Obesity

Obesity is a disease characterized by the accumulation of excess body fat and, consequently, body weight above what is considered healthy. Although it has a metabolic component, genetic and environmental factors also influence its development.

Body mass index (BMI) determines whether a person's weight is healthy in relation to their height. This value is calculated by dividing weight in kilograms by height in meters squared (BMI = kg/m²). According to the result, obesity is classified into three classes:

• Class 1 obesity: BMI is between 30 and 34.9 kg/m².
• Class 2 obesity: BMI is between 35 and 39.9 kg/m².
• Morbid obesity (Class 3 obesity): BMI is greater than 40 kg/m².

Childhood obesity is the excessive accumulation of body fat during childhood. In these cases, BMI is calculated in the same way as in adults, but the results are compared with growth charts (percentiles) adjusted for age and sex. A child is considered obese when their percentile is equal to or greater than 95. It is essential to address this disease as soon as it is detected, since 80% of children with obesity remain obese into adulthood.

It is a mistake to consider obesity merely an aesthetic issue, as it is recognized as a chronic and serious disease that can lead to other health-threatening conditions, such as diabetes or heart disease. Nevertheless, the prognosis is favorable if the patient adopts lifestyle changes and loses weight before developing comorbidities.

Symptoms

The main symptoms of obesity are excess body fat and a waist circumference greater than 88 centimeters in women and 100 centimeters in men. Other signs of the disease are associated with excess weight itself. The most common are:

• Excessive fatigue.
• Difficulty performing daily activities.
• Limitation of physical activity.
• Reduced exercise tolerance.
• Sensation of shortness of breath.
• Excessive sweating and heat intolerance.
• Infections in skin folds.
• Obstructive sleep apnea syndrome: breathing repeatedly stops during the night, limiting oxygen delivery to the body and preventing adequate rest.

Children with obesity commonly present:

• Persistent headache.
• Frequent urination.
• Excessive thirst.
• Poor growth.

Causes

Obesity occurs primarily when more calories are consumed than the body metabolizes at rest or burns through physical activity. In most cases, it is the result of an unbalanced diet and a sedentary lifestyle.

Risk Factors

The main factors that increase the risk of obesity are:

• Genetic predisposition.
• Certain medications, such as tranquilizers, antidepressants, steroids, anticonvulsants, or hormonal drugs.
• Anxiety: often leads to compulsive eating behaviors.
• Stress: many individuals turn to food to cope with stressful situations.
• Smoking cessation.
• Sleep disturbances: insufficient sleep or poor sleep quality may cause hormonal changes that increase cravings for calorie-dense foods.
• Hormonal disorders:
  • Hypothyroidism: the thyroid gland does not produce enough hormones, causing the body's metabolism to slow down.
  • Cushing syndrome: a pituitary disorder that increases cortisol levels.
  • Prader-Willi syndrome: a genetic disorder characterized by reduced sex hormone levels, decreased muscle strength, and increased hunger.

Complications

Patients with obesity frequently present the following conditions:

• Hypertension.
• Hypercholesterolemia.
• Elevated blood triglyceride levels.
• Excess uric acid, which may cause gout.
• Joint pain or deformity, especially in the knees and hips.
• Osteoarthritis: inflammation and degeneration of the joints.

Some of the most common complications include:

• Diabetes mellitus.
• Cholelithiasis.
• Hepatic steatosis or fatty liver disease: increased fat deposits in the liver, which may lead to cirrhosis (formation of scar tissue).
• Hiatal hernia: the upper part of the stomach protrudes into the chest through the opening where the esophagus passes through the diaphragm.
• Gastroesophageal reflux disease (GERD).
• Heart disease.
• Stroke.
• Increased risk of cancers of the uterus, cervix, endometrium, ovaries, breast, esophagus, colon, rectum, liver, gallbladder, pancreas, kidney, and prostate.
• Mental health problems, such as depression, low self-esteem, or social isolation.

Prevention

The best way to prevent obesity is to exercise regularly and follow a balanced diet that includes the following habits:

• A varied diet.
• Carbohydrates should account for 50% to 60% of total caloric intake.
• Proteins, from both animal and plant sources, should provide 10% to 15% of total calories.
• Fats should not exceed 30% of daily intake.
• Reduce salt consumption.
• Avoid saturated fats and trans fatty acids.
• Consume 5 servings of fruits and vegetables daily.
• Limit consumption of foods high in simple sugars (sugar-sweetened beverages, pastries, confectionery products).
• Drink between 1.5 and 2 liters of water daily.

A complete breakfast every day, including dairy products, cereals, and fruit, is recommended to avoid choosing less healthy foods during the mid-morning period.

Which specialist treats obesity?

Obesity is a condition managed within the specialty of Endocrinology and Nutrition.