Preventing Obesity?

Chronic rapidly increasing obesity has become a majorproblems, increased risk of certain cancers. Other
public health problem in industrialized countries. Thedisorders such as cholesterol, sleep apnea,
World Health Organization (WHO) has called obesityosteoarthritis, infertility, venous insufficiency, reflux
epidemic first non-infectious history. Its managementesophagitis is frequently associated with obesity. In
is seen as a priority, and even more so than beingthe United States for example, overweight is
overweight affects individuals of younger andresponsible for the increase in diabetes among people
younger.in their thirties, in the space of ten years, this disease
Data collected by WHO showed that nearly half ofhas increased 76% in this age group and 33% in the
Americans are overweight, while a quarter of thegeneral population. Among children, too, a form of
population is frankly obese, a figure that may reachultra-early diabetes type 2 appeared a few years
70% of some populations. Europe is not spared, withago, which is growing alarmingly. The first cases of
30% of adults overweight, obesity affecting 12% ofatypical diabetes have been detected in France in
adults in Western Europe. In France, the prevalence1999 and the new disease is spreading.
of obesity has increased by about 45% betweenThe treatment of obesity does not limit itself to
l987 and 1996, and the number of obese individuals issolve a weight problem, but is to take charge of the
estimated at 8 million. Obesity also affects the youngmedical problem in its entirety. These treatment and
population, since the number of obese children hasprevention of physical disorders while developing a
doubled since the 80s, and the prevalence of obesityprogram tailored to weight loss. Recall that the
is estimated at 10-12% in children aged 6 to 12 years.approach of drug treatment of obesity is
Some studies predict that at this rate half thecontroversial. Medications such as diuretics,
European population is affected by obesity by 2030.anorexigenic catabolic and promote weight loss but
Obesity is a condition characterized by excess bodydo not act specifically on the reduction of fatty
fat (or fat). An international standard has beentissue. In addition, generally effective in early
adopted for measuring overweight and obesity. Thistreatment, they have not proven long term. And in
is the Body Mass Index (BMI), defined as weightmany cases, they are the cause of severe metabolic
divided by the square of height in kg/m2 (see box).disturbances, and therefore strongly discouraged.
BMI estimates the degree of obesity and thus allowsThus, diuretics that force the kidneys to excrete
to assess the health risk (co-morbidity) associatedmore water can cause serious electrolyte imbalance,
with it (see box). A person is considered obese whenor dehydration. The catabolic can be toxic, causing
this value is greater than or equal to 30 kg/m2. Inside effects on the heart and central nervous
addition to BMI, it should also measure the distributionsystem. The anorectic can lead to addiction and
of body fat. Indeed, it is now accepted that theother psychological disorders they were removed
presence of excess fat in the abdomen causes anfrom the European market at the beginning of the
increased risk to health. Thus, a waist circumferenceyear.
exceeding 88 cm in women, and 102 cm in men,A new treatment acting on the gastrointestinal tract
indicating visceral obesity and increased risk ofto block fat absorption in part by the agency was
developing other clinical problems.recently prescribed. Other molecules are under
The reasons for the development of obesity aredevelopment or after marketing procedure. Finally, in
many. Obesity is a multifactorial symptom resultingsome cases, the severity of obesity is such that
from complex interactions between a genetic andsurgery on the stomach is stimulated, the
more or less conducive environment in which itgastroplasty. It aims to reduce food intake by
operates. Indeed, the heritability of fatness isreducing gastric volume: the stomach and divided into
undeniable. Certain subjects resist obesity whilsttwo compartments, like an hourglass, the narrow
others are particularly sensitive to changes in diet andpassage is created using a ring. Considering its effect
its fat content. For example, an overweight child withon weight loss and reduction of associated
at least one obese parent has a 80% risk ofpathologies, it seems that the effectiveness of
becoming obese as adults, against only 10% chance ifgastroplasty in the short and medium terms is
both parents were poor.recognized. But among experts, Some wonder about
The various family analysis concluded that there wasthe soundness of a surgical measure in response to a
a small number of genes playing a role in body sizebehavioral problem.
and regional distribution of body fat. The results ofHowever, medication does not solve the problems of
research of the past three years suggest theweight and not "cure" not obese. They must be
involvement of a score of different genes ormedically monitored, and enroll in a comprehensive,
chromosomal regions. This means that theinvolving diet and regular physical activity. It is now
biochemical and physiological systems responsible forcommonly accepted that the diet must be
the formation of obesity are multiple and occur atcustomized, that is to say into consideration the
different stages of energy regulation. The humanhabits and feeding behavior of each individual, but
genome and advances in molecular genetics shouldalso realistic, since it is imperative that they are
therefore allow to classify the "obesity" based on thelong-term.
metabolic mechanisms put into play.In industrialized countries, the economic cost of
However, research suggests that genetic factors areobesity and associated diseases is 2.4 to 5% of
involved themselves in less than one third of caseshealth spending. Of course, the numbers vary
of obesity, showing that heredity does not explaindepending on the disease taken into account in
everything. Furthermore, it is unlikely that the humanassessing the costs and the proportion of cases
genome has changed in the space of one generationattributable to obesity-related illnesses each. Thus, a
to the point of causing the obesity epidemic raging.recent U.S. study estimated $ 238 billion (253 billion
The fact that, globally, overweight affects moreeuros) the expenditure incurred in the United States
people than the current generation of parents andto treat diseases related to obesity such as diabetes
grandparents, shows that other factors are to blame.and cardiovascular disease, these data do not take
Indeed, the rapid changes of environment andinclude expenditures related to treatment of obesity
behavior in recent decades are major determinantsitself. In Canada, the direct cost attributable to
of the rapid development of this disease. And it isobesity treatment has been estimated at more than
primarily in dietary habits and lifestyle that are the1.8 billion Canadian dollars in 1997 (1.3 billion euros),
root causes of the obesity epidemic.while in France the cost was $ 11.9 million francs in
Eating foods with high calories and high in fat, coupled1992 (1.8 million).
with a lifestyle more sedentary plays a role in theThe treatment of obesity is so complicated that it is
development of overweight and obesity trendsbetter not to accumulate excess weight rather than
around. Remember that gaining weight is never thetrying to lose. It is therefore important to adopt
result of an imbalance of energy balance, that is topreventive measures to avoid the occurrence of
say between calorie intake and food use by theoverweight among children and the installation of
organization (to operate and maintain bodyobesity in adults. The only way not to gain weight is
temperature ). When food intake exceeds energyto limit energy intake and exercise physical activity,
expenditure, excess energy is stored as body fat. Ifprevention campaigns should focus on the acquisition
this mechanism is set aside has enabled man toof basic knowledge about nutrition and proper eating
overcome periods of scarcity, it seems to serve inhabits while encouraging regular exercise. This is to
times of glut.establish a healthy lifestyle, and not to develop
Far from being merely a matter of aesthetics, beingobsessive behavior for weight control. It should
overweight causes many health complications:perhaps be guided by the preventive methods
respiratory disorders, hypertension, cardiovasculardeveloped in Finland, the only country to have
disease, metabolic disorders (diabetes type 2,stabilized their numbers.
noninsulin-dependent diabetes says bold), rheumatic