Obesity

1. What is obesity?
2. Prognosis of obesity
3. Symptoms of obesity
4. Medical tests for obesity
5. What causes obesity?
6. Can it be prevented?
7. Treatments for obesity
8. What specialist treats it?

What is obesity?

Both obesity and overweight are defined as an excess accumulation of fat in the body. In this case, it should be noted that this accumulation of body fat is not only an aesthetic problem, but it is a problem that has a direct influence with other pathologies, increasing the risk of suffering from different diseases and health problems, such as arterial and heart diseases, as well as diabetes.

Obesity can be classified as a chronic disease. It is possible to know if a person is obese through the Body Mass Index (BMI). This calculates a person’s weight by height.

Prognosis of obesity

Generally, obesity arises after a combination of several causes and factors, such as genetics, lifestyle, level of physical activity, diet, some medications, age, pregnancy, etc. However, even if one or more risk factors are met, they can be counteracted through diet, physical activity, behavioral changes…

If a person is obese, he or she may have serious health problems, such as any of the following:

• Type 2 diabetes
• High blood pressure
• Metabolic syndrome
• Heart disease
• Stroke, such as embolisms or strokes
• Cancer in multiple varieties
• Gallbladder disease
• Sexual health problems and erectile dysfunction
• Non-alcoholic fatty liver disease
• Osteoarthritis
• Sleep apnea syndrome

In the event that obesity continues to progress, the quality of life may decrease, and there are several psychological problems related to obesity, such as the following:

• Depression
• Disability
• Sexual problems
• Social isolation

Symptoms of obesity

An accumulation of excess fat under the diaphragm and in the wall of the thorax can cause an increase of the pressure in the lungs, causing the sufferer to feel breathing difficulties and choking, even if the effort made is minimal.

These breathing difficulties can interfere with sleep, causing momentary stops in breathing, i.e. sleep apnea.

In turn, excess weight can cause joint problems and orthopedic problems, such as pain in the lower back (low back pain) and aggravation of osteoarthritis problems, especially in the knees, hips and ankles.

Skin disorders are also common, since obese people have a body surface area that is small in relation to their weight, and heat cannot be eliminated efficiently, so they sweat more than people who do not suffer from obesity.

Along the same lines, swelling of the ankles and feet due to fluid accumulation (edema) is common.

Medical tests for obesity

To identify obesity, BMI should be performed. In the event that this indicates that the patient is obese, a physical examination will be performed, as well as other complementary tests, such as an elaboration of the patient’s medical history, measurement of waist circumference, blood tests and control of other known health problems.

What are the causes of obesity?

There are genetic causes, hormonal causes and behavioral causes, but obesity usually occurs when a person ingests more calories than are burned through physical activity. These excess calories end up accumulating in the body in the form of fat.

Apart from the inactivity that causes the non-burning of calories, if the patient has a sedentary lifestyle, it is easy for excess calorie intake to occur.

Diet and eating habits are fundamental at this point, since in many occasions diets are made up of fast food and/or high-calorie food.

A person is obese
when his or her BMI is over 30

Can it be prevented?

A series of measures can be taken to prevent obesity, although all of them are similar to weight loss measures. The most common are:

• Exercising regularly: 150 to 300 minutes of moderate physical activity per week prevents weight gain.
• Follow a healthy diet and eating plan: with a diet rich in nutrients and low in calories, avoiding saturated fats, avoiding alcohol and sweets. Fruits, vegetables and whole grains are healthy.
• Avoid food traps: identify the situations that cause us to eat uncontrollably.
• Check your weight regularly: a weekly weight check indicates whether or not your efforts are working and allows you to detect slight weight gain before it becomes a problem.
• Be consistent.

Treatments for obesity

The goal of obesity treatment is for the patient to achieve a healthy weight. All weight loss programs require the patient to make changes in eating habits and increase physical activity:

• Changes in diet: reducing calories and having healthy eating habits are basic to overcome obesity. In this case, drastic and unrealistic diets such as flash diets should be avoided. The comprehensive slimming stage will last at least six months, and the maintenance stage will last one year.
  • Reducing calorie intake
  • Feeling satisfaction by eating less
  • Choosing healthy foods
  • Restricting the consumption of certain foods
  • Dietary replacements
• Exercise and physical activity: increasing physical activity is basic to treat obesity. Most people who manage to lose weight and keep it off for at least a year usually exercise regularly, even if it is just walking.
  • Exercise
  • Keep moving
• Behavioral changes: a behavioral modification program can help the patient make lifestyle changes to lose weight and keep the weight off.
  • Psychological counseling
  • Support groups

If these measures do not work, weight loss surgery, also known as bariatric surgery, may be chosen. In this case, there is a limitation of the amount of food that can be ingested, decreasing the absorption of food and calories. This surgery can be done if other methods have been tried and have not worked and if the following are met:

• The patient has extreme obesity, i.e., a BMI of 40 or more.
• BMI is between 35 and 39.9 and you have a serious weight-related health problem, such as high blood pressure or diabetes.
• You must be committed to making lifestyle changes in order for the surgery to succeed.

Bariatric surgery does not guarantee a long-term loss of all excess weight; success will also depend on the patient’s commitment to make lifestyle changes.

Some common surgeries are:

• Gastric bypass surgery: a kind of pouch is created in the upper part of the stomach. The small intestine is then cut and connected to this pouch, so food and liquids will go directly from the pouch into this part of the intestine, bypassing most of the stomach.
• Laparoscopic adjustable gastric banding surgery: in this procedure, the stomach is separated into two sacs with a kind of inflatable band. By adjusting it, like a belt, a channel is created between the two sacs.
• Biliopancreatic diversion with duodenal crossover: an important part of the stomach is removed, a valve is introduced that allows food to pass into the small intestine, while preserving the duodenum. Subsequently, the mid-intestinal section is closed and the last part is connected to the duodenum. The section of the intestine that has been separated is connected to the final part of the intestine, so that both digestive juices and bile can flow into this part.
• Gastric sleeve: in this case, a part of the stomach is removed, creating a smaller reservoir to store food.

Which specialist treats obesity?

There are several specialists who work together in obesity. The General Surgeon, the Internal Medicine specialist, the Digestive System specialist, the Endocrinologist, the Nutritionist…