Why Do We Get Fat, Why Can’t We Lose Weight?

What is obesity? How common is it, how is it diagnosed?

An increase in the amount of fat in the body that poses a health risk is called obesity. Obesity, one of the most important epidemic diseases of our age, also plays a role in the emergence of nearly two hundred diseases, especially diabetes, cardiovascular diseases and cancer. More than 2 billion people in the world are overweight and 2 are obese. In Turkey, one out of every three adults is overweight and the other is obese, while only one has a normal body weight. Similarly, the data in our country show that three out of every 10 children are overweight.

We diagnose obesity when the body mass index (BMI), which is obtained by dividing the body weight in kilograms by the square of the height in meters, is over 30 kg/m2. We define this figure as being between 25-30 as overweight. However, these figures may not fully reflect the body fat ratio in some people. We call apple type obesity when the waist circumference, measured at the level of the navel, is over 80 cm in women and 94 cm in men. This situation carries a higher health risk compared to increased fat in the hip area, that is, pear-type obesity. We also make other evaluations in our patients that we follow up and treat for obesity.

What causes obesity?

It is not a situation that develops due to the individual mistakes of the person and under his own control. We can define obesity, which is a chronic, complex, progressive and recurrent disease, as the normal response of our body to the abnormal environment that our genes and metabolism are not accustomed to. Dietary habits and inactivity are very important in the development of obesity, but many factors such as mood disorders, stress, insufficient sleep, changes in our gut microbes and hormone disruptors that we are exposed to from our environment make it easier for our body to store fat.

Is there a relationship between obesity and COVID19?

Obesity and COVID19 disease affect each other negatively. Obesity increases the need for hospitalization, intensive care and assisted ventilators by 30-80 percent in COVID19 patients. It aggravates the disease by causing disorders on the respiratory, heart, metabolism, immune and coagulation systems. With the epidemic measures, decrease in physical activity, deterioration in eating and drinking behaviors, socioeconomic difficulties and psychosocial status disorders occur. The reflection of all these on our energy metabolism is a tendency to increase in weight in both obese and non-obese individuals.

What to do for weight control?

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The private sector, non-governmental organizations and governments have important duties in the prevention and management of obesity. In an individual with obesity, “eating less and moving more” alone does not provide a permanent solution. I define them with the 4 letters of the word “BUSE”. The letter “B” is nutrition. It is essential to have a healthy, balanced and adequate diet. We already consume too much saturated fats, sugar, processed foods. On the other hand, we consume less fibrous foods, we do not eat natural and varied foods. For example, consuming five servings of vegetables and fruits a day alone reduces the risk of obesity, cardiovascular disease and diabetes by 30 percent. The letter “U” represents sleep. Attention should be paid to six to eight hours of uninterrupted night sleep. Anything less or more is a health risk. The letter “S” represents stress. It is not possible to control body weight without controlling stress. In case of high stress, the body retains extra fat, especially around the internal organs and abdomen. Exercise if the last letter is “E”. Permanent weight control cannot be achieved without movement. For this reason, adequate exercise should be done by following personal precautions during the epidemic period. With the “BUSE” formula, it is possible to control both weight and keep the immune system strong.

In most of the patients who apply to us because of obesity, we can provide the necessary weight loss to reduce the health risks with lifestyle planning. In some of our patients, we may need to use medication or it may be necessary. Successful obesity treatment requires an evidence-based, multidisciplinary, personalized and sustainable approach.

Spring 2022 / Pharmetic Health Magazine

prof. Dr. OKAN BÜLENT YILDIZ Hacettepe University Faculty of Medicine Department of Endocrinology and Metabolic Diseases

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