food often considered expensive. It is easy for us to fall for calorie-dense food and snacks without us realizing how much energy we are putting in our body.

All these factors can significantly contribute to problems in the regulation of appetite (e.g. too many hunger signals and too weak satiety signals), how fat is stored, and/or energy balance.

Obesity is a medical condition in which excess energy accumulates in fat-cells, also known as adipocytes. Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014“. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010ISSN 2002-4436.

Which Complications are Associated with Obesity?

So what is so bad about having more body-fat? From an aesthetic point of view: nothing at all. No one needs to feel ashamed for having more body-fat than others. All bodies are beautiful! However, with increasing weight the risk for developing obesity-associated complications increases, too. Those complications include (among others): asthma, cardiovascular disease, sleep apnoea, fatty liver disease, high blood pressure, type-2-diabetes, dyslipedemia, infertility, PCOS, erectile dysfunction, anxiety, depression, osteoarthritis, pregnancy complications, … In combination with being judged as lacking self-control, the individual burden of obese people becomes heavy.

As a result of these complications, obesity is unfortunately one of the leading preventable causes of death world wide. The good news: even a small reduction in weight can decrease the risks for developing secondary diseases significantly (and for example fertility can be increased again!).

Increased BMI is associated with decreased life expectancy. Prospective studies collaboration, Whitlock, Lewington et al., 2009. https://bit.ly/2A148eP

Why is it so Difficult to Lose Weight?

In order to lose weight, one needs to consume less energy than it is burned. This reduction in food intake kind of alerts the body: suddenly there is not as much food available than the body was used to. It thinks it is starving. In order to enhance ‘chances of survival’ and energy consumption, the body starts processes that support weight gain. For instance, it starts to produce more hunger signals (e.g. in the form of the ‘hunger hormone’ ghrelin) and suppresses the production of satiety signals (e.g. Leptin, GLP-1, Insulin, CCK). The internal switch for ‘eating’ is constantly turned on, which can make it incredibly hard to fight against it. Additionally, the body can decrease the metabolic rate, meaning how much energy we burn during the day. Taken together, we burn less calories and want to eat more.

Stay safe. Stina <3.

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https://www.who.int/topics/obesity/en/

https://bit.ly/2A148eP

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