Review Note

Obesity Overview

• General Classification:
  • BMI > 30 is considered obese.
  • BMI > 25 is considered overweight.
• Associated Risks:
  • Obesity is a major risk factor for various non-communicable diseases.
    • Risk increases with BMI.
    • Cardiovascular disease: Leading cause of death. (Hypertension, atherosclerosis, stroke)
    • Type 2 diabetes mellitus (DM2).
    • Musculoskeletal disorders, especially osteoarthritis.
    • Cancers: Breast, ovarian, prostate, liver, gallbladder, kidney, colon.

Provoking Factors

• Dietary and Physical Factors:
  • Intake of energy-dense foods high in fat.
  • High caloric input, low caloric output 
  • Physical inactivity.
• Environmental and Social Factors:
• Changes in the environment and society.
• Lack of supportive policies in various sectors such as:
• Health, agriculture, transport, urban planning, environment, food processing, distribution, marketing, education.
• Endocrine disorders like Cushings
• Genetic mutations like in MC4R gene

Assessment and Treatment (Based on BMI, WHO Guidelines)

• Lifestyle Interventions:
  • 5-15% weight loss over 6 months is a realistic goal with proven health benefits.
  • Address modifiable factors like diet and physical activity.
• Pharmacological Treatment:
  • BMI ≥ 27 kg/m² with obesity-related comorbidities → Consider weight-loss drugs as adjunctive treatment.
  • Orlistat (inhibits instestinal lipase, decreasing fat absorption)
  • Liraglutid (GLP-1 analog)
  • BMI > 30 kg/m²:
    • Without additional comorbidities → Weight loss drugs may be used as adjunctive treatment.
• Surgical Treatment:
  • BMI ≥ 35 kg/m² with comorbidities or BMI ≥ 40 kg/m² → Bariatric surgery is indicated.