More than half of the world’s population could be obese by 2035. That’s more than four billion people, according to World Obesity Atlas 2023.

Obesity, also known as obesity, is a complex disease that can occur at any age. It affects adults and children alike. The World Health Organization (WHO) defines obesity as “abnormal or excessive accumulation of fat that poses a health risk”. It’s a severe form of obesity.

In 2016, 1.9 billion adults worldwide were overweight. That corresponds to 39 percent. 650 million people worldwide were diagnosed with obesity, accounting for 13 percent of the world’s population.

According to the WHO Global Health Observatory The proportion of adults with obesity has almost tripled since 1980. Children are no exception – About 38 million children under the age of five are overweight or obese. In addition, there are more than 340 million children and young people between the ages of five and 19.

Obesity occurs when a person consumes too many calories, which the body then turns into fat. The imbalance between calorie intake and calorie burn can have many causes: social, psychological, biological, and genetic factors play a role, but so does lifestyle.

Obesity is not a lack of self-control

Contrary to popular belief, obesity is not the result of a lack of willpower. “We know that appetite and satiety are inherited and that up to 70 percent of body weight is genetic. There is every reason to treat obesity as a chronic, relapsing disease,” explains John WassProfessor of Endocrinology at the University of Oxford, opposite the journal “The Lancet“.

The factors responsible for obesity fall into two categories. First, it is a person’s biological and genetic makeup. On the other hand, there are external factors such as the environment and social conditions. These include, for example, income or access to good health care.

Genetic factors, lack of exercise, poor eating habits, psychological and general health problems, social and economic conditions, drugs, pollutants and many more can contribute to the development of obesity.

Diseases like that too Cushing’s Syndrome, in which there is increased appetite and weight gain, can be triggers. With this disorder, body fat tends to accumulate in the abdomen and neck. But certain medications can also lead to weight gain or obesity without the affected person being able to influence this. Examples include steroids and some antidepressants.

The consequences of obesity on our body

Excessive fat and extremely high body weight lead to various serious symptoms: Patients usually have major problems with physical activities. Pain often develops in different regions of the body or osteoarthritis, a degenerative joint disease, develops. In addition, obesity can lead to breathing problems, especially at night, a condition known as sleep apnea.

Obesity can cause type 2 diabetes, increase blood pressure, cholesterol and blood sugar. As more and more fat is deposited in the arteries, there is an increased risk of cardiovascular diseases such as strokes and heart attacks.

Obesity is also associated with certain types of cancer connected. These include uterine and esophagus cancer, liver, kidney and colon cancer. The disease can mental health severely, because obese people often develop fears and have low self-esteem. This, in turn, increases the risk of depression.

The body mass index, BMI

Obesity can be determined and diagnosed with the so-called body mass index, BMI. Obesity begins with a value of at least 30. But according to the WHO, a BMI value of over 25 can at least indicate the beginning of obesity.

BMI is calculated by dividing body weight in kilograms by the square of height in meters. There are numerous ways to easily calculate the BMI on the Internet, for example at the obesity society. The necessary data that must be entered are age, weight and height. The calculation then happens automatically.

But BMI is a controversial measurement. For example, it does not take into account gender and the percentage of body weight that is muscle compared to fat.

For example, a weightlifter with a lot of muscle mass can have a high BMI of over 30 without having an excessively high body fat percentage.

There are other ways to more accurately measure body fat percentage. “The best possibility, [Körperfett] to measure is magnetic resonance imaging [MRT]”, says Alexander MirasProfessor of Endocrinology at the University of Ulster in the UK.

But MRI scans are expensive. They are mainly used when the exact body fat content is required for research purposes.

Excess abdominal fat poses higher health risks than fat accumulation in other areas of the body. Medical guidelines therefore recommend looking at waist circumference and not just BMI to assess a person’s health.

What can we do about obesity

For each individual, obesity is best characterized by a balanced nutrition impede. That means eating less fat and sugar and more fruit, vegetables, grains and nuts. It is also important to stay or become active. The WHO recommends about 20 minutes of exercise every day.

When people with obesity change their lifestyle and optimize their diet to lose weight, public health policy is also involved. “If anything, too much emphasis has been placed on blame and personal responsibility, including on the part of doctors,” he said Francesco RubinoChair of Metabolic and Bariatric Surgery at King’s College London, opposite The Lancet.

Because obesity is a chronic disease, physicians should create a long-term treatment plan that includes lifestyle changes such as changing eating habits, switching to a more balanced diet, and modifying other habits such as getting enough exercise. In addition, regular follow-up examinations are important.

The initial weight loss doesn’t have to be extreme. Studies have shown that as little as a 10 percent reduction in body weight can significantly reduce risk factors associated with obesity. With a well thought-out treatment program, this is possible within six months. More intensive weight loss programs must be discussed with a doctor.

When nothing helps

If diet and exercise don’t help, there are a few drugs approved in the US to treat obesity that can be used in addition to diet and exercise. But they may have side effects. One of the newer remedies on the market is semaglutide.

It is marketed under the Ozempic, Wegovy or Rybelsus brand names and was recently launched in the US and National Institute for Health and Care Excellence (NICE) approved in the UK. As an adjunct to diet and exercise, it could result in weight loss of more than ten percent. The drug must be self-injected once a week. But during therapy, nausea, vomiting, diarrhea and constipation may occur.

Semaglutide reduces appetite by mimicking the hormone GLP-1, which our bodies release after eating.

For people who are severely obese, usually with a BMI over 40, bariatric (weight-loss) surgery such as B. a gastric bypass, can be an effective therapy. Since every case is different and overweight and obesity in particular depend on many individual factors, the advantages, risks and effects of the respective procedure should be discussed with a doctor.