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The hallmarks of obesity

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The hallmarks of obesity

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Overweight, obesity

In this article, the author considers contemporary perceptions of the phenomenon of excessive body weight from several perspectives: medical, cultural, social and psychological.

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Excess body weight is becoming a common phenomenon in highly developed countries. This is due, among other things, to the high availability of food and everyday conveniences that significantly reduce physical activity (e.g. cars, lifts, electric household appliances). Conversations about weight and various diets and weight-loss aids are a regular topic at social gatherings, especially between women. Most often, the size of one's own body weight is judged on the basis of one's knowledge, experiences and perceptions of what values are correct. In this way, we form an opinion as to whether our appearance, and that of another person, is within the norm or whether it needs to be remedied. The basic criterion usually becomes the bathroom scale, but there are many more criteria for recognising overweight or obesity. They depend on the point of view adopted, i.e. the perspective in which the phenomenon is described.

The medical perspective
The medical perspective considers body weight in objective terms. It indicates which values of body weight are within and which are outside the norm, based on medical knowledge of human development, the desirable proportion of the various body dimensions and the specific parameters that favour the least morbidity and mortality. Commonly used in the diagnosis of obesity are:
  • bodymass index (the so-called Body Mass Index, or BMI) - calculated according to the Quetelet formula: BMI = body weight (kg) : height (m2); the classification of individual BMI values, was developed by the World Health Organisation and is as follows:
NOMRIA = 18.5-24.9 BMI
OVERWEIGHT = 25.0-29.9 BMI
1st degree obesity = 30-34.9 BMI
II degree obesity = 35.0-39.9 BMI
Degree III obesity = 40 and over BMI
  • comparison of the correct body weight to the right body weight - the right body weight is calculated according to the formula: /height (cm) - 100/ - 10 % (for women) or 5 % (for men); the result indicates how many kilograms one should weigh; to assess whether one's own weight is correct one compares one's current weight (specific weight) with the calculated weight (due weight), as follows:
NOMRIA = specific weight same as due weight
Overweight = specific weight between 110% and 120% of normal weight
Obesity = specific weight greater than 120% of reference weight
  • body fat content in total body weight - this can be measured using a specialised instrument (e.g. Body State); the result of the measurement indicates how much body fat percentage is present in the body; it is interpreted separately for women and men, as shown below:
NOMRIA = 20-25% (women) or 10-15% (men)
Overweight = 25-30% (women) or 15-25% (men)
1st degree obesity = more than 30% (women) or more than 25% (men)
  • waist circumference - can be measured with a tailor's centimetre; results are interpreted separately for women and men and according to the relevant ethnic group; in Europe, these values are described as follows:
NOMRIA = less than 72 cm (women) or less than 89 cm (men)
OVERWEIGHT = 72-80 cm (women) or 89-94 cm (men)
OBESITY = over 80 cm (women) or over 94 cm (men)
  • waist circumference to hip circumference ratio (the so-called Weist to Hip Ratio, or WHR) - calculated according to the formula: waist circumference (cm) : hip circumference (cm); the result is helpful in determining the type of obesity; WHR values above 0.85 in women and above 1.0 in men, are indicative of abdominal obesity, which is particularly dangerous to health.
The medical diagnosis also takes into account other factors that characterise excessive body weight, such as, for example, the cause, time of onset or type of obesity. Obesity is thus distinguished:
  • primary (is a primary disease, not due to other diseases; it accounts for 95% of cases) or secondary (is caused by other diseases or disorders, e.g. hypothyroidism)
  • early (starts in childhood or adolescence) or late (starts in adulthood)
  • gynoid (a.k.a. hip and thigh) or android (a.k.a. abdominal).
From a medical perspective, obesity is a chronic disease of the whole body. It involves secondary damage to the structure and function of individual organs and systems caused by an increase in the number and/or size of fat cells. As a chronic disease, obesity should be detected as early as possible and necessarily treated.