Obesity

Obesity is a chronic disease characterized by excess accumulation of body fat that can have adverse effects on health. It is defined as a condition in which the body mass index (BMI) exceeds 30 kg/m². Obesity is associated with many complications, such as type 2 diabetes, cardiovascular disease, hypertension, sleep apnea, osteoarthritis, and certain types of cancer. The disease is the result of a complex interaction of genetic, environmental, and behavioral factors, making it one of the leading problems in modern society.

History of the disease and interesting historical facts

Historically, obesity has been associated with abundance and wealth. In antiquity and the Middle Ages, overweight people were often seen as symbols of health and happiness. For example, in Ancient Rome, obesity was considered a sign of wealth, and images of overweight people were used in art as a standard of beauty. However, over time, attitudes toward excess weight have changed. In the 20th century, with the deterioration of people's health and the increase in obesity-related diseases, its causes and consequences began to be actively studied. In 1997, the WHO recognized obesity as a chronic disease, which led to its inclusion in international health guidelines.

Epidemiology

According to the World Health Organization (WHO), the global obesity epidemic has reached alarming proportions. Since 1975, the incidence rate has more than tripled. As of 2021, more than 1.9 billion adults were overweight, of whom more than 650 million were obese. Obesity is spreading at particularly high rates in low- and middle-income countries, where traditional dietary patterns and physical activity previously existed. Obesity is also observed in children and adolescents, where the number of people suffering from this pathology tripled between 1975 and 2016.

Genetic predisposition to this disease

Research shows that genetic factors play a significant role in the development of obesity. About 100 genes have been identified that affect appetite, metabolism, and distribution of fat mass in the body. One of the most studied genes is the FTO gene. Mutations in this gene are associated with an increased risk of obesity and impaired fat and carbohydrate processing. Other genes, such as the MC4R gene, also affect appetite regulation. Genetic predisposition can interact with environmental factors such as diet and physical activity, creating a multifactorial origin of the disease.

Risk factors for the development of this disease

There are many factors that contribute to the development of obesity, which can be classified into three main groups:

• Physical factors: a sedentary lifestyle, lack of physical activity and energy, inadequate nutrition, including a large amount of carbohydrates and saturated fats.
• Chemical factors: the influence of drugs such as corticosteroids and antidepressants, which can contribute to weight gain.
• Psychological and social factors: stress, depression, socioeconomic status and cultural traditions that influence diet and lifestyle.

Diagnosis of this disease

Diagnosis of obesity begins with an assessment of the patient's physical condition. The main symptoms are excessive fat tissue, especially in the abdominal area, difficulty breathing during sleep, fatigue, and decreased physical activity. The main diagnostic methods include:

• Laboratory tests: assessment of metabolic disturbances, including glucose, lipid and hormone levels.
• Radiological examinations: using ultrasound and CT scans to assess the distribution of body fat.
• Other types of diagnostics: questionnaire to identify eating habits and physical activity levels.
• Differential diagnosis: It is important to rule out other diseases that can cause fatty tissue accumulation, such as endocrine disorders.

Treatment

Treatment of obesity should be comprehensive and include lifestyle changes, pharmacological and surgical care. The main areas include:

• General treatment: changing diet, increasing physical activity and psychological support.
• Pharmacological treatment: use of medications to reduce appetite or absorb fat.
• Surgical treatment: Bariatric surgery, including gastrectomy and gastric bypass to reduce food volume.
• Other types of treatment: psychotherapy and weight control programs.

List of medications used to treat this disease

Among the drugs used to treat obesity, the following can be distinguished:

• Orlistat (Xenical)
• Lorcaserin
• Phentermine/topiramate (Qsymia)
• Naltrexone/bupropion (Contrave)
• Semaglutide (Wegovy)

Disease monitoring

Monitoring the patient's condition with obesity includes regular control stages aimed at assessing the effectiveness of treatment and changes in body weight. The prognosis largely depends on the patient's acceptance of behavioral recovery and compliance with dietary and physical activity recommendations. Complications of obesity include the accumulation of cardiovascular disease, diabetes, joint disease, and the risk of certain types of cancer, which requires constant medical supervision.

Age-related features of the disease

Obesity can manifest itself differently in different age groups. In children and adolescents, weight gain can lead to psychoemotional problems and difficulties in socialization. In adults, obesity can be complicated by metabolic syndromes and associated diseases. In older people, excess body weight can worsen quality of life, increasing the risk of falls and disrupting physical activity.

Questions and Answers

• What impact does obesity have on health? Obesity significantly increases the risk of developing chronic diseases such as diabetes, cardiovascular disease and some cancers.
• Can obesity be prevented? Yes, a combination of healthy eating and regular physical activity can help prevent obesity and maintain a healthy weight.
• How long does obesity treatment last? Obesity treatment is a long-term process and requires constant monitoring, attitude and lifestyle adjustments.
• What medications do you start with in treating obesity? Treatment varies from person to person, but medications such as orlistat and naltrexone/bupropion are often used.
• Is it possible to cure obesity forever? A complete cure is not possible without lifestyle changes, but it is possible to achieve lasting weight loss and maintain it at a healthy level.