Overweight and obesity

Overweight and obesity

Overweight and obesity are a serious health concern affecting all industrialized countries.
Overweight has been associated with a number of diseases, mainly certain cardiovascular conditions and cancers.
Its management, whether therapeutic or preventive, requires a high level of awareness and a long-term commitment from patients in order to provoke a lasting lifestyle change.

 

Fat is the enemy

Overweight and obesity are defined as “an abnormal or excessive fat accumulation that may impair health”. In adults, classification is based on the calculation of the body mass index (BMI) corresponding to weight divided by square height, represented as kg/m². A BMI of between 25.0 and 29.9 kg/m² indicates overweight. Anything above 30 kg/m² indicates obesity.
Note that, for children, BMI is not relevant. Instead, it is better to refer to the weight-for-age curve.

 

An overweight world

Today, we are experiencing an epidemic of overweight and obesity of global proportions.
In France, 66.9% of men and 52.2% of women are considered overweight, of whom 22% and 21.1%, respectively, are obese. These figures reach as high as 72.7% (35.5% obese) and 63.2% (37% obese) in the United States.
Young people are also affected, with 18% of those aged 5 to 19 years being overweight globally and 30% in France, of whom 8.1% are obese.

overweight

1.9

billion adults being overweight (39% of the population). The number of cases has nearly tripled since 1975.

obesity

650

650 million obese, among 1.9 billion overweight adults.

The cost of a sedentary lifestyle

Overweight is directly linked to an energy imbalance between the calories consumed and the calories burned on a daily basis. This gap is magnified due to sedentary lifestyles, combining the frequent consumption of very high-calorie foods (fats or sugars) and low physical activity.
Other risk factors have also been identified: genetic predisposition, medications (anxiolytics, antidepressants, anticonvulsants, etc.), disordered eating habits (snacking, bulimia, etc.), psychological distress, family life, alcohol consumption, etc.

 

Multiple comorbidities

Overweight and obesity diminish quality of life and contribute to the development of several chronic diseases: type 2 diabetes, cardiovascular conditions, musculoskeletal disorders, certain cancers, etc. Breathing problems and sleep apnea are also common and are a risk factor for developing acute noncommunicable diseases.
In children, obesity is associated with a risk of breathing difficulties, fractures, arterial hypertension, insulin resistance and psychological problems.
In addition to physical complications, obesity can also lead to psychological concerns linked to damaged self-esteem.

 

Overweight management

The objective of treatments is not to reach a normal BMI at all costs, but rather to lose weight in a sustainable fashion in order to reduce the risk of complications. Proper management requires support from healthcare professionals and an individually adapted plan structured to provide, at minimum, advice regarding diet and physical activity.
A pharmacological treatment may be used once weight has been stabilized or, inversely, if the patient is unable to lose weight. 

 

Focus on prevention

Prevention is the best solution to overweight and obesity. Education and awareness should promote a balanced, varied diet spread across three proper meals throughout the day (no snacking).
Regular physical activity, for its part, helps regulate energy reserves by increasing the use of fats, as well as reducing the amount of time spent in front of a screen.

Sources: HAS #1; HAS #2; AMELI; WHO #1WHO #2

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