Obesity disease

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OBESITY DISEASE
Polikandrioti Maria, 1 Stefanou Evagelia. 2

1. RN, Msc, Laboratory Instructor, Nursing Department A, TEI, Athens, Greece.
2. RN, Msc, Specialized Technician, Nursing Department A, TEI, Athens, Greece.
Abstract

Obesity consists a major nutritional health problem in developed and developing countries,
which has reached epidemic proportions. Obesity is defined as the condition of excessive fat
accumulation to such an extent that affects the individual’s health.
Objective: The purpose of the present review was to explore the obesity-related diseases and
the medication for treatment of obesity.
Method and material : The method οf this study included bibliography research from both the
review and the research literature which carried out mainly internationally over the last five
years and referred to obesity.
Results: The rapidly increased incidence of obesity is due to environmental factors that
influence a genetically pathological predisposition. The body mass index (BMI) is an
internationally accepted index to estimate body weight, which allows a comparison of
prevalence rates worldwide.
Obesity has been recognized as an important contributing factor in the development of chronic and serious diseases, such as cardiovascular disease, diabetes mellitus type 2, hypertension, stroke, heart failure, dyslipidaemia, uric acid, sleep apnea which is the cause of sudden death in sleep and other diseases. The majority of research studies indicate that weight loss is the main goal of treatment of obesity. Taking medication as an option for the treatment of obesity should be the ultimate therapeutic tool because it is associated with many side effects. Conclusions: The results of the present review illustrate that obesity is a public health issue
which is rapidly increasing and thus needs to be addressed seriously. Specific diet combined
with physical activity can achieve the desired loss of body fat and are the most effective and
long-lasting ways to treat obesity.
Keywords: obesity-related diseases to obesity- medication-complications
Corresponding author:
Introduction
O threatens public global health. The because it affects people’s lives negatively and imposes excessive financial implications www.hsj.gr Health Science Journal® All Rights Reserved
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in every health system. In addition, obesity Assessment of obesity
focused not only on the prevalence and the Obesity is defined as the accumulation of significant consequences on the quality of required for the normal body function. This patients’ life. Furthermore, is associated with increased incidence of type 2 diabetes disease, arthritis, sleep apnea, and certain essential and the storage fat. The essential fat is necessary for the normal functions of the body and is mainly stored in the bone Organization (WHO), obesity is classified as marrow, the heart, the lung, the liver, the chronic and severe disease in developed and spleen and the muscle. The essential fat developing countries, affecting both adults also includes the female fat, which is stored and children. Recent research data suggest in the breasts and hips. Storage fat is the fat that the global incidence of obesity has stored mainly in the subcutaneous tissue as a increased more than 75% since 1980, while result of the additional energy received through food. In healthy young adults the developing countries and particularly, in low- total body fat represents the 15-20% of total income countries. -7 More than 1.1 billion adults are overweight, of which 312 million are obese. According to estimates of the International Obesity Task Force, 1,7 billion people are exposed to health risks related to type). Central obesity is characterized by body weight, while the increase in Body Mass location of the fat in the upper torso and Index (BMI) is responsible for more than 2.5 million deaths annually, which is expected to among the male population. Regional obesity is characterized by deposition of fat in the significantly among the different women.14-16 geographical regions of the planet. In The scientific data confirm that central Europe, higher incidence of obesity occurs in obesity is associated with greater health risks compared to the total obesity. In particular, compared to those of Western and Northern, it is associated with increased incidence of diabetes mellitus type II, as well as higher been carried out report different incidence The severity of obesity is estimated from rates of obesity, although all converge at the distribution in the human body. The accurate serious obesity problem. Greece ranks in the measurement of the amount of fat requires methods and equipment that exist only in European countries in rates of obesity and this finding underpins the spread of the clinical practice, more simple methods are used, such as the weight - height tables, the particularly after the formal abolition of the Body Mass Index (BMI) assessment and the skin fold measurement.14-16 The weight - height tables, which are published in many health, its’ underlying etiology has not been different versions, indicate an acceptable www.hsj.gr Health Science Journal® All Rights Reserved
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disadvantage in using them, is the fact that it is not possible to distinguish between fat and muscle percentage. Consequently, a very Cardiology classified obesity as an important muscular person is possible to be described disease. It is widely accepted that obesity common, easy and reliable way to classify cardiovascular risk factors and as it is shown by the Framingham Heart Study, body weight Although there is a high correlation between is classified as the third risk factor for BMI and fat percentage, it does not provide developing cardiovascular disease in men, information about the weight of the muscle formula that is defined by dividing the body weight to the second power of the height: BMI = body weight (Kg) / height cm.2 The clinical and biochemical disorders of the normal range is 20-25 kg/cm2. When the BMI of a person is > 40 kg/cm2, then this person hyperglaecemia and dyslipidaemia. During is characterized as severely obese. 14-16 the last two decades two important aspects Skin- fold measurements technique is the have been developed about the detrimental effects of obesity. The first concerns the importance of visceral fat and the second the endocrine function of adipose tissue, which produces a large number of molecules important information about the that modify the vascular, metabolic, immune accumulation and distribution of the body and other functions of the cardiovascular fat. More specifically, it is considered an system. Fat accumulation is accompanied by adequate tool for assessing central obesity. a commensurate increase in the volume of Also, the ratio of Waist to Hip (WHR) is cardiac cavities and the heart wall, while the another easy method for assessing central reduction of body fat is accompanied by a obesity. WHR is defined as the ratio between reduction in the adverse effects of cardiac the lower part of the crest of the iliac ala function. In addition, the increase of body and the perimeter of the hips, measured at fat results in a corresponding increase in Diseases associated with obesity
causes cardiac hypertrophy, as a result of Obesity affects all aspects of human life in a negative way and is associated with requirements. This increased work of the many diseases. Scientific data argue that the heart gradually leads to fatigue and heart morbidity, while 10 kg of weight loss can According to the literature, about 75-80% obesity starts. According to the literature, of diabetic patients are obese, showing that the increase in body weight after the age of obesity is a strong risk factor for developing 18-20 years is associated with statistically type 2 diabetes mellitus (DM). The risk for developing type 2 DM increases with higher disease. Also, the distribution of the fat and BMI, whereas, in case a person has already especially the accumulation of fat in the developed the disease, weight loss reduces abdomen rather than the obesity itself are this risk as well as mortality rates. Nine kg highly associated with the development of of weight loss reduce type 2 DM associated weight loss can significantly improve the disease, obesity is strongly associated with hypertension and atherosclerosis. www.hsj.gr Health Science Journal® All Rights Reserved
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Accumulation and swelling in the artery among obese men. In consistence to that, walls, which is made by immune cells and mortality rates by endometrium, uterine, consists of lipids (mainly) and connective cervical, ovarian, breast and gall bladder women. The two factors that might explain common disease among people whose weight the link between obesity and cancer are diet increases with age, while almost half of and endocrine disorders. Diet is related to According to the literature, increase of body disorders are related to hormone-related pressure (SBP) by 6 mmHg and diastolic blood pressure (DBP) by 4 mmHg. The risk is even play an important role on the morbidity and mortality in obese patients, although they predisposition. As a general rule, for every are usually underestimated. The syndrome 1% reduction in body weight SBP reduces by 1 obesity-hypoventilation is a heterogeneous Obesity is characterized by a pathologic situation with increased total cholesterol and dysfunction and failure of lung function, hypoventilation of the lung cells and the night-apnea syndrome. The sleepiness that is common among obese people and especially studies have shown that there is a strong Sometime after they are asleep, the upper respiratory tract gets blocked and hypoxemia and hypercapnia occur. This has as a result increased levels of plasma free fatty acids, the patient to wake up suddenly, in order to reduced activity in muscle lipoprotein lipase be able to breath normally again. This can especially during the REM phase of sleep, development of the metabolic syndrome.5,23- correlation between obesity and endocrine people with normal body weight, the effect of obesity on breathing function increases result in severe hypoxia, cardiac arrhythmia regardless of fat distribution and studies weight reverses these abnormalities, if heart problems have not been permanent yet. 31-34 earlier age in obese girls. Weight loss has beneficial effects on ovarian function and load exerted to bones and joints and explains arthritis, especially in the hip and the knee. Weight loss has as a result pain relief from testosterone. In addition, glucocorticoid decrease in bone mass, which increases with levels change with increased levels of plasma The majority of the data relating obesity and overall mortality risk, indicate that the predisposing factors increase the incidence higher the BMI (> 30) the higher the risk of of certain types of cancer. Mortality rates by mortality. In contrast, more than 9 kg weight loss in obese women is associated with 25% www.hsj.gr Health Science Journal® All Rights Reserved
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reduction in risk of mortality from all causes, food, the ones that inhibit the absorption of food from the gastrointestinal tract and the cardiovascular disease and cancer. Also, in case the patient has already developed an The drugs that reduce desire for food or obesity-related disease, intentional weight suppress the appetite lead to a reduced food loss still reduces mortality risk by 20%, According to their effect in the Central reduction) and type 2 diabetes mellitus (30- Nervous System, they are classified in three 40% reduction). It is important to distinguish additional categories: the ones that work between intentional weight loss and weight amphetamines), those that work through the Pharmaceutical treatment of obesity
serotonergic receptors and those that work Proper diet and physical exercise is the ideal method for creating a negative energy Simbutramin (Reductil). Simbutramin inhibits the binding of serotonin and nor-adrenaline Medication, as a method of treating obesity, should be chosen only when the nutritional treatment has been shown to fail. Although reducing the calorie intake as a result of medication helps in weight loss and prevents saturation while the increase in energy cost relapse, it has many side effects and the due to an increase in thermogenesis. 35-38 patient still needs to follow a certain diet absorbed by the gastrointestinal tract and has a long half-life, which allows daily medication must meet the following criteria: metabolized in the liver and is excreted diseases related to obesity such as diabetes (together with the metabolites), mainly by the kidneys. The main side effects include disease, night-apnea syndrome, degenerative arthritis, etc. should have been developed constipation. The drug is not recommended for people with a history of cardiovascular 3) At least two risk factors such as age ≥ disease and tachycardia, and in patients with non-regulated arterial hypertension. Studies hypertension, high LDL cholesterol, low HDL have shown that simbutramin increases heart cholesterol, high levels of fasting plasma rate by 4-5 beats/min and blood pressure by glucose or family history of early coronary di 3 mmHg. The increase in blood pressure is rarely the cause for stopping the specific 4) No beneficial results after following certain diet and physical exercise program that inhibit the absorption of food from the gastrointestinal tract and are divided into 2 further categories: a) the drugs that inhibit treatment of obesity starts back in 1893 gastric emptying and b) the drugs that inhibit intestinal absorption, like orlistat (Xenical). increase thermogenesis. Since then, there Orlistat inhibits the action of gastric and have been many drugs, which aimed either triglyceride hydrolysis and therefore inhibits energy costs. Many of them used only for a short period of time and almost all were reduction of absorption of dietary fat can reach up to 30%. The maximum activity is severe side effects. Today, the drugs for daily or immediately after meals. It has been categories; the ones that reduce desire for shown that the orlistat leads to a moderate www.hsj.gr Health Science Journal® All Rights Reserved
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decrease in total cholesterol, 10% reduction of LDL-cholesterol, 10% reduction of fasting 2. Heseker H., Schmid A. Epidemiology of administration. Orlistat has also been tested as a drug of diabetes type II prevention, 3. Sichieri R., do Nascimento S., Coutinho gastrointestinal disorders are the main side which occur in 15-30% of the patients who use the drug, are usually mild and subside metabolism. This category includes thyroid obesity in France. Presse Med. 2007;36(6 hormones, caffeine, nicotine, drugs that act as the sympathetic NS such as ephedrine, the hormone and human gonadotropin that give positive results in the treatment of obesity. obesity internationally are orlistat and Simbutramin. The choice of medication is based on family history, the accompanying 10. Berghöfer A., Pischon T., Reinhold T., diseases and the diet, and should not be Conclusions
Obesity is a severe pathologic situation that causes both morphological and functional associated with a high risk of morbidity and individual's life and has deleterious effects, not only on health and self-esteem but also on the socio-economic status of the patient. At the same time, each government spends a huge amount of money for the treatment of the different diseases caused by obesity. Seeking medical help is an essential step because it helps to reduce morbidity and mortality rates among obese individuals. Bibliography
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