overweight

Overweight: description

The term “overweight” refers to the increase in body weight by an excess of the normal amount of increase in body fat. In case of severe obesity, physicians speak of obesity (obesity).

When are you overweight?

Which weight range in the individual case is considered normal and from when someone is overweight, depends essentially on the height. There are various size-weight indices that can be used to judge a person’s weight. Best known is the body mass index (BMI):

It is calculated by dividing the body weight (in kilograms) by the square of the height (in square meters). Depending on the result, the body weight of an adult is assessed according to the World Health Organization (WHO) as follows:

BMI (kg / m2)	category
< 18,5	underweight
18,5 – 24,9	normal weight
25 – 29,9	overweight
30 – 34,9	Obesity Grade I
35 – 39,9	Obesity Grade II
>40	Obesity grade III

“Normal” overweight (BMI 25 to 29.9) is also called pre-obesity.

The BMI must be taken into account that it is influenced by the physique and muscle mass. This means that very muscular people may incorrectly be considered overweight according to BMI. It follows that the BMI is only limitedly suitable as sole criterion for overweight.

obesity

Read more about the causes, symptoms, diagnosis, treatment and prognosis of severe obesity in the article Adiposity.

Where do the fat pads sit?

In overweight, physicians distinguish two types of fat distribution – depending on where on the body, the excess fat prefers to accumulate:

• Android type (“apple type”): The fat pads sit mainly on the body trunk, especially on the stomach. This fat distribution is especially evident in men.
• Gynoider type (“pear type”): The excess fat accumulates more and more on the buttocks and thighs. This type is found especially in women.

The android type is associated with a higher risk of complications (such as diabetes and cardiovascular disease) than the gynoid type.

Overweight: frequency

In Germany about two-thirds of all men (67 percent) and around half of all women (53 percent) are overweight. Of these, about a quarter (23 percent of men and 24 percent of women) even have a strong overweight (obesity).

Overweight in children

The number of overweight children has been rising for several years. You can read more about this topic in the article on child obesity.

Overweight: symptoms

Obesity puts a strain on the entire organism, and the more it does, the more excess kilos you put on the scales.

Thus, the high body weight heavy on the joints, especially those in the lower spine area and on the hip, knee and hock joints. The joints wear out faster and hurt (knee pain, back pain etc.).

More body tissue means a higher oxygen demand. In people with obesity, therefore, the lungs must work harder. However, she often fails to get enough oxygen for all body cells. It develops a chronic lack of oxygen. This is also helped by the fact that overweight people often have brief respiratory murmurs during the night (sleep apnea), which also affects oxygen intake. Snoring, little restful sleep and daytime sleepiness are the consequences of disturbed sleep.

In addition to the lungs, the heart also has to perform better in overweight people than in normal weight people. This is the only way to ensure adequate circulation of the many fatty tissues. This constant extra work puts a strain on the heart as well as the increased blood pressure, which is also a consequence of being overweight. In the long run, chronic heart failure (heart failure), angina (“chest tightness”) and myocardial infarction develop in many cases.

Other symptoms of overweight include reduced exercise capacity, rapid fatigue and increased sweating. Depression and social withdrawal are also more frequently observed in those affected.

Overweight: causes and risk factors

Obesity occurs when the body gets more energy in the long term than it needs. This positive energy balance has no single cause. Rather, several factors in the emergence of obesity play a role, experts suggest. These factors include:

Genetic predisposition

In some families several members are overweight. This suggests that genetic factors play a role in obesity. For example, the so-called basal metabolic rate seems to be genetically determined. The basal metabolic rate is the amount of energy that burns a person at rest, so alone for the maintenance of metabolism (maintaining organ functions and body heat, etc.) needed. Some people have a high basal metabolic rate, which means they can eat relatively much without being physically active even if they are not physically active.

In contrast, people with a low basal metabolic rate use fewer calories in peace, so they increase rapidly if they eat a little more than needed. Such people are therefore at a higher risk of becoming overweight.

Eating habits and nutrition

As the stomach fills and the stomach wall expands, it is reported to the brain via hormones and nerve impulses. This then signals the feeling of satiety that the body has enough now. In some people, this information is disturbed, so that sets the feeling of satiety until late: people therefore eat more than they need, which increases the risk of obesity.

Another contributor to the growing prevalence of obesity in society is the fast food industry, which offers fast food with its mostly high calorie meals and snacks – a welcome offer for people under pressure. Due to the hasty consumption, for example on the way to the next appointment or by the way at the desk, the feeling of satiety is often not registered in time – in the end you eat more than is good for you.

Lack of exercise

Many professionals have a (predominantly) sedentary job. The way to work, the supermarket or the cinema is covered in the car. The leisure time at home is often spent in front of the TV or computer. Modern lifestyle is associated with a lack of exercise in many people, which not only promotes overweight and other health problems such as cardiovascular disease.

Psychological factors

The influence of psychological factors in the development of obesity should not be underestimated. So many people look for distraction and comfort in the food in grief, stress, boredom, frustration or lack of self-confidence.

drugs

Some medications increase appetite, so people eat more than they normally do. This can favor overweight. Examples of such drugs are mainly hormone preparations such as the pill, medicines for allergies, some psychotropic drugs and cortisone preparations.

Other underlying diseases

Diseases of hormone-producing organs of the body can contribute to the development of obesity. These include, for example, hypofunction of the thyroid gland (hypothyroidism) as well as adrenal tumors.

Other factors

Educational rules and norms can also have an influence on the development of obesity, for example, that you always eat your plate empty – even if you are already full.

Social factors can also play a role. Overweight and obesity are more prevalent in lower social strata than in higher ones, which is likely to have multiple causes. One of them is that the tight budget money is usually spent on prepared meals and preserves rather than on fresh vegetables and fruits. In addition, physical activity in lower social strata often has a worse image than in higher social classes.

Overweight: examinations and diagnosis

For a more detailed clarification of obesity, the doctor will first talk in detail with the patient. Among other things, he inquires about his diet, his physical activity, any complaints and underlying illnesses as well as psychological stress.

This is followed by the physical examination. First and foremost, the doctor measures the size and weight of the patient to calculate the BMI. It is also helpful to calculate the Waist-to-hip Ratio (WHR) ratio: this measure can be used to determine the body fat distribution pattern (android or gynoid).

For the clarification of possible concomitant or secondary diseases of obesity (such as high blood pressure, diabetes, dyslipidemia, etc.) further investigations are necessary. These include, for example, blood pressure measurement, ECG, blood tests and an ultrasound examination of the liver and gallbladder.

Overweight: treatment

Not every overweight needs to be treated. If the BMI is between 25 and 30 and there are no overweight-related illnesses (such as high blood pressure, diabetes, depression, etc.), weight loss is not essential. Patients should be careful not to continue to increase.

Obesity at a BMI between 25 and 30 should be treated if:

• Diseases exist which are due to the overweight and / or
• Diseases exist that are aggravated by obesity and / or
• an android fat distribution type is present or
• there is considerable psychosocial distress.

In case of severe overweight (adiposity), therapy is generally recommended.

How is overweight treated?

Patients with overweight who are in need of treatment should change their nutritional and physical behavior over the long term. The weight loss should be slow to avoid weight fluctuations – the primary goal is not just a lower body weight, but overall a lifestyle change, especially in terms of diet and physical activity. The therapy and the treatment goal can be discussed with the doctor and / or a nutritionist.

nutrition

Whether overweight or normal weight – experts recommend a balanced, varied diet. Daily cereal products and potatoes (good satiety!), Vegetables and fruits, milk and dairy products should be on the menu. Meat, sausages and eggs should only be eaten in moderation. Once a week fish should come to the table. You should only eat a little fat and high-fat foods and consume sugar and salt only moderately.

It is also important to ensure adequate hydration, for example in the form of tap or mineral water or unsweetened tea. Less favorable are lemonades & Co: They usually contain a lot of sugar and too few minerals. Even with alcohol, caution is advised, among other things, because it provides a lot of calories.

Part of a healthy diet is to prepare the food tasty and gently and to eat it in peace.

Physical activity and exercise

The diet change should be accompanied by a physical exercise program to help maintain weight loss. For people with obesity endurance sports such as walking, jogging, cycling and swimming are particularly suitable. Also helpful is any form of physical activity in everyday life such as climbing stairs and brisk walking.

To counteract the loss of muscle mass in weight loss, you can do weight training, such as in the gym.

behavior therapy

Especially in case of severe overweight (obesity), the nutrition and exercise program should be accompanied by a behavioral therapy. She supports those affected in changing the lifestyle.

Medicines and surgeries

The use of weight loss medication and surgical methods (such as gastric reduction) are only considered in cases of severe overweight (obesity).

Overweight: disease course and prognosis

The goal of successfully losing weight and keeping the lower body weight on a permanent basis can generally only be achieved with a lifestyle change, that is, a healthy, balanced diet and plenty of physical activity. If other diseases are involved in the development of obesity (such as hypothyroidism), they must first be treated if you want to successfully lose weight.

Unilateral diets that promise a quick weight loss are not recommended. On the one hand, you do not learn a healthy diet that can be maintained in the long term; on the other hand, as soon as you eat normally again, you usually take it quickly – and often a few more pounds than before the flash diet.

Overweight: consequences

Obesity can lead to many health problems and complications. These include, for example, atherosclerosis (arteriosclerosis) and subsequently cardiovascular diseases (such as heart failure, heart attack and stroke). In addition, the body weight increases the risk of diabetes mellitus (diabetes), lipid metabolism disorders (such as high cholesterol), fatty liver, gout and gallstones and joint wear (osteoarthritis).

In addition, a strong overweight increases the risk of cancer: in women, for example, the risk of cervix, ovarian and menopausal (post-menopausal) breast cancer increases. In men with overweight increases the risk of prostate and colon cancer.