More than 1.6 billion people are overweight. Of those at least 400 million are obese. That much we know for sure. But the figures could be - and probably are - a lot higher. Besides those already overweight, the scale and growth of the global problem emerge in the fact that the figures have risen threefold since 1980. There is no longer any doubt; the world is hit by a serious fat epidemic. And it will continue for generations, as overweight is not only something you can be genetically predisposed to. Most overweight parents are likely to pass their lifestyle and with that the problem on to their children.
But what is the difference between being a little chubby and overweight? Should a voluptuous, naturally gifted woman or an impressive, big, heavy-set man suddenly be considered fragile patients on the verge of collapsing from coronary diseases?
The general perception of overweight has changed throughout history, just like there are vast regional and cultural differences in perception. And especially women have seen quite big differences in body weight ideals over time.
Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Body Mass Index (BMI) is the weight in kilograms divided by the height in meters squared. BMI can be used for classification of overweight and obesity.
A BMI above 25 is referred to as overweight and when BMI passes 30, the term obesity is used. However, BMI does not tell the full story. The risks of acquiring some diseases linked to body weight increase already at a BMI lower than 25. Also the BMI method will not always reveal the cause of overweight. A bodybuilder can be overweight, but the real problem of overweight and obesity is too much fat in the body, which for bodybuilders is usually not the case. Still BMI is a good indicator for comparing groups of people, and it is used widely in health statistics.
When using BMI the medical classification of overweight and obesity is basically simple, but unfortunately the causes are complicated. Often weight gain is explained as a combination of excessive fat consumption and too little exercise. However, it has not been possible to demonstrate a causal relationship between intake of dietary fat, physical activity and weight gain or obesity. The only dietary components for which an association with weight gain and obesity can be found are consumption of fast foods and non-caloric sweeteners. Obesity may also be caused by or linked to other medical conditions. Thus, obesity is more complicated than just a question of lacking self-control in relation to food consumption and exercise. Which in itself is complicated enough from a psychiatrist’s point of view.
It has been argued that if overweight is simply a change in what we consider normal in terms of weight and the way we look, the change is not really worrying. Over time a different average body weight will develop. The perception of the term “normal body weight” would just need to be adjusted, and there would be no problem. But overweight and obesity are followed by a substantially higher risk of developing a long list of derived medical conditionslike cardiovascular diseases, diabetes and liver diseases to mention just a few. So overweightis not just a question of a figure on the bathroom scale and aesthetics of the body. It is a potentially life-threatening condition.
The fight against obesity is fought in various ways ranging from guidance on diets and exercise, through food supplements to operations. The complex medical nature of obesity has so far prevented a real breakthrough in the pharmaceutical treatment of obesity. But while a pharmaceutical treatment against obesity has not yet been developed, massive research in obesityrelated diseases has generated a variety of drugs targeted at the consequences of obesity.
And the fight goes on.
Read more on the theme obesity in our company magazine Angle, June 2010 issue