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Obesity

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A 1680 painted by Juan Carreno de Miranda of a girl presumed to have Prader–Willi syndrome[1]
An obese teenage boy
Percentage of the adult population with a BMI over 30, for the OECD countries

Obesity is the condition of being much too heavy for one's height so that one's health is affected. In other words, it means to be too overweight. Also known as being fat. It is considered a disease and has been described as an epidemic and a form of suicide.

To know if a person is overweight, the body mass index (BMI) is calculated, by dividing the person's weight (in kilograms), by their height (in metres) squared (multiplied by itself). (This is only meaningful for adults who are fully grown, and should not be used for children. Growth charts can be used to measure obesity in children.)

A BMI between 18.5 and 25 is considered normal. People with a BMI of 25 or more are said to be overweight; with 30 and above, they are considered obese, and with 35 and above, they are considered severely obese (this used to be called morbidly obese). In general, the BMI number is a good quantifiable measurement of a person's obesity. However, it is a poor predictor in people who are very athletic, because a person with a higher than average amount of muscle tissue will weigh more than an average person, thus resulting in a BMI that is higher than normal, even if that person is very large.

In 2024 a study of more than 220 million people in almost 200 countries, found that more than 1 billion people were obese. Between 1990 and 2022 obesity in women increased from 8.8% to 18.5% and for men from 4.8% to 14%.[2]

Causes

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Two white mice both with similar sized ears, black eyes, and pink noses. The body of the mouse on the left, however, is about three times the width of the normal sized mouse on the right.
Two mice: one on left not able to produce leptin in his body and becomes obese; and a normal mouse (right)

The most common cause for obesity is eating more calories than are used by the body. Other factors that often contribute to obesity are:

Genetics are known to contribute to obesity.[3] Low levels of leptin, a hormone, is linked to obesity.

Health issues

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Many health problems are associated with obesity. An example is Type 2 diabetes. A woman with a BMI higher than 35 is 93 times more likely to develop diabetes.[4] A 2009 review found that people with a BMI between 40 and 50 were 22.5 times more likely to die from diabetes than people with BMIs between 22.5 and 25.[5]

An obese woman is more likely to have an unhealthy baby.[6]

Risk is associated with where the excess fat is stored on the body. Abdominal obesity is particularly dangerous.

Some people think that the idea that obesity causes bad health is not completely true and has been exaggerated. An example is J. Eric Oliver. He wrote a book called Fat Politics: The Real Story Behind America's Obesity Epidemic.[7] There is evidence for this belief. The Centers for Disease Control and Prevention said in 2003 that 400,000 people died because of being obese in 2000. Then in 2004 they said that the number was wrong. A 2013 review of scientific papers found that Grade 1 obesity (BMI 30-34.9) is not associated with increased deaths. Grades 2 (BMI 35-39.9) and 3 (40+) obesity are associated with much higher rates of death. It has been suggested that obesity is associated with mortality (death) because of mortality in Grade 2 and 3 obesity. People with grade 2 and 3 obesity are 29% more likely to die.[8]

'Metabolically healthy obesity' is increasingly being recognized. Up to 40% of obese people are metabolically healthy.[9] They are not more likely to get heart disease or die than metabolically healthy non-obese people.[10]

The 'obesity paradox' is a term used to describe how obesity can lower the risk of death.[11] Obesity increases the chance of getting heart disease. But obese people with heart disease are less likely to die in a 7-year period.[12] The obesity paradox has also been found in patients with stroke,[13] diabetes,[14] and chronic obstructive pulmonary disease.[15]

Treatment

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Scientists have not yet found a 'cure' for obesity that most people are willing to implement. It is common wisdom that people who lose weight will regain it all within 5 years.[16] However, this position has been scientifically challenged for over a decade.[17] Additionally, modern research has achieved significantly higher success rates than the figure that dominates the popular internet.[18][19][20][21] Therefore, diet and exercise is the most common recommended treatment for obesity - it has the potential for a very high treatment success rate.

Surgery can be used to treat obesity. Gastric bypass is the most common weight loss surgery. It makes a person's stomach smaller so that they feel full after eating less food and causes their body to absorb less calories. People who have surgery are usually very obese. In Britain there are long waiting lists for this. It is very easy to get this surgery in Turkey. Seven Britons have died after having weight loss surgery there since 2019 and many more have had serious problems.[22]

Some people think that obesity should not be treated at all. This position is contradicted by substantial medical research.[21] Weight loss medicines can make people want to eat less or make less of the energy from food be absorbed by their bodies. The only weight loss drug approved by the FDA for long term use is orlistat. The U.S. Food and Drug Administration has not approved other drugs because they have side effects. Also they are worried that people who are not obese will take them.

Societal views

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In the West, people associate obesity with negative characteristics such as laziness, ugliness, stupidity, etc.[23] Discriminating against someone because of their weight is legal in the United States. The fat acceptance movement says that this is wrong and is a kind of prejudice called fatphobia. In some cultures, obesity is viewed as positive. To those cultures, obesity is associated with wealth, beauty, and fertility.

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References

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Wikimedia Commons has media related to Obesity.
  1. ↑ Mary Jones. "Case Study: Cataplexy and SOREMPs Without Excessive Daytime Sleepiness in Prader Willi Syndrome. Is This the Beginning of Narcolepsy in a Five Year Old?". European Society of Sleep Technologists. Retrieved April 6, 2009.
  2. ↑ "'Epidemic of obesity' blights children as global rates soar". www.ft.com. Retrieved 2024-03-01.
  3. ↑ Froguel, P.; Guy-Grand, B.; Clément, K. (18 March 2000). "Genetics of obesity: towards the understanding of a complex syndrome". Presse Med. 29 (10): 564–571. PMID 10761527. Retrieved 11 March 2017 – via PubMed.
  4. ↑ Jung, 1997
  5. ↑ Lancet 2009
  6. ↑ O'Reilly, James R.; Reynolds, Rebecca M. (1 January 2013). "The risk of maternal obesity to the long-term health of the offspring". Clin Endocrinol. 78 (1): 9–16. doi:10.1111/cen.12055. ISSN 0300-0664. PMID 23009645. S2CID 45254082. Retrieved 11 March 2017 – via Wiley Online Library.
  7. ↑ "Oliver argues health risk of being obese exaggerated". Retrieved 11 March 2017.
  8. ↑ Flegal, Katherine M.; Kit, Brian K.; Orpana, Heather; Graubard, Barry I. (2 January 2013). "Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-analysis". JAMA. 309 (1): 71–82. doi:10.1001/jama.2012.113905. PMC 4855514. PMID 23280227. Retrieved 11 March 2017 – via jama.jamanetwork.com.
  9. ↑ "Being big isn't always bad". Retrieved 11 March 2017.
  10. ↑ "Medscape Log In". Retrieved 11 March 2017.
  11. ↑ Greenberg, James A. (1 June 2013). "The obesity paradox in the US population". Am J Clin Nutr. 97 (6): 1195–1200. doi:10.3945/ajcn.112.045815. PMID 23636238. Retrieved 11 March 2017 – via ajcn.nutrition.org.
  12. ↑ "Obese heart patients 'do better'". BBC News. 17 March 2013. Retrieved 11 March 2017.
  13. ↑ Andersen, Klaus Kaae; Olsen, Tom Skyhøj (1 January 2015). "The obesity paradox in stroke: Lower mortality and lower risk of readmission for recurrent stroke in obese stroke patients". Int J Stroke. 10 (1): 99–104. doi:10.1111/ijs.12016. PMID 25635277. S2CID 25489688. Retrieved 11 March 2017 – via Wiley Online Library.
  14. ↑ Franz, Marion J. (1 August 2013). "The Obesity Paradox and Diabetes". Diabetes Spectrum. 26 (3): 145–151. doi:10.2337/diaspect.26.3.145. S2CID 70745012. Retrieved 11 March 2017 – via spectrum.diabetesjournals.org.
  15. ↑ Guenette, J. A.; Jensen, D.; O'Donnell, D. E. (2010). "Respiratory function and the obesity paradox : Current Opinion in Clinical Nutrition & Metabolic Care". Current Opinion in Clinical Nutrition and Metabolic Care. 13 (6): 618–624. doi:10.1097/MCO.0b013e32833e3453. PMID 20975350. S2CID 10501580. Retrieved 11 March 2017.
  16. ↑ Anderson, James W.; Konz, Elizabeth C.; Frederich, Robert C.; Wood, Constance L. (1 November 2001). "Long-term weight-loss maintenance: a meta-analysis of US studies". Am J Clin Nutr. 74 (5): 579–584. doi:10.1093/ajcn/74.5.579. PMID 11684524. Retrieved 11 March 2017 – via ajcn.nutrition.org.
  17. ↑ "95% Regain Lost Weight. Or Do They?". The New York Times. 25 May 1999. Retrieved 11 March 2017.
  18. ↑ Lowe, Michael R.; Kral, Tanja V. E.; Miller-Kovach, Karen (1 April 2008). "Weight-loss maintenance 1, 2 and 5 years after successful completion of a weight-loss programme". The British Journal of Nutrition. 99 (4): 925–930. doi:10.1017/S0007114507862416. PMID 18042306. S2CID 31907898. Retrieved 11 March 2017.
  19. ↑ Curioni, C. C.; Lourenço, P. M. (31 May 2005). "Long-term weight loss after diet and exercise: a systematic review". Int J Obes Relat Metab Disord. 29 (10): 1168–1174. doi:10.1038/sj.ijo.0803015. PMID 15925949. S2CID 205677437. Retrieved 11 March 2017 – via www.nature.com.
  20. ↑ http://www.ajpmonline.org/article/S0749-3797%2807%2900163-8/abstract
  21. ↑ 21.0 21.1 Wing, Rena R.; Hill, James O. (1 January 2001). "Successful Weight Loss Maintenance". Annual Review of Nutrition. 21 (1): 323–341. doi:10.1146/annurev.nutr.21.1.323. PMID 11375440. Retrieved 11 March 2017 – via Annual Reviews.
  22. ↑ "Warnings against 'reckless' weight loss surgery abroad". BBC News. 2023-03-21. Retrieved 2023-03-21.
  23. ↑ Flanagan, Sahale A. (1 October 1996). "Obesity: The Last Bastion of Prejudice". Obes Surg. 6 (5): 430–437. doi:10.1381/096089296765556520. PMID 10729890. S2CID 45883636. Retrieved 11 March 2017 – via link.springer.com.
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