Overweight and obesity: the pandemic of the 21st century

Overweight is the increase of corporal weight over a given pattern.

Experts often believe in using a formula called body mass index (BMI) to determine if a person is overweight. BMI is used to estimate your body fat level using height and weight measured in kilograms and meters.

• A BMI of 18.5 to 24.9 is within a healthy range of weight
• A BMI of 25 to 29.9 is within a suspicious range. Given that the BMI only calculates how your weight is compared with what is healthy, it is not precise for every person. Some people in this group, whereas athletes, could have much more muscular weight and therefore not as much fat. These persons will not have an increased risk of health due to their weight.
• A BMI of 30 or greater is within the obesity range.

Nevertheless, some individuals in this group could have a big amount of muscular weight and as a consequence less fat, as in the athletes' case. With these individuals, their weight does not correspond to an increased risk of health issues.

On the other hand, obesity is a chronic disease that is a component of metabolic syndrome and serves as a risk factor for the development of other potentially serious conditions (cardiovascular diseases, type 2 diabetes mellitus, non-alcoholic fatty liver disease, stroke, osteoarthritis, and cancer, among others).

There are three types of obesity:

• Class 1:BMI from 30 to less than 35
• Class 2: BMI from 35 to less than 40
• Class 3: BMI from 40 or greater. This class is considered “Severe obesity”

The risk of many health problems is greater for adults who have an excess of corporal fat and are within the overweight group.

The causes of overweight and obesity are multiple, and include factors such as genetic inheritance; the nervous system's behavior; endocrine and metabolic, and the lifestyle of each individual. In general, both conditions causes are the following:

• Hypothyroidism
• Medications such as contraceptive pills, antidepressants, and antipsychotics

Even so, other factors that could cause an increase in weight exist, such as

• Stopping from smoking: Many individuals who stop smoking increase from 4 to 10 pounds (lb) or 2 to 5 kilograms (kg) within the first 6 months after stopping the habit.
• Stress, anxiety, sadness, depression, or poor sleep
• Menopause: women may gain 12 to 15 pounds (5.5 to 7 kg) during menopause
• Pregnancy: women may not lose the weight gained during this period

There are multiple risk factors for the development of overweight and obesity. The two most significant are a lack of physical exercise and frequent overeating (consuming more than the body requires).

However, many other risk factors contribute to the development of both conditions, ranging from genetic predispositions to medical factors (such as the presence of other diseases or reactions to medications) or environmental influences. Stress and sleep deprivation are also recognized as two major risk factors for obesity and diabetes.

The two most common ways to evaluate weight and measure health risks related to them are:

• The body mass index (BMI)
• The waist circunference

Measuring the waist is an alternative way to calculate how much corporal fat is in the body, along with the BMI. Excess weight around the midsection or stomach significantly increases the risk of type 2 diabetes, heart disease, and stroke. Individuals with "apple-shaped" bodies (meaning they tend to store fat around their waist while having slimmer lower bodies) are at an even greater risk of developing these conditions.

Body composition measurements, particularly those assessing body fat, can provide a more accurate tool for evaluating obesity than BMI.

The treatments for overweight and obesity are focused on reducing the weight of the patient.

The safest way to lose weight is through an active lifestyle, lots of exercise, with a healthy diet. Even a modest weight loss can improve health. Healthy diets also help reduce weight in patients, simultaneously lowering the risk of potentially serious diseases associated with overweight and obesity.

It is believed that extreme diets (those under 1,100 calories per day) are believed to be neither safe nor effective. Such diets often lack sufficient vitamins and minerals. Most people who lose weight this way tend to overeat again and develop obesity once more.

Weight loss surgery (also known as metabolic and bariatric surgery, or MBS) can reduce the risk of certain diseases in individuals with severe obesity.

Surgery may benefit those who have been obese for 5 years or more and have not been able to lose weight through other treatments, such as diet, exercise, or medication. However, surgery alone is not the solution for weight loss.

Surgeries to decrease weight include:

• Laparoscopic gastric banding
• Gastric bypass surgery
• Vertical sleeve gastrectomy
• Duodenal switch

There exist many recommendations related to life habits to prevent overweight and obesity. The most frequent ones are:

• Limit consumption of foods rich in sugars and fats.
• Eat several times a day fruits and vegetables, along with legumes, whole grains, and dried fruits.
• Engage in regular physical activity: about 60 minutes per day for young people and 150 minutes per week for adults. For those with a high degree of obesity, it is recommended to start with a 30-minute walk with a brisk pace each day.
• Quit smoking. Smoking is linked to many diseases, as well as weight gain. In the long term, quitting will be highly beneficial for your health.

Additionally, we recommend consulting with a healthcare professional about the different prevention programs, which include: primary prevention, aimed at reducing the incidence of a disease by implementing measures designed to prevent its onset (such as vaccination programs or awareness campaigns and counseling to change high-risk behaviors, for example); secondary prevention, which seeks to reduce the prevalence of a disease by implementing measures to stop or delay its progression once it has already developed in an individual (such as screening or early detection programs, for example); and tertiary prevention, which aims to prevent complications or further damage by implementing measures to control its progression (such as regular monitoring of chronic patients, for example).