Severe Overweight (Obesity)
Obesity - also known as obeseness, adiposity or adipositas – refers to severe overweight due to excessive body fat. According to the World Health Organization (WHO) we speak about obesity, if the body mass index (BMI) equals 30 kg/m² or lies above this value. For classification we distinguish between three levels of severity:
- Obesity level I BMI 30 to 34.9
- Obesity level II BMI 35 to 39.9
- Obesity level III BMI 40 and above
BMI = body weight (in kg) : (body height in meters x body height in meters) Example: 82 kg : (1.65 m x 1.65 m) = 30.1
Obesity grade III is also called "Adipositas permagna“" or "morbid obesity". It carries a significantly increased risk for various diseases and is often accompanied by cardiovascular diseases, diabetes type 2, hypertension, degenerative diseases of the skeleton (in particular joints), gout, gall bladder diseases, sleep apnoea and other ailments. Quite frequently patients also suffer from psychological stress due to their physical appearance. The German Cancer Research Center (DKFZ) in Heidelberg assumes that, for the future there will be a close connection between the increase of cancer and the increase of obesity in our population.
Nevertheless, it is not only the BMI that is crucial for the risk of a disease, but also the bodily fat distribution pattern. In particular an increased accumulation of abdominal fat (fat distribution "apple body shape") is deemed to be the trigger for the metabolic syndrome, a precursor of diabetes. If body fat mainly sits on hips, buttocks and thighs ("pear body shape"), this is considered to be significantly less risky.
Fatty tissue around the abdominal area is considered the most harmful one: It creates numerous substances which promote an insulin resistance - and thus the incidence of diabetes. An abdominal girth that is considered to increase the risk starts at 80 cm for women and 92 cm for men. Particularly at risk are women with an abdominal girth as of 88 cm and men as of 102 cm.
There are also other clinical measurements used for the description of overweight:
The waist-to-hip ratio
(WHR) is a ratio achieved when dividing the waist circumference by the hip circumference. Men with a waist-to-hip ratio above 1.0 and women above 0.85 are at a higher risk for the metabolic syndrome.
The waist-to-height ratio (WHtR) is a ratio achieved, when dividing the waist circumference by the height. Standard values are:
- Up to 50 years of age 0.32 to 0.5
- 50 to 60 years of age 0.5 to 0.6
- 60 years and above below 0.6
All values above could significantly damage the health of the patient.
The treatment of obesity
is generally very complex. In each individual case aspects related to nutrition, physiology of movement, psychology plus social factors need to be considered. Severe cases might require medicinal, maybe even surgical measures.