Why is obesity defined as a disease - and when does it really endanger us?

The last few years have been confusing: on the one hand, the conversation about a positive body image is getting better and better, and on the other hand, medical officials insist that obesity is nothing less than a disease.

How do you deal with it?

Iris Cole

02/09/2022

Friday, 02 September 2022, 07:41

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Why is obesity defined as a disease - and when does it really endanger us?

(Walla system)

The attitude towards obesity in recent years has become particularly complex - on the one hand, the body-positive movement seeks to normalize various body structures, and on the other hand, medical organizations repeatedly clarify that obesity is a disease with dangerous consequences.

Dr. Reli Reicher, a senior physician in the obesity and endoscopic bariatrics unit at the Institute of Gastrointestinal and Liver Diseases at the Ichilov Hospital, was a guest on the "Expert Clinic" podcast to explain when obesity puts us at risk - and how to deal with it.

"Obesity is definitely a disease," said Dr. Reicher, "but it is important to talk a little about the definition of obesity, the definition is problematic, there are many people who perceive themselves or are perceived by others to be overweight, but they are not necessarily ill on the entire spectrum of obesity disease.

No measure or definition is perfect in this respect.

We all know BMI - the ratio between body weight and height, is the most common index used to measure excess weight, and it is far from perfect." An example of this are bodybuilders whose BMI is high but they are certainly not obese. And on the other hand, "people can suffer from complications of the obesity disease, even if they do not cross the BMI threshold that the medical world has determined indicates obesity."

If so, how can we define obesity that endangers our health?

"I think the most holistic definition is an excess of fat tissue that leads to health damage," said Dr. Reicher, "The obvious things that go along with obesity are diabetes, cholesterol, cardiovascular disease, but there are other things that people are less aware of: people who suffer from obesity suffer from a higher rate of depression and anxiety.

They also suffer from social stigmas that cause them to lose twice - the suffering and the heartache, and this also makes him feel ashamed and therefore avoid treatment, and not come and ask for help from the medical team."

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We must lower the level of shame and guilt surrounding obesity

Beyond the fact that people who suffer from medical complications of obesity are often ashamed to ask for help, the medical teams also do not always know how to deal with this complex and charged issue.

"It is important to recognize obesity as a disease, both by the general population but also for medical teams," said Dr. Reicher, "many times people who suffer from obesity come to the doctor, and it doesn't matter which doctor it is, and one of two things happens - or the doctor completely avoids talking about obesity

A person who had a heart attack can sit with a cardiologist and is significantly overweight, and they will talk about everything there, but you won't say a single word about obesity.

Or there will be an insensitive and inappropriate reference.

There should be a lot of sensitivity, and the key, in my opinion, really lies in recognizing obesity as a disease for everything."

We must address the issue, but with sensitivity.

An illustration of a sad woman on a scale (Photo: ShutterStock)

According to Dr. Reicher, if obesity is presented as a disease, the physiology of obesity is simply explained. "It is at the end of the central satiety and hunger centers that control our eating behavior and are located in the brain stem, similar to blood pressure and similar to body temperature.

No one feels guilty that they can't lower their blood pressure by willpower or lower their body temperature by willpower alone.

I think that if we put the emphasis on this, we can lower the level of shame and guilt surrounding obesity."

And what about those who prefer to stay fat? This is also a complex issue, since obesity has significant long-term consequences. "The bottom line is, even the people who are fat and healthy, if you follow them Long enough - they will be less healthy than their normal weight counterparts," said Dr. Reicher.

Few people receive medical help for obesity

Obesity is a disease that affects about 30 percent of the population, which is a lot.

If we compare this to diabetes, a disease that has many points of overlap with obesity, 85 percent of patients with diabetes receive treatment, but with obesity less than 1 percent of people seek medical help.

"Most people who suffer from obesity will not come to see an obesity doctor. They will see their family doctor, or their orthopedist when their knee hurts, and they will see a cardiologist when they have heart disease. The failure is first of all the medical staff, because doctors prefer to either ignore it and not talk about it For that, or treat with one medicine for cholesterol and one medicine for blood pressure, and give aspirin so there won't be a heart attack, and don't treat the elephant in the room."

There are effective solutions today.

The obesity drug Ozmpic (Photo: ShutterStock)

It is important to know that between diet and exercise and bariatric surgery - the oldest and most effective intervention - there are many other options in between.

"Unlike other treatments in medicine, all the treatments we know how to do are designed to

help the patient persist in changing their lifestyles. This is the basis for every other treatment, and nothing can replace it," said Dr. Reicher.

Life, is that a diet alone hardly works. "When we do a reduced calorie diet, which is the basis of every diet, we actually increase the symptoms of the obesity disease.

The symptoms of obesity are poor satiety and increased hunger.

When you only diet, you increase these symptoms, we are hungrier and less full, and this turns the treatment into an exhausting and ceaseless battle with yourself, so the tools we give are designed to reduce the symptoms - to increase the feeling of satiety and reduce the feeling of hunger for as long as possible."

Today there are effective medical treatment options for obesity, and you can read about them in detail here, but it is important to know that emotional support and the support of a nutritionist are also needed to make a real change.

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Tags

• Obesity

• obesity

• over-weight