Obesity can be a risk factor for other diseases – 03/21/2023 – Health

President Luiz Inácio Lula da Silva (PT) said, during an event in Brasília last week, that obesity is a serious health problem just like hunger.

Lula made the statement when commenting that the Minister of Justice and Public Security, Flávio Dino, is practicing physical activity to lose weight. “Obesity causes as much harm as hunger. That’s why Flávio Dino is riding a bicycle,” said the president, only to be the target of criticism from opponents and people against what they called the “romanticization” of obesity.

The issue of obesity and overweight is in vogue. At the 2023 Oscar ceremony, actor Brendan Fraser won the award for best actor for his performance in the film “The Whale” (2022), in which he plays a reclusive university professor who lives with morbid obesity and refuses to treat the condition. . Part of the public considered the film fatphobic for portraying Fraser’s character, Charles, as a lazy person who refuses to take care of himself.

Stigmatization is one of the causes —if not the main one— for obese or overweight people not to seek medical help, says the coordinator of the Specialized Center for Obesity and Diabetes at the Hospital Alemão Oswaldo Cruz, Ricardo Cohen.

“They look at a person with obesity and say ‘he’s guilty’, ‘he doesn’t practice physical activity because he’s lazy’, but in fact we know that there is a biological substrate and also the influence of the environment that leads the individual to gain weight and have a greater risk of developing obesity”, he says. “Often, the individual does not yet have obesity, but is equally ‘guilty’ for seeking treatment.”

The doctor also says that it is important to define what obesity is and what obesity is.

“Nowadays nobody defines obesity from BMI [Índice de Massa Corporal, que é o cálculo do peso dividido pela altura ao quadrado], because there are large people with high BMI who are not obese. The differentiation that is made in the clinic is whether it is debilitating or not”, explains Cohen.

According to the expert, clinical obesity is characterized by the accumulation of adipose tissue (fat) that causes some sign or symptom of organ dysfunction or affects mobility. An important effect of obesity is the chronic inflammation of the body, which also impairs the immune system.

On the other hand, when there is adiposity but no organ damage or dysfunction, the condition is called preclinical obesity. “Today there are several ways and drugs to treat obesity and weight loss is just one of them”, he reinforces.

Associate Professor at the School of Nursing at UFMG (Federal University of Minas Gerais), Deborah Malta also states that obesity is not, epidemiologically, a disease in itself.

“Most physicians in clinical practice treat obesity as a disease, with its own classification, but for the WHO global burden of disease study [Organização Mundial da Saúde] we use obesity as a risk factor for several diseases”, he says.

Among the diseases for which obesity is a risk factor are diabetes, hypertension, cardiovascular and neurodegenerative diseases and some types of cancer.

The researcher points out, however, that the proportion of people living with overweight and obesity in Brazil and in the world is alarming, a scenario that has worsened with the pandemic. Between 2019 and 2021, the rate of overweight Brazilians increased from 55.37% to 57.25%, and, with obesity, from 20.27% to 22.35%.

Malta was, for nine years, coordinator of Vigitel, a national survey that gathers data on health indicators and risk factors. She points out that, although the pandemic has aggravated hunger in the country, President Lula is correct in saying that obesity is a serious problem.

“There is also a schooling component. Although men have a higher rate of overweight and obesity in general, women with lower schooling are the ones who showed the greatest increase in overweight (64%), which is a reflection of a worsening access to food and greater burden of poverty in these families”, says Malta.

“When we compare the risk factors for mortality, obesity has a risk factor about ten times greater than acute malnutrition. In addition, it can lead to health problems later on, such as diabetes and cardiovascular disease”, he adds.

For Paulo Augusto Miranda, president of the Brazilian Society of Endocrinology and Metabology, the coexistence in the same country of hunger and food insecurity, at one end, and obesity at the other end, reflects how the two problems are exacerbated by social inequality.

“That is why we cannot have a simplistic, individualized view of obesity, as if it were a matter of choice. It is also a matter of supply and access to food and how many people are driven to buy ultra-processed foods because they are cheap and offer a sense of satiety.”

The doctor also says that, in addition to the direct effects on health, obesity impacts the economy as a whole.

“By 2035, obesity costs could reach 3% of GDP [Produto Interno Bruto] Brazil, or more than US$ 70 billion. The question needs to be treated with a less simplistic look, through [da criação] of public policies of access to inviting spaces for the practice of physical activity and the reduction of the consumption of ultra-processed foods”, he concludes.