According to WHO, there are more than 250 million people in the world who are obese. In the USA, over 50% of the population has overweight, with apparent fatigue occurring in 35% of women and 31% of men. In Europe, the frequency of obesity reaches: 20% in Switzerland, Bulgaria, Italy, France, Spain; 30% in Germany, Finland, the UK and 40% in Romania. If such high rates of increase in morbidity continue, by 2025, the number of obese people is expected to double. The consequence of obesity is arterial hypertension, type 2 diabetes, ischemic heart disease, joint disease.
Obesity is a multifactorial disease
Obesity is a chronic multifactorial disease that develops under the influence of physiological and genetic factors, as well as environmental factors. An increase in body weight of 30-50% is hereditary. At the moment, more than 50 factors are discovered that determine the development of the phenotype of obesity. For example, the receptor gene for leptin; a gene that codes for the formation of beta3 and beta2-adrenergic receptors; lipoprotein lipase gene, fat gene (carboxypeptidase E gene); a type 4 receptor of melanocyte-stimulating hormone, etc.
However, in the development of obesity there is no fatal dependence on the genotype! The main role in the spread of obesity is played by environmental factors: excessive consumption of high-calorie food, chaotic diet with a predominance of bulk nutrition in the evening and night, low physical activity. It is to these factors that the attention of doctors in the prevention of obesity and its negative consequences should first of all be directed.
People are prone to overeating fatty high-calorie food, because such food is tastier due to the increased content of fat-soluble aromatic molecules. The excess caloric content of the diet at 50 kcal per day (0.3 cans of Coca-Cola, a handful of chips or 25 g of ice cream) is the cause of an increase in body weight per year by 2.25 kg.
2 types of obesity
Obesity is characterized by excessive deposition of fat in the body and a violation of the functional activity of adipose tissue. There are 2 types of obesity: android and gynoid.
The android type of obesity (abdominal, visceral, or “upper” male) is characterized by an uneven distribution of fat with excessive deposition of it in the upper half of the trunk, abdomen and visceral fat. In this case, the diameter of fat cells can increase by 20 times, and in severe forms of obesity, the amount of adipocytes additionally increases.
In the case of the gynoid type of obesity (gluteo-femoral, gluteal or femoral, or “lower” female type), a uniform distribution of fat is noted, with predominance in the buttocks and thighs.
Obesity is one of the four components of the metabolic syndrome, known as the “deadly quartet”, which includes obesity, hypertension, dyslipidemia and impaired carbohydrate metabolism.
Mortality from cardiovascular disease in obesity
Cardiovascular diseases (coronary heart disease, myocardial infarction, stroke) are the main cause of death of patients with metabolic syndrome and diabetes mellitus.
The risk of death of a patient with a metabolic syndrome without clinical manifestations of heart failure from major cardiovascular complications is the same as in patients who had previously had myocardial infarction without a metabolic syndrome. The increase in obesity is associated with an increase in overall and cardiac mortality. With an increase in BMI and obesity of grade III, the overall mortality rate increases almost 2-fold, and the cardiac mortality rate more than 2-fold.