Obesity

from Wikipedia, the free encyclopedia

As overweight high is body weight (or a large body mass) referred to in proportion to body size. In the narrower sense, it only refers to so-called pre - obesity , in contrast to severe overweight , obesity or obesity . The medical specialty that deals with obesity is bariatric .

Definition

Definitions

Overweight can be defined in different ways, see calculation formulas . Due to the different recording methods, the classification of a person as "overweight" is not always clear.

Body fat distribution

This article or the following section is not adequately provided with supporting documents ( e.g. individual evidence ). Information without sufficient evidence could be removed soon. Please help Wikipedia by researching the information and including good evidence.

Scientific studies have shown that the "inner belly fat" (fat in the abdomen, also visceral fat ) is directly related to cardiovascular diseases . Measuring your waist circumference is considered to be the easiest way to determine the amount of fat in your abdomen. A waist circumference of over 88 cm in women or over 102 cm in men indicates an increased risk of cardiovascular diseases.

distribution

The following important information is missing from this article or section:
Unfortunately nothing about the connections between socio-economic status, ethnicity and immigration status on the one hand and obesity on the other. There are numerous scientific studies on this.
Help Wikipedia by researching and pasting it .

Percentage of obese people (BMI 30 or higher) by country (as of 2014)

The incidence of obesity is increasing in all countries around the world.

Obesity occurs more frequently in industrialized countries , where few people do hard physical work and where food is in abundance, and is perceived as unaesthetic due to the modern ideal of slimness.

The highest growth rates of overweight in the total population, especially young overweight in the age group, are not achieved in the grown industrial nations, but in the emerging countries . It can therefore be assumed that the global obesity explosion is still reserved for the next generation.

In Germany

General

Around two thirds of men and around half of women in Germany are overweight. The following data refers to overweight including obesity, i.e. all people with a BMI from 25 and up are meant. The occurrence of obesity alone (only BMI ≥ 30) is added in round brackets (if the proportion of overweight is given as 20% and that of obesity as 5%, then 20% - 5% = 15% of people have one BMI from 25-30.).

According to the Robert Koch Institute (RKI), there is data on the incidence ( prevalence ) of obesity in Germany that are based on physical examinations: in both the 1998 Federal Health Survey and the DEGS 2008/11, 67.1% of men and a BMI of 25 and up was measured in 53.0% of women. However, the proportion of obese overweight people (BMI ≥ 30) increased between these two examination surveys (men: 18.9% to 23.3%; women: 22.5% to 23.9%).

Data obtained from surveys are lower because the respondents often assess themselves to be somewhat larger and somewhat easier than they actually are. In the additional microcensus survey carried out by the Federal Statistical Office in 2003 , 57.7% of men and 41.2% of women aged 18 and over had a BMI of 25 or higher. In the follow-up survey in 2009 it was 60.1% of men and 42.9% of women.

The data from the 2003 telephone health survey were extrapolated using a correction factor to compensate for the self-assessment (“greater / lighter”) and thus came to values ​​that come very close to those measured. In this analysis, the proportion of German adults with a BMI greater than 25 (30) kg / m² was 65.8% (17.1%) for men and 52.1% (19.0%) for women. On average, 58.8% (18.1%) of all German adults are overweight (or obese).

The proportion of people who are overweight increases steadily with age . For men, obesity is most common in the age group of 60 to 69 year olds, among women in the age group of 70 to 79 year olds.

In addition, the prevalence of overweight and obesity correlates with school education: the higher the level of education , the lower the proportion of overweight people. This is especially true of women.

With children

The Robert Koch Institute between 2003 and 2006, the study Child and Adolescent Health Survey ( KiGGS ) to study the health status of children and adolescents conducted. Because of the child-specific age development and the resulting variability of the BMI, overweight was defined as exceeding the 90th percentile and obesity as exceeding the 97th percentile of a reference population from 1985–1999. According to this definition, 15.0% of children in Germany between the ages of 3 and 17 in the KiGGS population are overweight and 6.3% are obese. Overall, the proportion of overweight adolescents (14-17 years) to small children (3-6 years) has doubled (17.1% to 9.2%), the proportion of obese children has almost tripled (from 2.9% to 8.5%) and is on a par with the proportion of overweight children (8.6%).

Overweight in children according to KIGGS
Age Boys girl
in years % overweight % obese % overweight % obese
3-6 6.4 2.5 6.0 3.3
7-10 8.9 7.0 9.0 5.7
11-13 11.3 7.0 11.6 7.3
14-17 9.0 8.2 8.1 8.9
all (3–17) 8.8 6.3 8.5 6.4

If one takes the reference data from 1985–1999 as a basis, a marked increase in particular from school entry (at the age of 6–7 years) can be observed. There are still no gender-specific differences; The likelihood of being overweight is higher if the social status (unemployment, workers and migrants) and overweight mothers are low .

International comparisons are sometimes difficult because different standards are applied; z. For example, the CDC in the USA uses the 85th percentile (overweight) or the 95th percentile (obesity).

In Europe

The Süddeutsche Zeitung , Der Spiegel and other media caused a sensation in 2007 with the assertion that the German population in the EU played a leading role in obesity. The data is based on a compilation of various data sources published by the International Association for the Study of Obesity on April 23, 2007. However, these data show considerable deficits and are unsuitable for a quantitative comparison of the European countries. Data from Switzerland, Hungary and Slovakia are from 1992, while the data from France and Austria are from 2005/2006. There are no uniform survey methods, the data are not age-standardized according to the compilation itself and the source of the data is not specified. Among other things, survey data are mixed with measurement data and the group of 18 to 25-year-olds is omitted, which has a much lower proportion of overweight people.

According to a report by the state of Berlin in cooperation with the EU Commission from 2010, 59.7% of German citizens are overweight. Here, after the British, the Germans take “second place” in Europe. Britons are two-thirds overweight.

Overall, it can be said that cross-border comparisons are extremely difficult and “should be treated with caution”.

United States: Distribution by marital status

A longitudinal study published in 2007 over 5 years with 8000 people including 1200 couples between the ages of 12 and 28 showed that newly married women and men put on significantly more weight than couples who lived together but did not get married. The weight gains were lowest among singles . One author of the study concludes that marriage reduces the incentive to stay slim.

Factors

General

According to a commission of experts on the subject of obesity, the main cause of obesity is not individual risk behavior (such as overeating and lack of exercise). Rather, the global increase in obesity is due to systemic problems affecting society as a whole, which are also driving malnutrition and climate change. The Commission therefore sees obesity, malnutrition and climate change as different aspects of a single, global problem ("global syndemic") caused by the inertia of politics ("political inertia"). The fundamental common cause of all these problems is therefore poor governance ("inadequate political leadership and governance"), the opposition of powerful economic interest groups (in particular the coal / oil / gas companies and the food industry) and a lack of demands for fundamental changes in these structures Pages of civil society. It is these social influencing factors that enable or promote individual risk behavior in the first place.

Such individual risk factors include:

Other causes can be:

These causes are intensified by advertising for high-energy food and beverages: alcohol, sweets, fats, ready-made meals, fast food, sweets, snacks. WHO and the EU want to limit this through advertising restrictions, especially in youth advertising.

Genetic and other factors always work at the same time for a lifetime, they do not represent alternative modes of action.

An indication of a genetically determined preference for obesity can be found in studies on twins who were raised separately (“ twin research ”). The twins studied resembled their birth parents more closely than their adoptive parents in terms of their weight characteristics. Other research suggests that genetic defects can lead to a reduced release of the hormone leptin , which plays an important role in regulating the feeling of hunger.

The decisive factors (and the only factors that can be influenced) are social conditions, individual living conditions, personal eating behavior and exercise habits. The proportion and the extent of obesity in various populations have increased enormously with the availability of food, without corresponding genetic changes being possible during this period. An influence of living conditions on the occurrence of obesity can be found in any case.

Two changes in social living conditions are essentially responsible for the spread of the "overweight" phenomenon:

  1. The constant and inexpensive availability, especially of (heavily processed) foods with a high physiological calorific value, is very important . This permanent availability is partly caused by a food industry, which regularly prevents a stricter regulation of unhealthy food (e.g. by bans or tax increases for very sugary drinks) through lobbying.
  2. The reduced physical activity (professional work usually no longer physically stressful, e.g. due to increased screen work, high television consumption in leisure time) is responsible for the fact that we have lower energy consumption. The effects, of course, apply to different degrees to each individual. Globally, it particularly affects the youth now growing up. The increasing obesity of the youth is a result of the hypercaloric diet as well as the increasing sedentary lifestyle. So more energy is consumed than is needed.

According to a study by the German Institute for Nutritional Research , which was carried out on mice, there is a connection between the consumption of fruit sugar (fructose) and obesity, which is not based on increased calorie intake, but on an influence on fat and carbohydrate metabolism. In fact, it was also shown in a study on humans that fructose is converted into body fat by the body much faster than grape sugar (glucose). The results of this study also indicate that fructose intake stimulates lipogenesis (fat synthesis) and increases the storage of fats from food.

The fact that night work and lack of sleep can lead to obesity is at least partially attributed to a disturbance in the insulin balance: animal experiments have shown that disturbances in the internal clock in the experimental animals led to insulin resistance .

Factors in children

Risk factors that were mentioned in the Child and Adolescent Health Survey ( KiGGS ) study by the Robert Koch Institute and that require further investigation:

  • genetic factors (parental excess weight)
  • high birth weight
  • lack of sleep
  • little physical activity
  • long periods in front of the television and computer
  • Smoking by mother during pregnancy
  • excessively high calorie diet
  • psychological factors

Medical perspective: frequently observed secondary diseases

There is now clear evidence that pre-obesity is a health risk for a healthy and never smoking subpopulation. Just a few years ago, studies, for example by the Center for Disease Control and Prevention , received a great deal of attention, which show that so-called overweight people have a higher life expectancy than so-called normal weight people; the so-called “obesity paradox” caused a sensation worldwide. A frequently cited meta-analysis comes to the conclusion that there is an increased mortality compared to normal weight for the general population only from a BMI of 35.

However, this contradicts the most comprehensive study evaluation published to date in 2016, according to which the risks for coronary heart disease, stroke, respiratory diseases and cancer are all increased with a BMI above 25 and continue to increase with every additional kilo. The "obesity paradox" does not exist; the popular thesis of "healthy obesity" is thus viewed as refuted; it is based on distorted data. For example, it was not taken into account that some chronic illnesses, smoking, etc. reduce weight, but increase the risk of death and thus distort the statistics.

The CDC still only warns of negative consequences in the case of obesity (BMI> 39), but continues to use the term overweight for the BMI range 25.0–29.9 and normal weight, healthy weight (normal or healthy weight) for the BMI Range 18.5–24.9 fixed.

It is known that not only the extent of obesity, but also the distribution of adipose tissue ( waist-to-hip ratio ) influences the risk of cardiovascular diseases. In 2005 , the International Diabetes Federation established an increased waistline as one of the criteria for diagnosing the metabolic syndrome .

The consequences of being overweight can be:

The following can also occur:

  • Joint damage (especially knee joint) due to increased mechanical stress
  • premature wear of the spine ( osteochondrosis intervertebralis )
  • decreased fertility . 9 kg weight gain increases the chance of infertility by 10%.

Obesity can not only be psychologically caused, but can also lead to psychosocial complications: In many cases, those affected feel excluded or they are socially excluded. It is a vicious circle: In order not to present oneself with obesity in swimming trunks, for example less (swimming) sport is done.

Combating individual and mass obesity

Insights from medicine and nutritional science

Countless books, magazines, TV shows and websites cover the topic of how to fight obesity most effectively. Common advice is intense sporting activity and a change in diet ( diet ). However, opinions about which diet was the right one differed from author to author. Critics complain that - especially with unusual diets such as the Atkins diet and raw food - a diet carried out without medical supervision harbors a health risk.

Non-invasive aids such as medicinal appetite suppressants or drugs (e.g. orlistat ) or medical devices (fat binders in the digestive tract, e.g. L112 ), which are intended to reduce fat absorption, or surgical interventions in which the body fat is removed , are mainly used in the case of severe overweight the stomach is made smaller (by resection, shunt) or the stomach volume is reduced (by balloon or ring).

If the obesity is due to a pathologically disturbed eating behavior (e.g. binge eating ), medical measures against obesity as a pure fight against symptoms make little sense if the eating disorder is not treated psychologically at the same time . Self-help groups provide possible help.

Since the reduction of carbohydrates in particular contributes to an improvement in all cardiovascular risk factors, diets with a high fat content and a low carbohydrate content (so-called low-carb high-fat diets) also seem to be effective for long-term weight reduction. Various meta-studies also underline the effectiveness of low-carbohydrate diets.

A recently carried out meta-analysis , which only considered randomized controlled studies (from January 1, 1980 to February 28, 2005) and was published after the Cochrane study, showed that low-carbohydrate, non-caloric-restrictive diets are at least as effective as Reduced-fat caloric-restrictive diets for weight loss within a year. Nevertheless, it should be weighed up whether the desired positive changes in triglycerides and HDL cholesterol compared to the possibly worsening LDL cholesterol values ​​are desirable.

Another more recent study (January 2000 to March 2007) comparing low-carb and low-fat diets showed that weight, HDL, triglycerides, and systolic blood pressure performed significantly better in the groups on the low-carb diet. In addition, the drop-out rate was higher in the low-fat groups. The authors conclude that low-carb diets are more effective for weight loss.

A meta-analysis from the American Journal of Clinical Nutrition from 2013 compares low-carb, Mediterranean, vegan, vegetarian, low-glycemic index, fiber and protein-rich diets with control diets. The authors concluded that low-carb, Mediterranean, low-glycemic index, and high-protein diets are effective in improving cardiovascular risk factors.

Specially tailored for children

As a result of the Child and Adolescent Health Survey ( KiGGS ) study by the Robert Koch Institute, health insurance companies and schools are increasingly offering programs to encourage families to change their way of life. B .:

  • regular meals with fruits, vegetables, fiber (without fat, white flour and sugar)
  • lots of exercise and sport together

Encouraging the children to drink water at school helped in the study “Drink fit - join in!” To reduce the trend towards obesity.

At the same time, however, critical voices are also increasing. A connection between childhood or adolescent overweight and secondary diseases has not been proven. Also (so far) no connection between childhood and adult obesity has been proven: Not every plump or fat child becomes a fat adult.

Measures on the part of politics

In 2007 the federal government started the “ Healthy Diet and Exercise ” campaign in Germany . The aim is to encourage the 37 million overweight or obese adults and 2 million children in Germany to adopt a healthier diet and exercise behavior, thereby reducing the spread of obesity over the long term. In the course of the debate, some politicians have called for the VAT rate on sweets to be increased to 19%. However, the then consumer protection minister Horst Seehofer rejected a higher VAT for sweets.

In 2008 the Federal Cabinet adopted the National Action Plan IN FORM - Germany's Initiative for Healthy Eating and More Exercise . This replaces the campaign for healthy eating and exercise and will run until 2020.

Cultural and social psychological perspective

In different cultures, overweight people are often assigned certain personality and character traits. In the United States e.g. B. stereotypically, fat people are often attributed a lack of self-discipline and orderliness. Like all stereotypes , such attributions are false and not confirmed by empirical research. In English has to prejudice the term, based on such stereotypes, anti-fat bias ( "Anti-thickness perception distortion naturalized"). Here discriminate Dick stereotypes which affected not only but lead particularly in overweight children also become a phenomenon for which Claude Steele and Joshua Aronson 1995 the term stereotype threat ( " stereotype threat ") have shaped. Overweight children, because they are highly sensitive to the expectations of their peers at certain age phases , e.g. B. Poor school performance just because they feel they are expected to do so.

See also

Web links

Wiktionary: Obesity  - explanations of meanings, word origins, synonyms, translations

Individual evidence

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