Obesity, in German obesity or obesity, particularly affects people in industrialized countries and the western world. In Germany, over 20 percent of people are considered obese.

What is obesity?

On the basis of the graph for women, the BMI can be roughly determined. A BMI graphic for men can be found here: BMI men

Obesity is derived from the Latin word "adeps" for fat. According to experts, this increase in body fat is classified as a chronic disease. Not every overweight is equally obese.

According to the World Health Organization, obesity is above 30 (BMI = body fat index). A total of 3 degrees of severity are distinguished, which are also subject to BMI classification.

A Grade I obesity is present at a BMI of 30-35, up to a BMI of 40, people are affected by a grade II obesity, above it is only grade III, which is also called morbid obesity. The quality of life is already clearly limited, the life expectancy is significantly lower than in normal-weight people.


Obesity is more common in western industrialized countries, suggesting a derivation of the causes on the living conditions. Studies have shown a direct correlation between the daily intake of fat and obesity, but not the generally excessive intake of calories.

Also, sugary drinks lead to obesity and eventually to obesity. In addition to the wrong diet, too little exercise is a cause of obesity. Lack of exercise in this context means not only too little sport, but also the general living conditions. Sedentary activities, passive recreational activities and a good infrastructure are particularly found in Western countries and, together with the wrong diet, quickly lead to weight gain.

Also factors from the outside are reasons for being overweight. The excessive supply of goods, the popularity of fast foods, a lot of advertising and the habituation to sugar and fat (sugary teas, soft drinks, fast foods) even in children lead to obesity. Metabolic diseases such as hypothyroidism can also be mentioned as a cause. Studies have also shown that genetic predispositions can lead to obesity.

Symptoms, complaints & signs

The most obvious symptom of obesity is the apparent obesity of the person concerned, which manifests itself in a full and expansive body shape. Therefore, obesity is generally easy to diagnose - even though its causes may be very different. Obesity is acquired in all cases over a long period of time and can be treated by changing the lifestyle.

The symptoms of obesity include a mostly ponderous gait, resulting from the limited mobility. Mostly, exercise is directly related to breathlessness because the cardiovascular system has to move and entertain a mass for which it is not designed. Due to the aggravated agility usually creates a conditional deficit, as those affected are no longer able to pursue sporting activities.

Long-term problems in the musculoskeletal system, which are triggered by excessive loads on joints and tendons. Even back problems such as herniated discs are commonly seen in obese patients. Last but not least, adiposity is considered one of the main causes of sequelae of the cardiovascular system.

Mostly due to unhealthy, too high-fat diet and too little exercise also worsen the blood levels. Outwardly unnoticed, deposits form in the veins and arteries, which can lead to diseases of the vessels and the heart. Strokes and heart attacks are the result in the long term.

Diagnosis & History

Obesity is primarily determined by the measured BMI. Decisive for the sequelae of obesity, such as high blood pressure or cardiovascular diseases, is not only the BMI, but the distribution of body fat. Fat deposits in the abdomen, as this fatty tissue often encloses the organs, and thus adversely affects the sugar metabolism.

Belly fat produces bad blood lipids that cause cholesterol levels to rise and settle on the arterial walls. If the fat spreads primarily to the thighs or butt, it is called the pear type - it has a lower risk of developing complications. For diagnosis, the waist circumference and the waist-hip ratio are also measured. Both give information about the fat distribution pattern.

An increased risk therefore women with a waist circumference of more than 80 cm and men from a value of 92cm. The waist-to-hip ratio should be less than 1 for men, and women over 0.85 are considered at risk. In children, these values ​​are rarely meaningful, which is why their age in relation to size and weight must be consulted. This is done with percentile tables.

differential diagnosis

Dietary obesity must be clearly differentiated diagnostically from diseases such as Cushing syndrome (hypercortisolism), hypothyroidism, lipid metabolism disorders and polycystic ovarian syndrome (PCO) syndrome.


Obesity can lead to the development of diabetes mellitus (type 2). Diabetes causes a disruption of the metabolism, the characteristic feature being resistance to the hormone insulin. Left untreated, severe diabetes can lead to death. In addition, further complications and side effects such as neuropathy are possible.

Obesity often causes complications that affect the cardiovascular system. This results in a higher risk of related diseases, including heart attacks and strokes. In addition, obesity increases the risk of various cancers.

The metabolic syndrome is a combination of abdominal obesity, insulin resistance, hypertension and dyslipoproteinemia. The latter describes a disorder of protein concentrations in the blood serum. The High Density Lipoprotein (HDL) and the Low Density Lipoprotein (LDL) occur in altered proportions.

Obesity is associated with elevated cholesterol in many cases. This promotes arteriosclerosis and gallstones. The excessive weight also leads to an increased burden on the musculoskeletal system. Especially the joints and discs suffer from obesity. As a complication, you may also experience snoring or temporary respiratory arrest during sleep.

In turn, this sleep apnea syndrome can lead to disturbed sleep patterns: those affected wake up more often from the deep sleep phases, which are important for the normal regeneration of the body.

When should you go to the doctor?

Many people suffer from increased weight. Presumably, most people will not go to the doctor because of obesity, as long as they do not suffer serious consequences. The reason: In spite of all the media information is often missing the insight into the long-term health consequences, which may have a strong overweight.

Many overweight people dare not go to the doctor. Increasing sense of shame ensures that the body weight increases even further. Sooner or later, possible sequelae of obesity will occur. Even if there are no pathological symptoms as a result of being overweight, the doctor should be consulted. As a minimum, an annual health check and all checkups scheduled for the age group are advisable.

In case of vegetative disorders such as excessive sweating, shortness of breath or increasing shortness of breath or palpitations with little effort the visit to the doctor is necessary. Through a diet, the discomfort can be reduced. Even if it comes to symptoms of the musculoskeletal system, pain and constant muscle tension, doctor visits are necessary. Otherwise, permanent damage threatens. Obesity can lead to chronic diseases with progressive disease. Regular doctor visits can prevent this.

Visits to the doctor are also advisable if the person concerned notices social and professional opportunities and is sidelined by his weight problem. If the massive overweight due to mental problems, a psychotherapist should be consulted.

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Treatment & Therapy

The doctor measures the abdominal girth and body fat percentage as well as the body mass index of the patient in order to be able to initiate an exact diet and further therapy.

The primary goal of a therapy is always to lose weight. For this, often severe interventions in the living conditions are necessary. In the majority of obese patients, diet is the main cause of obesity. The education about healthy nutrition is the first step to treat obesity.

As behavioral and nutritional patterns develop over years, behavioral therapy is often advisable. An attacked self-image and psychological causes must also be treated often, which is why psychotherapy is often indicated. The second important pillar in the fight against overweight is exercise. The WHO recommends 30-60 minutes of sports at least 3 times a week for weight loss. A detailed consultation is also necessary here, so that the joints and tendons of the obese man are not harmed.

In children, families and relatives need to be heavily involved in the therapy process. For severe obesity grade II and other diseases such as diabetes or heart disease, surgical procedures are also available. A gastric band or gastric reduction are restrictive procedures and obstruct people's food intake. Combined surgery can also affect the gastrointestinal tract and not only directly affect food intake but also fat metabolism.

Medications, such as appetite suppressants, are not suitable for obesity therapy. The only approved remedy is orlistat, which intervenes in the lipid metabolism and disturbs the intake of dietary fat. However, this drug should only be used in conjunction with therapy, since primarily eating habits and a lack of exercise must be treated by means of a change in behavior.

Outlook & Forecast

Schematic representation of the anatomy of a gastric reduction. Click to enlarge.

People who are severely overweight tend to be at risk of developing metabolic syndrome. Similarly, the likelihood of heart attack, heart failure and high blood pressure is greatly increased.

As a rule, obesity is a relatively dangerous and very unhealthy condition for the patient's body. Failure to treat or drastically reduce weight can lead to life-threatening symptoms and, in the worst case, death.

In most cases, patients suffer from movement restrictions and are quickly exhausted when the body is strained. The increased sweating often leads to an unpleasant body odor and the increased weight causes pain in the joints. Furthermore, heart problems also occur, so that most patients are exposed to cardiovascular disease and may experience a heart attack.

Due to the obese figure of the patient it comes partly to mental complaints and to a social exclusion. Children, in particular, can suffer from bullying and teasing as a result of obesity and as a result develop severe mental health problems. Furthermore, it can lead to the development of diabetes.

An obesity can be treated, but the patient himself is responsible for a proper treatment. Only in a few cases is an exclusively medical treatment possible. Through a healthy lifestyle and sporting activities, the disease can be counteracted. Where appropriate, psychological treatment is needed to address the causes of obesity.


A healthy lifestyle from childhood is the best way to prevent being overweight. The diet should contain as little fat and sugar as possible, and sports should be on the program 2 to 3 times a week. Especially children are very receptive to preventive measures and healthy eating habits and a lot of exercise become the norm, which last into adulthood.


Together with the gastric reduction, the gastric band belongs to the possibilities of bariatric surgery. If conservative weight loss methods have failed, it is usually the last resort. Click to enlarge.

Follow-up after surgery for obesity is life-long. In the first year six appointments are scheduled, in the second year two and then an annual. If the patient has discomfort, he should consult the attending physician regardless of the appointment. The challenge for those affected is the change in lifestyle, which mainly affects the diet and physical activity.

Here they usually need support so as not to fall back into old patterns. It can be in the form of nutritional counseling, a doctor or a support group. A nutritional plan is an essential part of the first weeks. In addition, side effects of obesity such as diabetes and high blood pressure will most likely decrease.

The drug treatment must therefore be adjusted. If the intestine can receive less nutrients from the diet through surgery, dietary supplements must be prescribed. These must be adjusted annually according to the state of health of the patient in their dose.

Since patients with obesity often have low self-esteem, it is important that social inclusion be part of the aftercare to prevent relapse. This can be done by getting into professional life soon or finding new hobbies. If necessary, a behavioral therapy can be prescribed to assist the patient in the challenges of everyday life.

You can do that yourself

Overweight people can do a lot for weight loss. Basically, when it comes to obesity, insight into illness and the will to change are essential in terms of weight loss. Those who do not want to admit to massive excess weight and see no sense in a significant change in diet and exercise habits, will sustainably and healthily lose weight through virtually no medical treatment.

If necessary, psychological counseling and therapy is an important component that can be tackled in parallel with a medically supported diet. Successful obesity can only occur in the context of a diet, who consumes less than he consumes daily. The negative calorie balance is therefore the goal.

As long as no specific health concerns stand in the way, every person can do something in everyday life with a reduced fat and calorie-reduced diet and at the same time increased calorie consumption through exercise to lose weight. It is important to know that weight loss in everyday life should be slow and not caused by crash diets. These cause a significant reduction in the basal metabolic rate and thus significantly increase the yo-yo effect.

Well-founded knowledge about nutrition is therefore advisable if you yourself want to do something against obesity. This one can own oneself, in addition, supported by courses for example those of the health insurance companies, appropriate. Even self-help groups can be a great help in weight loss in everyday life.

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