Obesity is a complex multifactorial disease. The worldwide prevalence of overweight and obesity has doubled since 1980 to the point where almost a third of the world’s population is now classified as overweight or obese. Obesity alone affects 800 million people worldwide (WHO data). The condition is a major risk factor for many other diseases, including type 2 diabetes, cardiovascular disease and various forms of cancer.
Are we all at risk of obesity ?
On 3 May 2022, the WHO Regional Office published a new report on obesity in Europe. It reveals that the overweight and obesity rates studied have reached epidemic proportions and continue to rise, with none of the 53 Member States currently on track to meet the common goal of halting the rise in obesity by 2025. Alarmingly, 59% of adults and almost 30% of children in Europe are overweight or obese.
As research confirms, it is among children that overweight and obesity develops most rapidly. In addition, there is a high probability that a child with obesity who does not receive holistic treatment will enter adulthood with obesity. Research shows that the majority of young people do not grow out of their obesity problem, and four out of five obese teenagers will have problems with excess body weight in adulthood.
Data from Poland is somewhat better. According to the HBSC (Health Behaviour in School-aged Children) study, 21.7% of Polish citizens aged 11 to 15 are obese or significantly overweight (according to WHO criteria). According to research conducted by the Food and Nutrition Institute in Warsaw over the past 30 years, the prevalence of obesity among boys aged 11-15 has increased threefold in this period, while it has increased 10-fold among girls of the same age.
Obesity is not only a risk factor for the development of diseases, but a disease in itself!
Obesity is a common and preventable disease, classified as a non-communicable chronic disease of clinical and public health importance. It is often a major risk factor for the development of several non-communicable diseases, significant disability and premature death. There is now a global epidemic of obesity in all age groups in both developed and developing countries.
The increasing prevalence of obesity places a heavy burden on the health care system and budget. Overweight and obesity are among the leading causes of death and disability in Europe, with recent estimates suggesting that they cause more than 1.2 million deaths per year, equivalent to more than 13% of total mortality in Europe. Obesity is thought to be a cause of at least 13 different cancers and it is estimated that it will be directly responsible for at least 200,000 new cases of cancer each year across Europe. With this number set to continue to rise in the coming years. It is also important to remember that being overweight and obese is also a leading risk factor for disability.
Looking closely at the statistics, obesity rates have increased in all age groups and both genders, regardless of geographic location, ethnicity or socio-economic status, although the prevalence of obesity is generally higher in older people and women.
It is important to note that in epidemiological studies, it is usually the BMI index that is used to define overweight and obesity. However, the low sensitivity of BMI is characterised by low sensitivity due to high inter-individual variability in body fat percentage partly attributed to age, gender and ethnicity. Asians, for example, have a higher percentage of body fat than Europeans (for the same BMI). Greater cardiometabolic risk is also associated with the location of excess fat in visceral adipose tissue and ectopic stores (such as muscle and liver), as well as in cases of increased fat to fat-free mass ratio.
These data suggest that obesity may be much more common and requires more urgent attention than large epidemiological studies suggest. Relying on BMI to assess its prevalence may hinder future interventions to prevent and treat obesity.
In addition to physical problems, people struggling with obesity have to face constant shaming and blame for their condition. Many people, including unfortunately some doctors and public figures, do not understand the complex nature of this condition.
The root causes of obesity are a complex set of factors, among them diet, lifestyle, genetics, mental health, numerous socioeconomic factors and the state of the environment.
Analysing the rate of obesity progression, the question remains not if, but when, obesity will affect everyone!
What can we do? It is worth starting from the principle: you want to change the world – start in your own backyard. Weight loss is associated with significant health and economic benefits.
Effective weight loss strategies include diet therapy, physical activity and lifestyle modification. Pharmacological treatment is reserved for obese or overweight patients who have coexisting risk factors or obesity-related diseases. Prevention programmes for the general population have a greater potential to stop the obesity epidemic and are more cost-effective than clinic-based weight loss programmes and bariatric (surgical) treatment. Given the increasing risk of obesity, particularly among children, I encourage the dissemination of education about risk factors for the development of obesity, proper nutrition and physical activity as both preventive and curative measures, as well as broad psychological support for those affected. In my opinion, it is very important to ensure access to the services of a qualified medical team (doctors, dieticians, psychologists, physiotherapists) in primary health care, within the framework of universal health insurance.
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