What is Obesity? Obesity Symptoms, Diagnosis and Treatment

Today, more than one billion people around the world, including 650 million adults, 340 million adolescents and 39 million children, struggle with obesity. It is said that the diagnosis of this problem, which is increasingly important for the world, is too complex to be defined by just looking at the body mass index. Endocrinology and Metabolic Diseases Specialist Assoc.Prof. Dr. Özlem HALİLOĞLU said, “The European Obesity Association (EASO) recommends that the diagnosis of obesity be made not only with a measurement such as body mass index, but also with detailed clinical evaluations of individuals.” Assoc.Prof. Dr. HALİLOĞLU pointed out that with this new perspective, the diagnosis and treatment methods of obesity, which is rapidly increasing both in the world and in our country, can be updated in the coming period.

What is Obesity?

Obesity is a chronic and progressive disease that has multiple causes and can recur. Fat tissue accumulation above normal impairs the quality of life and causes a shortening of life expectancy by increasing the risk of diseases such as type 2 diabetes mellitus, hypertension, deterioration in blood fats, cardiovascular diseases, asthma, cancer and osteoarthritis. Moreover, the increase in numbers every year also increases the burden that obesity imposes on society. Yeditepe University Hospitals Endocrinology and Metabolic Diseases Specialist Assoc. Prof. Dr. HALİLOĞLU said that the prevalence of obesity in the adult population worldwide is estimated to be approximately 13 percent. Dr. Özlem HALİLOĞLU said, “39 out of every 100 people are overweight. It is estimated that the prevalence of obesity has increased at least threefold since 1975, and there are currently more than 1 billion obese individuals worldwide, including approximately 650 million adults, 340 million adolescents and 39 million children.” She said.

What are the symptoms of obesity?

In addition to body mass index, anthropometric measurements such as waist circumference, waist-hip ratio, waist circumference/height ratio, neck circumference, wrist circumference and skinfold thickness are also evaluated in individuals with obesity. Again, in recent years, body composition has been determined using bioimpedance devices and a prediction can be made about the individual's fat, skeletal muscle and bone mass. But it should not be forgotten that it cannot be distinguished whether the amount of fat measured by the bioimpedance method is visceral fat (around the internal organs) or subcutaneous fat.

“We Are the Heaviest Country in the European Continent”

Assoc. Prof. Dr. HALİLOĞLU pointed out that obesity is not only a disease of high-income or upper-middle income groups, but that its numbers are also increasing rapidly in developing countries. Dr. HALİLOĞLU, however, said that the increase in the frequency of obesity in childhood and adolescence, similar to that in adults, is another point that should be emphasized.

Assoc. Prof. Dr. HALİLOĞLU pointed out that, according to research, the prevalence of obesity has increased to over 30 percent in our country and that we have become the heaviest country in the European continent. Dr. Özlem HALİLOĞLU said, "While the prevalence of obesity in adults was found to be 22.3 percent in the Turkey Diabetes Epidemiology (TURDEP-I) study conducted in Turkey in 1997-98, 12 years after this study, in the TURDEP-II study conducted in the same centers, it was shown that the frequency increased to 35 percent." She said.

What are the diseases caused by obesity?

Assoc. Prof. Dr. HALİLOĞLU points out that obesity can be seen together with many cardiometabolic, mental and mechanical diseases and therefore it is a growing problem for our country as well as in the world. Dr. HALİLOĞLU stated that prediabetes and type 2 DM, dyslipidemia (deterioration in blood fats), hypertension, cardiovascular diseases, fatty liver, polycystic ovary syndrome, infertility, sleep apnea syndrome, asthma, osteoarthritis (calcifications), urinary incontinence, depression and cancer are among the diseases that can develop together with obesity.

How to Diagnose Obesity?

“Although obesity is a chronic disease, detailed clinical recommendations regarding the diagnosis and management of obesity are inadequate, as with other chronic diseases.

“Traditionally, the most commonly used method for the diagnosis and classification of obesity in adults is body mass index calculation. Body mass index (BMI) is calculated by dividing a person's body weight in kilograms by the square of their height in meters (kg/m2). In addition to body mass index, anthropometric measurements such as waist circumference, waist-hip ratio, waist circumference/height ratio, neck circumference, wrist circumference and skinfold thickness are also evaluated in individuals with obesity. Again, in recent years, body composition has been determined using bioimpedance devices and a prediction can be made about the individual's fat, skeletal muscle and bone mass. But it should not be forgotten that it cannot be distinguished whether the amount of fat measured by the bioimpedance method is visceral fat (around the internal organs) or subcutaneous fat.

How to Treat Obesity?

Underlining the need for personalized treatment planning to prevent obesity-related diseases, Assoc. Prof. Dr. Özlem HALİLOĞLU concluded her words as follows: "It should not be forgotten that by setting the right treatment target, improvement in both mental and physical capacities and quality of life is achieved in the long term."

Is Obesity More Common in Women or Men?

In Turkey, the prevalence of obesity is higher in women than in men.

Why Has Obesity Become Such a Significant Problem?

Essentially, two fundamental things have changed. First, the content of the food we eat and our portion sizes have changed. Second, we have started to move less. In other words, we have become unable to burn the calories we consume. We are leading increasingly sedentary lives in our daily routines.

With the impact of technology, we spend long hours in front of computers, televisions, and cell phones. Our work life also mostly takes place indoors, inside buildings. As a result, we move less and consume more calorie-dense foods in larger portions. The calories we don't burn are starting to come back to us as weight.

Is Every Overweight Person Considered Obese? What Constitutes Obesity?

The definition of obesity is actually very clear: an increase in body fat mass. To measure this, a calculation method called the body mass index (BMI) is used. It is obtained by dividing a person's weight in kilograms by the square of their height in meters. Regardless of gender, a BMI below 25 is considered normal. A BMI between 25 and 30 is considered overweight, while a BMI above 30 is defined as obesity.

Does Obesity Lead to Serious Health Problems?

Yes, obesity is a contributing factor to many diseases. Diabetes, hypertension, heart disease, and even some types of cancer are among the most common. It is also known that obesity increases the risk of accidents and suicide.

Does Obesity Cause Cancer?

Yes, there is a close relationship between obesity and cancer. Endometrial cancer in women, in particular, is known to be closely related to obesity. In addition, pancreatic cancer is also closely linked to obesity. Therefore, obesity is considered an important factor that increases the risk of cancer.

Is Exercise a Solution for Obesity?

Exercise is an essential factor in the treatment of obesity. This is because a person who wants to lose weight must first change their lifestyle. Trying to lose weight by regulating diet alone can only be effective to a certain extent. Therefore, exercise is essential to achieve lasting and effective results.

Doing aerobic exercises such as walking, cycling, swimming, treadmill running, or dancing for at least half an hour every day of the week is very beneficial. Adding 15 minutes of muscle-strengthening exercises can yield excellent results.

What is the Relationship Between Obesity and Insulin Resistance?

As fat mass increases, the body sends certain signals: “Excess fat means excess energy.” However, these signals create a toxic effect. Substances secreted by fatty tissue travel to the pancreas, liver, and muscles, disrupting the effects of insulin. This condition is defined as insulin resistance. If not addressed in time, insulin reserves begin to deplete. This leads to the onset of diabetes.

When blood sugar begins to rise, symptoms such as dry mouth, frequent urination, excessive thirst, fatigue, and drowsiness appear. In the advanced stage, the body becomes unable to use glucose at all. This can lead to a condition known as “diabetic coma,” which can result in loss of life.

What is the Relationship Between Obesity and Hypertension? What is Metabolic Syndrome?

Obesity, diabetes, hypertension, and high cholesterol are intertwined conditions. These conditions are grouped under the heading of “metabolic syndrome.” At its core are the negative effects caused by excess weight and fat tissue. The most important step at this point is to regulate nutrition and lose weight. This is the most powerful step that will lead to the improvement of these diseases. However, losing weight alone is not always enough. If diabetes has developed, treatment for diabetes must be administered; if hypertension is present, it must be treated; and if cholesterol is high, it must be controlled.

This content was prepared by Yeditepe University Hospitals Medical Editorial Board.

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