Obesity - Health Risks and Economic Costs
An increasing prevalence of obesity all
over the world reflects a lack of effective measures in both prevention
and treatment of obesity. Obesity as a disease has been underestimated
by the lay-public as well as health care providers. However, obesity represents
a substantial health problem associated with a decreased quality of life.
Obesity is linked to numerous chronic diseases (cardiovascular diseases,
diabetes, hyperlipidemia, gout, osteoarthritis, gall-stones, and bowel,
breast and genitourinary cancers) that lead to premature disability and
mortality. Health risks increase with a body mass index (BMI) over 25
in individuals 19-35 years of age and with a BMI over 27 in those 35 years
of age and older. Health risks also increase with an excess accumulation
of visceral fat manifested as an increase in waist circumference (>
100 cm) or in waist to hip ratio (> 0.85 for females and > 1.00
for males). According to studies carried out in different countries current
economic costs of obesity represent 5-8 percent of all direct health costs.
In contrast, effective treatment of obesity results in a substantial decrease
in expenditures associated with pharmacotherapy of hypertension, diabetes,
hyperlipidemia and osteoarthritis. Both scientists and clinicians involved
in obesity research and treatment recommend to introduce the long-term
weight management programs focussing more on the overall health of the
participants than the weight loss per se. Therefore, it will be necessary
to establish new realistic goals in the obesity management that reflect
reasonable weights and recently experienced beneficial health effects
of modest (5-10 percent) weight loss. Comprehensive obesity treatment
consisting of low fat diet, exercise, behavioral modification, drug therapy
and surgical procedures requires differentiated weight management programs
modified according to the degree and type of obesity as well as to current
health complications present. The Czech Society for the Study of Obesity
defined a comprehensive weight reduction program carried out in weight
reduction clubs, out-patient obesity clinics and in specialized departments
attached to the university hospitals. In order to provide an integrated
knowledge from many different disciplines connected with obesity three
week postgraduate course has been organized for physicians involved in
obesity management. Even the most spread weight reduction clubs in our
country (STOB) are supervised by the trained counselors. The main goal
of different weight management programs is to find out optimal approaches
leading to long-term beneficial outcome and ameliorating the variety of
disorders associated with obesity.
Source: Hainer V, Kunesova M, Parizkova
J, Stunkard A. IV. interni klinika 1. LF UK a VFN, Praha. 1997
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