Why can't I lose weight? Obesity is not a cosmetic defect

The World Health Organization (WHO) alarms that in just 30 years (1980-2008) the percentage of obese people in the world has doubled. In Poland, too, we can speak of a real obesity epidemic. More than 50% of adults in our country are overweight, while about 20% of Poles are obese (according to some data, even 25%)! Experts predict that if we do not decisively change our lifestyle, in 2035 in Poland not one in five, but one in three people will be obese.

Causes of excessive body weight

It is not enough to say, "You eat too much. Eat less and move more and the problem will solve itself." The causes of obesity are many and complex. Nevertheless, fat accumulation is led by a positive energy balance, which is the result of an imbalance between the amount of energy supplied to the body and that which we are able to burn. This involves access to highly processed foods, rich in simple sugars and fat, irregular meals or skipping them, snacking on caloric snacks. Added to this are genetic and environmental factors, sedentary lifestyles, too little physical activity, haste and chronic stress, chronic diseases and side effects of taking certain medications, disorders in the hunger and satiety control center as a result of overfeeding. Food is closely linked to our psyche, emotions, and can act as a comfort or reward.

What is obesity?

It should be made clear that obesity is a disease. In the international classification of diseases, it has its own number (E-66). It is an excessive accumulation of body fat above 30% in women and above 20% in men. To assess the percentage of body fat, a body composition test should be performed on a professional device (body composition analysis).

A simpler way is to calculate BMI (Body Mass Index) and interpret it based on the WHO classification in the table.

You can also measure your waist circumference at the level of your belly button. Weight reduction is recommended especially if it is ≥ 88 cm in women and ≥ 102 cm in men. Ideally, however, the waist circumference for women should not exceed 80 cm, while for men it should be 94 cm.

Why is obesity dangerous?

Obesity is a disease that poses a threat to health and life. It significantly increases the risk of type 2 diabetes, hypertension, dyslipidemia, gallbladder disease, insulin resistance. Obese people are more likely to have ischemic heart disease, myocardial infarction, stroke, sleep apnea, shortness of breath, osteoarthritis, gout, polycystic ovary syndrome, endocrine disorders, fertility disorders, certain types of cancer (e.g. colon, breast, ovarian, prostate, liver and biliary tract diseases). Obesity is also often accompanied by insomnia, depressive states associated with, among other things, low self-esteem and lack of acceptance by the environment. That's why it's WORTH reducing your body weight, first and foremost FOR YOUR HEALTH.

Where to start in treating obesity?

The first step may be a visit to the family doctor, who will order basic blood tests and assess the degree of obesity. An essential part of treatment will be lifestyle modification involving dietary changes combined with physical activity tailored to your abilities. At this stage, it is very helpful to have the support of an experienced nutritionist who will plan a management strategy. It is important to remember that a "miracle diet" does not exist. The role of the dietitian is to help you permanently change your eating habits in a safe and healthy way.

Sometimes drug treatment combined with diet therapy or, in very advanced situations, surgical treatment of obesity (CHLO) may also be necessary. If a doctor diagnoses obesity, its treatment can be reimbursed by the National Health Service.

Natalia Parulska, M.D.
Clinical Dietitian