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Overweight and obesity – definitions and diagnosing

Overweight and obesity – definitions and diagnosing

 

Dangers of obesity

Any kind of obesity can be dangerous to your health. It leads to an increased vulnerability to illnesses, in particular to the development of metabolic syndrome, and in the course of obesity continuing and even deepening – to incapacity, increased mortality and serious worsening of quality of life.

Obesity is a chronic illness, characterised by excessive accumulation of fat tissue: more than 25% of the body weight of an adult male and more than 33% of the body weight of an adult female. 

We distinguish two types of obesity:

1. original, which is the result of coexistance of environmental and genetic factors.

2. secondary, which is the symptom of metabolic disorders, central nervous system disorders and taking of certain medications.

The main cause of obesity is the surplus of consumed energy in relation to the degree of its spending.

Apart from emotional disorders, cultural habits, stress and inherited bad nutritional practices, there are also other factors which can lead to the development of obesity. These include: newborns' small birth body weight combined with high BMI, taking of certain medications (such as glucocorticosteroids, antidepressants, neuroleptics), injury of the hypothalamus, but also genetic factors.

Some of the illnesses coexisting alongside obesity include the Cushing syndrome, hypothyroidism, hypopituitarism, Turner syndrome, polycystin ovary syndrome and hereditary diseases such as Prader–Willie syndrome or Cohen syndrome. Therefore, when diagnosing and treating obesity, one should also take into account its possible causes, since reduction of energy intake and increase of physical activity may not always be sufficient.

Apart from classifying obesity according to its causes we can also classify it according to fat distribution:

  1. androidal obesity ('apple obese') – most of the fat is stored around the abdominal region and the upper chest; 
  1. gynoid obesity ('pear obese') - the excess fat is deposited around the hip, thighs and lower body; more prevalent in women.

The most popular methods of diagnosing obesity, used in everyday clinical practice, are the BMI (body mass index) and waist circumference.

Body mass index

The BMI measurement is obtained by dividing a person's weight in kilograms by the square of the person's height in meters. 

BMI ratio


High BMI can be the cause of diseases associated with overweightness and obesity, such as: diabetes, myocardial ischaemia, atherosclerosis, arthralgia, arterial hypertension, asthma, tumours and many others. Table 1 shows the relationship between one's BMI and nourishment level.

Table 1. Body Mass Index (BMI) 
              (as per WHO, 1999)

BMI Table

Waist circumference

Waist circumference determines the distribution of fat tissue in one's body and the type of obesity. Table 2 presents a way of interpreting patient's waistline. Waistlines in excess of 80 cm in women and 94 cm in men are indicative of abdominal obesity.

Table 2. Waistline index 
              (as per WHO, 1999)

Waist circumference measurements

Abdominal obesity (also known as visceral, central, android or apple shape) is especially dangerous to one's health.

It is often associated with increased concentration of triglyceride, VLDL (very-low-density lipoprotein), total cholesterol and LDL (low-density lipoprotein), decreased concentration of HDL (high-density lipoprotein), polycythaemia, impaired glucose absorption, hyperinsulinemia and increased concentration of fibrinogen.



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