Being very overweight puts a double burden on those affected: In addition to the health risks, there is often stigmatization from society. Together with DAK-Gesundheit, we explain an underestimated ailment.

When obesity becomes pathological

According to the World Health Organization, one is considered obese if the body mass index (BMI) is over 30 kg / m². This is calculated as follows: body weight divided by height squared. Example: A woman who is 1.65 m tall and weighs 100 kilos would have a BMI of 36.7 kg / m² and would therefore be obese.

This currently applies to around every fourth German adult between the ages of 18 and 79 – and the trend is rising. Six percent of children and adolescents are already affected.

Many people and sometimes even doctors do not classify obesity as a disease. Rather, they see suffering as a self-inflicted expression of an unhealthy lifestyle. Not only are those affected stigmatized, but the many possible causes and forms of obesity are also ignored.

Possible causes

The causes are diverse and have not yet been conclusively researched. One thing is clear: Little exercise, excessive and unhealthy eating and also family predispositions favor the development of obesity. But behind an unhealthy ratio of calorie intake and calorie consumption there can also be a metabolic disorder, psychological problems such as depression and sleep disorders or – according to current scientific studies – impaired stimulus processing in the brain.

In addition, once the excess weight is there, it is difficult to get rid of it. The basal metabolic rate increases with weight, which means that the body needs more calories when resting – it is more difficult to eat less. In addition, the patient’s natural feeling of satiety is often disturbed. Exercise is also more strenuous if you are overweight. And if a diet shows short-term success, the metabolism strives to compensate for the weight loss and the infamous yo-yo effect threatens. All of this leads to stress and strains the psyche – and that in turn often leads to increased calorie intake.

A vicious circle in which “just eat less and do more exercise” is too short-sighted. DAK-Gesundheit also wants to draw attention to this: with the “SCHWERE [S] LOS” campaign , together with Johnson & Johnson, it is providing information about obesity and the ailments associated with it, and aims to encourage more sensitive treatment of those affected.

Possible consequences

The risk of death with obesity is up to three times as high as with normal weight. Because being overweight can lead to numerous life-threatening secondary diseases such as diabetes, arteriosclerosis, cardiac arrhythmias and high blood pressure, and increases the risk of strokes and heart attacks. Some types of cancer (including colon cancer, breast cancer, and pancreatic cancer) are also more common in obese people.

In everyday life, the stress on the joints is a particular problem: knees, hips and feet in particular suffer. In the long run, the articular cartilage wears out and there is a risk of osteoarthritis. Back pain is also common with obesity and can become chronic. Combined with shortness of breath and decreased stamina caused by weight, the pain in muscles and joints means that exercise is often a torture for those affected.

The psychological consequences should also not be underestimated: everyday activities such as personal hygiene and work are becoming a challenge, and those affected often need special sitting and lying facilities (e.g. in the hospital, on the plane or in the office). Many therefore avoid public places such as restaurants and transport out of shame. Social isolation threatens, and the risk of anxiety disorders and depression increases.

Overweight children in particular, but also many adults, also often suffer from exclusion by their fellow human beings, which can even lead to bullying.

So is treated

Obesity is treated on three levels: When changing diet, the main aim is to break existing patterns in eating behavior and to change the diet in the long term. When it comes to exercise, the focus is on gentle endurance sports that stimulate fat burning and do not put unnecessary stress on the joints (e.g. walking, swimming, cycling). In addition, behavior therapy can be useful, which helps the patient to integrate the new habits into everyday life and to cope with possible setbacks. The additional exchange with other affected persons in a self-help group can also be useful.

Those affected need professional support from doctors and therapists during treatment. Because it must be adapted to the current life situation, existing diseases and the patient’s history of suffering. It is also important to involve partners, friends and family. Especially with obese children, parents play an essential role in implementing the therapy.

In addition to obesity, possible secondary diseases must also be treated, possibly with medication.

If none of these therapeutic approaches are successful, obesity surgery can be considered. The stomach is surgically made smaller, for example by removing part of the organ or inserting a gastric band or balloon, so that it can absorb less food. Which surgery is sensible must always be clarified thoroughly with the treating physician, as complications and side effects of such an operation are to be taken very seriously.

Do you have any further questions about obesity and its treatment? You will find helpful facts and information on the information pages of DAK-Gesundheit

Prevention is important

Basically, when it comes to obesity, prevention is easier than treatment. Do not take serious obesity (from a BMI of 25 kg / m²) seriously, check your lifestyle, discuss with the doctor how you can improve your diet, integrate more exercise into everyday life and reduce psychological stress. Check whether there are any cases of obesity in your family and whether you can rule out metabolic disorders and mental illnesses.

It is particularly important to take countermeasures as early as possible for overweight children: studies show that the risk of obesity increases sharply in adulthood if boys and girls are overweight before puberty. It is up to you, as parents, to set a good example when it comes to nutrition and exercise and to encourage people to enjoy sport and healthy eating.

DAK-Gesundheit has taken the increasing frequency of obesity in childhood as an opportunity to sensitize teachers, students and parents to the topics of exercise and nutrition with the prevention initiative ” fit4future “ and to inspire them for a healthy lifestyle with exercise material and suggestions for teaching.

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