More than half of the world's adults live overweight Obesity By 2035, if we don't act, warns the World Obesity Federation (WOF), a non-profit organization that seeks to increase global efforts to reduce, prevent and treat this disease.
The concern is not unfounded, after all, obesity is associated with a higher risk of negative health outcomes, including several types. Cancerand reduced life expectancy.
This National Obesity Prevention Day, check out 6 essential topics for understanding the disease that will be up for debate. Health and Wellbeing Summit – The future of health is herePromoted by Estado On October 13 and 14.
1 – More than half of the world's adults will be overweight and obese by 2035 (if nothing changes)
Experts believe the world is facing an epidemic of overweight and obesity. “No part of the world is immune to the effects of obesity, and those most affected in adolescence are the poor,” says WOF. World Obesity Atlas 2024.
In a study conducted by the NCD Risk Factor Consortium in collaboration with the World Health Organization (WHO), More than 1 billion people around the planet live with obesity. Among adults, obesity rates have doubled among women and nearly tripled among men between 1990 and 2022.
According to the 2021 surveillance survey of risk and protective factors for chronic diseases by telephone survey (VIGTEL), the prevalence of overweight (overweight) in the Brazilian population is 57.2% and obesity is 22.4%.
Based on data trends from 2000 to 2016, WOF estimates that the proportion of overweight and obese adults will increase from 42% in 2020 to 54% in 2035, assuming no change based on intervention. Almost 8 in 10 (79%) will live in low- and middle-income countries.
2 – Obesity is not a 'disease', it is a disease
In recent years, the public health communication has strengthened that obesity is a chronic, progressive and multifactorial disease. In other words, it is a condition that does not need to be cured (but can and should be treated, which guarantees the patient's quality of life), which progresses over time, which means that treatment must be started early to avoid the progression of symptoms. And problems, and there may be many reasons that interact with each other.
Geloneze also highlights that obesity has neurochemical aspects. “Hunger, satiety and energy expenditure regulatory centers in the brain, more precisely in the hypothalamus, are altered. It has nothing to do with the will of the person. It is not out of character or carelessness.”
Desire emphasizes that it's not about behavioral factors like eating less. “Obesity involves environmental, psychological, emotional factors and, above all, genetic and physiological issues. The body is a dynamic machine. It regulates and controls itself at all times, Even try to skip the weight loss process.”
Stigma that shifts blame and responsibility to the patient is not only wrong and unfair, but according to experts, it can harm the search for and success in treatment.
3 – To diagnose, perhaps BMI is not enough
Traditionally, overweight and obesity are diagnosed by calculating the body mass index (BMI), the ratio between weight and height. Formula: BMI = Weight (kg)/Height² (m²). For adults, the cut-off points are:
- Overweight – BMI greater than or equal to 25
- Obesity – BMI greater than or equal to 30
In children and adolescents, age should be considered.
Although BMI is a low-cost and therefore accessible patient screening measure, experts are increasingly realizing that it may not be sufficient given the complexity of a disease such as obesity.
No A new consensus on obesity The European Association for the Study of Obesity (ESO) states that BMI is no longer considered alone in the diagnosis and staging of disease in European adults and is beginning to attract attention along with aspects such as abdominal circumference and functional and psychosocial impact. Weight.
Brazilian experts have no expectation that the European consensus will produce any immediate changes in the diagnosis and treatment of obesity. However, it is hoped that it will inspire future behavior and, above all, help strengthen the movement already adopted by Brazilian professionals to reduce the importance of BMI and personalize treatment goals for the disease.
Desire highlights that looking only at the relationship between height and body weight can miss equally or even more important aspects such as where fat is located and the amount of muscle mass.
“Abdominal, waist and neck circumference indicates if there is more centrifugal fat, in the center of the body, more visceral, this is a big problem”, explains Geloneze.
“Sometimes, people who are 'normal' weight and have no visible fat have worse health than those who are metabolically healthy, even if they are obese,” Desire comments. This is a new category: metabolically obese with normal weight (Read more here).
One Review published Endocrine Reviews He points out that up to 30% of obese people have no obvious metabolic abnormalities – such as high cholesterol or blood glucose. Doctors call this metabolically healthy obesity.
“Metabolically healthy obesity does not necessarily mean healthy obesity. This is a big dilemma because the person may be at risk of developing certain cardiovascular problems in the long term even without psychological, orthopedic problems or metabolic changes. This condition is metabolically healthy, that is, with normal exams, intermediate, and aging brings it to an end”, highlights Geloneze.
4 – Obesity is a risk factor for many diseases
According to the WHO, obesity has a profound impact on the patient's quality of life. “This leads to greater risk diabetes Type 2 and heart disease can affect bone health and reproduction, increasing the risk of some types of cancer,” he warns.
It also helps to explain the stagnation in Global advances against cerebrovascular accident (CVA) in the world e According to the WHO and the National Institute of Diabetes and Digestive and Kidney Diseases in the United States, it can be a risk factor for hundreds of diseases. Among them:
- Increase in migraine cases
- Glaucoma
- Obstructive sleep apnea
- Arrhythmia (mainly atrial fibrillation)
- High blood pressure
- Heart failure
- heart attack
- Gastroesophageal reflux
- Liver steatosis
- Urinary incontinence
- Risk of not having a positive outcome of the pregnancy (higher chance of miscarriage and birth defect)
- Venous thrombosis
- Mental health issues
- Arthritis
- Cancers: Meningioma; Thyroid; Esophagus; the breast; multiple myeloma; liver; kidney; gall bladder; upper abdomen; endometrium; Pancreas; Colon and rectum; and uterus
5 – Severe childhood obesity can reduce life expectancy by 39 years
According to the WHO, more than 390 million children and adolescents between the ages of 5 and 19 will be overweight in 2022. “Obese children are more likely to become obese adults and are at greater risk of developing chronic diseases as they age. Alerts the company.
Children with severe obesity at age 4 cannot control the condition Life expectancy is just 39 yearsThat's according to research presented at this year's European Congress on Obesity.
6 – We live in a new era when it comes to medicines
In recent years, drugs to treat obesity have taken a surprising turn. The revolution began with the advent of GLP-1 receptor agonists – one of the hormones that help the brain understand when we've eaten enough – specifically a molecule called semaglutide, the active ingredient in a very popular drug. Osembic (It is actually indicated for type 2 diabetics), and Vex (obese patient version), both from the Danish pharmaceutical company Novo Nordisk.
Geloneze recalls that the first anti-obesity drugs were derived from amphetamines, catecholaminergics, which had the side effect of increasing cardiovascular risk and psychiatric problems. “They can't be used long-term because they can promote addiction, which is the opposite of what someone with a chronic illness needs.”
This has changed with the new generation of drugs. In addition to security, Has cardiovascular benefits and kidneys, comments Geloneze. However, he notes that the new drugs also have side effects such as nausea and are still expensive.
Desire highlights questions that remain to be answered, such as the loss of lean mass in patients using these drugs. “One study showed that almost 40% of the weight lost was lean mass. How can this be reduced? The focus cannot be on this ridiculous weight loss, but on thinking about what is lost. This is Difference between weight loss and weight loss.”
Experts agree that drugs are not a silver bullet. Treating obesity requires a multidisciplinary effort, including mental health and physical education professionals, and lifestyle changes, such as a healthy diet and increased physical activity, are critical to ongoing treatment.
“Health and Wellbeing Summit – Has the Future of Health Already Arrived? October 13th and 14th from 8am to 6:30pm at the Events Space of Shopping JK Iguatemi in São Paulo. To register, go to is the connection.
