Obesity is one of the most serious problems in the Western world. The World Health Organization has classified obesity as a growing epidemic. In the United States, one in four people is overweight. Almost a quarter of all white children in the world are obese.

The main cause of this disease is the modern lifestyle, which has led to an imbalance between the need for calories and their excess intake. Family eating habits and hereditary predisposition also play a role here.

What is the clinical significance of being overweight? Let’s turn to medical facts. 70% of cases of cardiovascular disease are somehow associated with obesity; 25% of overweight people suffer from hypertension; the risk of sudden death in overweight people is almost twice as high.

Obesity is one of the most important risk factors for stroke and diabetes. About 80% of people with diabetes are overweight. Overweight people are more likely to suffer from tumors such as cancer of the uterus, colon, gallbladder, kidney and breast, as well as fatty liver.

Obesity is one of the reasons for the development of varicose veins; in patients with increased weight, stones in the gallbladder are found three times more often. In addition, such patients very often suffer from heartburn.

Obesity also leads to breathing problems. This category of patients is characterized by nocturnal respiratory rhythm disturbances, accompanied by the development of respiratory failure, increased pressure in the pulmonary circulation and insufficiency of the right heart. Being overweight is a risk factor for developing pulmonary embolism.

Being overweight in pregnant women increases the risk of neonatal defects and is a risk factor for death in childbirth for both the baby and the mother. Overweight women are more likely to suffer from menstrual irregularities and childlessness.

Overweight people are more likely to have skin infections; they are also characterized by emotional experiences. Obesity tends to damage the knee joints.

The most accurate way to measure excess weight and its relationship to heart risk is by measuring the Human Mass Index. It is defined as the ratio between weight in kilograms and height in meters squared (weight: (height x height)) An index value over 25 suggests overweight. A value of more than 30 is the basis for the diagnosis of obesity. More than 40 suggests severe obesity. This index does not apply to athletes (large muscle mass).

It is not only the amount of excess weight that matters, but also its location. Thus, the central type of obesity (subcutaneous fat in the abdomen and waist) is a risk factor for cardiovascular disease and stroke.

Excessive fat in the abdomen (around the intestines and internal organs) is a risk factor for breast cancer, menstrual irregularities, and sleep-disordered breathing. How fat localization determines the risk of various diseases is unclear, but the relationship between fat location and the risk of associated disease is statistically clear.

For most overweight men, fat is located primarily in the waist area and has an apple-shaped belly. In women, there is a tendency to deposit fat in the buttocks and thighs, and the belly takes on the shape of a pear. An apple-shaped belly is more associated with the risk of cardiovascular disease than a pear-shaped belly.

Measurement of waist circumference also appears to be an important criterion for measuring the degree of cardiovascular risk in patients with central obesity. Thus, the waist in women which is more than 88 cm, and in men more than 102 cm, significantly increases the cardiovascular risk.

Weight loss is essential for treatment. Thus, weight loss by 10% can reduce the risk of developing cardiovascular diseases, stabilize blood pressure, cholesterol and triglyceride levels in the blood.

Weight loss alone may be sufficient to treat established forms of diabetes. With a decrease in the weight, might require lower doses of drugs, which leads to a decrease in the risk of side effects.

Treatment for obesity begins with lifestyle changes. A rational, properly balanced and individually selected diet combined with moderate physical activity as the first and important stage of treatment.

In case of insufficient effectiveness of these methods, special drugs can be used.

Orlistat (Xenical) – blocks the absorption of fats from the gastrointestinal tract. Liraglutide (Victoza) is used in adults with diabetes and obesity. Prescribing drugs is the prerogative of the doctor, used for special indications.

Surgical treatments are used for severe obesity and medical conditions. Surgical treatment does not involve cosmetic removal of fat.

Two types of operations are used: restrictive (reducing the size of the stomach) and disrupting the absorption of food from the gastrointestinal tract (gastrointestinal bypass shunts), each of which has its own advantages and problems. Research shows that the procedures lead to significant long-term weight loss, improved diabetes control, and reduced cardiovascular risks and mortality.

Surgical treatment is acceptable only for well-informed patients with severe obesity, high level of motivation, risk awareness and postoperative complications.

A question for an overweight patient. After all, the process is associated with the restructuring of the system of life priorities, tension, stress, additional costs and problems. We are talking about changes in the established habits, in the traditions of nutrition, in the mode of work and rest.

The fact is that a considerable number of patients will not reach the intended goal, and some, after the established weight loss, will gain even more weight. The degree of psychological discomfort associated with weight loss can be much greater than that of obesity. Only being overweight can go through this difficult path – this is a disease, and your own health is on the scale.