The risks associated with excess body weight.
Obesity is a chronic disease with a high prevalence worldwide, which is generally associated with a multitude of health complications.
Scientific data show that this phenomenon seems to be increasing in recent years, which is why it has become a public health problem, especially in developed countries.
Being overweight: a worrying reality …
The World Health Organization (WHO, 2015) states that in the world there are 1.9 billion adults who are overweight, of which more than 600 million suffer from obesity. In Spain, obesity has also become a serious problem, and this is confirmed by the data from the ENRICA study, which concludes that 39% of the Spanish population is overweight and 22.9% obese.
Due to the complexity of this phenomenon, the most effective treatment to combat this condition is made up of three basic pillars: nutrition, psychological aspects and physical exercise.
Causes of obesity
Obesity is a multicausal phenomenon and, therefore, the causes are due to several factors: those of genetic and endocrine origin, which account for 30%, and those of environmental origin, which account for 70%.
The latter include excessive food intake, especially unhealthy products, lack of physical exercise and, in general, a sedentary lifestyle.
Obesity and serious health problems
Obesity brings with it serious problems for the health of people affected with this condition. As Miguel Soca and Niño Peña conclude in an investigation carried out in 2009: “Obesity can cause a set of metabolic abnormalities, called metabolic syndrome (MS): a series of disorders characterized by glucose intolerance, diabetes, lipid disorders in the blood and increased blood pressure ”.
Likewise, obesity negatively affects hope and quality of life, as well as body aesthetics that, consequently, can cause social and psychological problems for the individual with this condition.
Diagnosis of obesity
Obesity is diagnosed, more than by weight, by the percentage of body fat of the individual. In general, in adult men, approximately 12-20% of their body weight is made up of fat. In the case of women, the percentage is a little higher, 20-30%, mainly due to hormones such as estrogen.
Currently, there are different methods that exist to quantify the percentage of body fat. Biompedance, X-ray engineering or densitometry are some examples. However, one of the most widely used methods is the Body Mass Index (BMI), obtained by the relationship between weight expressed in kilograms and height in meters squared (BMI: Weight / height2). With the result of this index , overweight individuals with a BMI equal to or greater than 25 kg / m2 and obese those who have a BMI equal to or greater than 30 kg / m2.
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Calculating body fat percentage
BMI is an easy measure to obtain, with a high correlation with body composition, and is useful as a diagnostic value. In addition, the higher BMI an individual has, the greater the possibility of developing morbidities associated with excess fat. However, BMI has its limitations and has been criticized for not allowing differentiation between the percentage of fat and muscle mass.
If the percentage of fat mass is considered, obesity corresponds to a fat percentage greater than 25% in men and 30% in women. To estimate the percentage of body fat, skinfolds are a very valid option. With this method it is necessary to do the summation of four folds: the bicipital, tricipital, subscapular and suprailiac
Finally, another of the measures used for the diagnosis of obesity is the waist-hip index (ICC), a specific anthropometric tool to measure intra-abdominal fat levels. This formula allows dividing the waist circumference by the hip circumference (ICC: waist circumference in centimeters / hip circumference in centimeters). The WHO establishes normal levels for the waist-hip index of approximately 0.8 in women and 1 in men.
Types of obesity
Obesity can be classified in different ways depending on the criteria established. One of the most used classifications is based on the distribution of body fat, in which there are three categories. According to the SEEDO Consensus (2007), they are the following:
1. Obesity of homogeneous distribution
Excess fat does not predominate in any area of the body, which is why it is called homogeneous distribution obesity.
2. Gynoid or peripheral obesity (pear-shaped)
Fat is basically located on the hips and thighs. This type of distribution is mainly related to venous return problems in the lower extremities (varicose veins) and knee osteoarthritis. Women are more likely to suffer from this type of obesity.
3. Android, central or abdominal obesity (apple-shaped)
The excess fat is located in the area on the face, chest and abdomen. It is associated with an increased risk of dyslipidemia, diabetes, cardiovascular disease, and mortality. This type of obesity is more common in men than in women.
Other classifications of obesity
In addition to the previous classification, there are others such as the following:
Types of obesity according to degree of risk
According to the consensus of the Spanish Society for the Study of Obesity (SEEDO 2007), obesity can also be classified as follows, taking into account the BMI:
- Underweight : Weight is below normal. The BMI is less than 18.5 kg / m2. It is not considered overweight.
- Normal weight: It is the normal weight of a person with respect to his height. The BMI is ideal: 18.5-24.9 kg / m2. It is not considered overweight.
- Overweight : Overweight occurs when a person weighs more than they should be based on their height. BMI 25-26.9 kg / m2.
- Overweight II : The person is heavier than he should be for his height but without being obese. BMI 27.29.9 kg / m2.
- Type I obesity : First degree of obesity. BMI 30-34.9 kg / m2.
- Type II obesity : Second degree of obesity BMI 35- 39.9 kg / m2.
- Type III obesity : This type of obesity is also called morbid obesity. BMI 40-49.9 kg / m2.
- Type IV obesity : This type of obesity is also known as extreme obesity. BMI greater than 50 kg / m2.
Types of obesity according to the cause
Depending on the source of obesity, it can be:
- Genetic obesity : the individual has received genetic inheritance or predisposition to be obese.
- Dietary obesity : characterized by a sedentary lifestyle and unhealthy food intake.
- Obesity due to imbalance : The person never feels satiated by an imbalance in the hunger regulation system.
- Thermogenic default obesity : The body does not burn calories efficiently.
- Nervous type obesity: Obesity caused by psychological problems such as anxiety, stress, and depression.
- Obesity due to endocrine diseases : It is obesity caused by hormonal diseases, for example, hyperthyroidism.
- Chromosomal obesity : This type of obesity is associated with chromosomal defects.
- Rodríguez Artalejo F. (2011) Epidemiology of obesity in Spain: ENRICA study. V NAOS Convention. Madrid: Center for Biomedical Research in Epidemiology and Public Health network.