Obesity is a widespread disease. Almost every fifth person in Germany is overweight and the number is increasing. About a stigmatized disease and overrated diets.
I am as tall as a thimble and weigh little more than a feather. It has always been like this. And that has always provided unabashed looks and topics of conversation. There were those who held a stick of bread in front of my nose in the restaurant with the words “Eat something” and others who wrote love songs to my body. As a teenager it was all annoying, made me overeat to get a little bigger and made me, that is, matchstick leg, only wear long pants in the summer.
Then came the year I met her, who everyone just called Miss Piggy.
The bread sticks that were handed to me were taken from her. She ate little and did a lot of sport. Still, she was fat and kept getting fatter. She gained pounds from nothing. And everyone, really everyone, had something to say about their bodies, a good tip and a truckload of prejudices. She was called fat, lazy, out of control.
What we had in common was that our bodies provoked others. But our situation was never comparable. Because while I’ve always been just a tad skinnier than everyone else, she had a serious problem. She knew that, and eventually I realized how pretentious and stupid it was to compare our experiences. And something else she understood early on—that obesity is a disease, not a crime.
Obesity, when diets no longer work
Obesity means something like severe overweight, but is also referred to as obesity. Those affected are not only confronted with prejudice and the stigma of being to blame for their weight, but also with the possibility of impending health restrictions. Obesity is about fat deposits that cannot be reduced with a little discipline and sacrifice. At least not in the way that is possible with “healthy” people.
“Obesity is excessive fat accumulation, which we can now understand and evaluate as a symptom of a chronic inflammatory metabolic disease,” says Sylvia Weiner, chief physician at the Clinic for Bariatic and Metabolic Surgery at the Northwest Hospital in Frankfurt am Main. And: “Diets are no longer enough for these people.” The causes of “morbid” obesity are manifold and have only been increasingly researched in the last ten years. “In addition to genetic aspects, a high-energy diet and too little exercise in our civilized world play a role in the development of the disease,” says the doctor.
Almost every fifth person is affected by obesity
According to the Robert Koch Institute (RKI), 54 percent of people in Germany are overweight, with almost one in five (18.1 percent) even being severely overweight. And there are more and more. According to the World Health Organization (WHO), in the 5 to 19 age group alone, the number of overweight or even obese children more than quadrupled between 1975 and 2016 from 4 to 18 percent. According to the RKI, the prevalence of overweight and/or obesity increases with age in both women and men.
One speaks of obesity when the famous Body Mass Index (BMI) is greater than 30 kg/m². “An arbitrary classification made by American insurance companies at the end of the last century,” explains Weiner. “Even an Arnold Schwarzenegger would certainly have had a BMI > 30 kg/m² in his prime, without being obese of course … .”
The WHO also classifies obesity as a chronic disease that requires long-term treatment and can have serious health consequences. This includes a reduced life expectancy. The complications of obesity include type 2 diabetes mellitus, high blood pressure and cardiovascular disease, fatty liver and adipose tissue disorders. How high the risk of those affected is for such a secondary disease also depends on how the fat is distributed on the body. According to the Integrated Research and Treatment Center (IFB) Obesity Diseases of the University Medical Center Leipzig, it is higher for people with abdominal obesity than for those affected with fat pads on the legs and buttocks.
Still a lot of prejudices
Body weight is regulated by hormonal control mechanisms. Obesity leads to a dysregulation of these control circuits. “The body is not able to react properly to an excessively high energy balance, signals are constantly being sent incorrectly in the body,” explains Weiner. As a result, the so-called body set point shifts in the body, and the vicious circle begins. The body interprets its body fat percentage as normal and reacts to reduced calorie intake with a reduced basal metabolic rate – “as a countermeasure, to put it casually, ‘not starving'”.
The body therefore needs fewer and fewer calories for daily survival functions such as breathing, the work of the organs and the regulation of body temperature. And: In people with obesity, measures such as diets and exercise that work in healthy people are less effective. Weiner explains: “Only intervention in the basic adjustment screws of the body set point, i.e. in the area of the control hormones, helps to break this vicious circle.” A variety of effective treatment options are now available that can be used depending on individual characteristics and the severity of obesity. This also includes surgical interventions.
However, this has still not really caught on in the public eye, as a current study shows. 1000 people in Germany were surveyed on behalf of the pharmaceutical company NovoNordisk. It was found that although 74 percent of those surveyed knew that obesity is a recognized disease, the main causes are seen in the behavior of the overweight person, such as poor nutrition (82 percent), laziness (55 percent) and lack of discipline (50 percent). At the same time, almost half of those surveyed (45 percent) said they felt sorry for overweight people, and nine percent even spoke of disgust.
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Source: Stern
