Obesity: Is your life at risk?

18 January 2017
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As obesity grows into an actual epidemic of the 21st century, the World Health Organization (WHO) is addressing it as a condition due to its effects on health, the ability to work, sociability as well as life quality and expectancy.

Moreover, a study conducted by the School of Public Health of Imperial College London, published in 2016, showed that in the last 40 years the number of obese people has seen an astonishing increase, from 105 million obese people in 1975 to 641 million in 2014.

Researchers analyzed an immense volume of data on 19.2 million people over the age of 18, in 186 countries and split the participants in categories based on their body mass index (BMI). When BMI is below 18.5 a person is considered underweight; BMI up to 25 is normal, 25-30 is overweight, 30-35 is obese, 35-40 is severely obese and a BMI over 40 is morbidly obese.

Based on this categorization, the rate of obese men around the world has more than tripled reaching 10.8% (from 3.2% in 1975), while the rate of obese women has doubled to 14.9% (from 6.4%). Women continue to be more obese compared to men, but the number of obese men is increasing rapidly.

From 1975 to 2014, the average BMI increased in men from 21.7 to 24.2, while in women from 22.1 to 24.4. According to scientists, this could very well translate into a weight gain of 1.5 kilos per decade among the entire world population.

“Based on our forecasts, if this trend continues at this pace, approximately one fifth of men (18%) and women (21%) from around the world will be considered obese in 2025, while more than 6% of men and 9% of women will be severely obese”, says Dr. Dimitris S. Mousiolis, General Surgeon – Bariatric, Laparoscopic, Colorectal Surgery (www.dmousiolis.gr). Μousiwlis
The ever increasing rates of obesity and associated health risks, has been the fuel of research – already since 1950, and has led to the development of surgical techniques for excess weight management. However, it is only in the last 15 years, through the establishment of laparoscopy in everyday surgical practice that an increase is seen in the application of Bariatrics, i.e. surgical procedures through which obesity can be handled rapidly and effectively.

“And while we ought to treat the potential of Bariatrics with unconstrained enthusiasm when it comes to treating morbid obesity, there are, unfortunately, countless examples of people with excess weight who are taken to surgery for weight loss, without meeting the relevant criteria for surgery, i.e. without being actually diagnosed with morbid obesity” points out Dr. Mousiolis.

Severe and morbid obesity is the cause of several medical conditions. “Based on medical data collected to date, among these conditions are:
– Type 2 diabetes mellitus: Excess weight increases the risk of development of type 2 diabetes mellitus that is mainly caused by insulin resistance. Without medication, complications associated with diabetes are mathematically proven to affect the vessels, kidneys and eyes.
– Arterial hypertension and cardiovascular problems: Hypertension causes lesions to the heart and vessels, mainly of the brain and kidneys.
– Joint issues: Joints deteriorate with time as they cannot bear the body’s excess weight for too long. This leads to arthritis, mainly on the hips and knees.
– Respiratory disorders: Asthma and stress-induced breathlessness are very common disorders among obese people. Sleep apnea is a very serious complication of obesity, as it leads to pauses in breathing during sleep which result in reduced oxygen supply to the body.
– Cholelithiasis: Excess amounts of cholesterol in the gallbladder cause the formation of gallstones that are associated with increased risk of complications, such as cholecystitis or pancreatitis
– Gastroesophageal reflux: This condition is caused by a dilatation of the diaphragm combined with increased intra-abdominal pressure, due to fat. Reflux results to oesophagitis, i.e. chemical burns on the oesophagus, which requires specific medical treatment.
– Dyslipidemia: a lipid metabolism disorder.
– Infertility and irregular periods: Excess fat increase elevates estrogens and causes irregular periods and infertility.
– Incontinence: Incontinence due to increased abdominal pressure and pelvic static disorders.
– Depression: A result of chronic discomfort, unsuccessful dieting and poor self-esteem.
– Cancer: High risk of renal cancer in men and women as well as risk of breast and uterine cancer in women.

Of course, we should not ignore exclusion from society and family members that is linked to the difficulty in finding a job or poor professional development, bad dressing habits, etc” points out the doctor.

Therefore, bariatric surgery should not be advised when excess weight is only 10-20 kilos, although there are people who ask for this procedure for non-medical reasons. According to the World Health Organization, bariatric surgery is an effective method for weight loss and weight preservation after weight loss, in cases where obesity is actually life-threatening and associated with the diseases and conditions mentioned above. Consequently, the key parameter for accessing whether a person is suffering from morbid obesity, and therefore is a good candidate for weight loss through bariatric surgery, is the Body Mass Index(BMI) and concomitant conditions. Weight-loss surgery is advised when BMI is over 40 (morbid obesity) or over 35 (severe obesity), in case of concomitant metabolic conditions, such as diabetes mellitus, hypercholesterolaemia and hypertension. Moreover, bariatric surgery is not advised for people who have lots of extra weight but who have had it for only a small period of time, e.g. 1-2 years. On the contrary, bariatric surgery is advised for people with severe and long-term obesity issues (who have been obese for more than five years) and only in case they have been –unsuccessfully – trying to loose the weight through other conservative methods such as dieting, exercising and medication ”, says Dr. Mousiolis.

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