Let Us Get to Know Obesity, a Friend of Cancer, Diabetes and Cardiovascular Disease

Looking at disease-related causes of death worldwide, cardiovascular disease, cancer and type 2 diabetes occupy the top three places. Examining their causes more closely reveals that their frequency is not coincidental. Consider obesity, for example.

Obesity is currently the second most important cause of preventable death after smoking. Moreover, obesity, the most important known cause of cancer after smoking, is also the most important cause of type 2 diabetes. In the presence of obesity, high cholesterol and type 2 diabetes, it also becomes a very important risk factor for cardiovascular diseases . In this seemingly complex system, where one disease actually prepares the ground for another, obesity is the most important predisposing factor—almost a friend—to these 3 diseases known as the leading causes of death.

The Most Important Health Problem of Our Time Hides Itself

Obesity , in its simplest terms, means excessive fat tissue accumulated in the body. Modern lifestyles have changed our eating habits, obesity has become increasingly common, and unfortunately it has become the most important health problem of our time . The real danger is that obesity develops slowly and is widespread worldwide. Consequently, societies increasingly accept it rather than recognize it as a disease; in a sense, they become accustomed to obesity.

Preventive medicine recommends screening adults worldwide for obesity. Men of average weight have %15-20 body fat, while women have %25-30. Since measuring body fat percentage is not very easy and its accuracy may not be very reliable, obesity is now defined as excessive weight rather than excessive fat accumulation.

How Is Body Mass Index Calculated?

The most widely used screening methods for assessing obesity are determining BMI and measuring waist circumference. BMI (Body Mass Index) is the height obtained by dividing weight in kilograms by square meters (BMI = kg /m2). A BMI of 25-29 is considered slightly overweight, while a BMI above 30 is classified as obesity. A value above 40 is classified as grade 3 obesity, called severe (morbid, meaning potentially fatal) obesity. Fat accumulation around the abdomen (apple-shaped obesity) is considered to increase heart disease risk more than accumulation around the hips and thighs (pear-shaped obesity). In men, a waist circumference exceeding 94 cm indicates increased risk and exceeding 102 cm indicates high risk; in women, exceeding 80 cm indicates increased risk and exceeding 88 cm indicates high risk.

Alarming Figures

According to World Health Organization data, obesity has increased worldwide in the past 35 years by a factor of 2. The rate has risen in our country as elsewhere and is expected to multiply further over time unless measures are taken. Among OECD countries, Türkiye ranked after America (%28,7) and Iceland (%22,2) as the 3rd country most affected by obesity (%19,9). Turkish Statistical Institute (TÜİK) data show that obesity rose from 2008, when it was 15,2 percent to 2014, when it reached 19,9 percent (an increase of 31,1 percent). Among people over 15 in our country, approximately %34 are overweight and %20 are obese, bringing the proportion with weight problems above %50.

How Does Obesity Develop?

Several factors contribute to obesity. Modifiable environmental factors such as eating habits, physical activity, sedentary living and irregular sleep are the main causes of obesity and excess weight. Other factors, such as genetics, cannot be changed. Those most commonly encountered include leptin deficiency and melanocortin-4 receptor mutations. Environmental and genetic factors interact physiologically, creating a third factor called energy balance. Obesity occurs when the energy balance between calories consumed and expended is positive.

How Does Obesity Relate to Its Closest Friends?

Being overweight or obese causes hardening and narrowing of the arteries (atherosclerosis), increasing the risk of heart attack and stroke . Rising blood sugar eventually increases insulin resistance , which over time increases the risk of type 2 diabetes . Accumulated fat cells, increased fatty acids and inflammatory components, together with increasing insulin resistance, increase susceptibility to certain cancers. Breast cancer (particularly in postmenopausal women), bowel cancer , uterine cancer , liver cancer, gallbladder, esophageal and pancreatic and kidney cancers are among the cancers thought to be associated with obesity.

Does Obesity Have Other Friends?

Being overweight or obese brings many health problems. Compared with normal-weight individuals, obese people have less muscle mass and more fat mass. Fat increases not only beneath the skin but also around internal organs, compressing surrounding tissues and causing certain clinical consequences. Thus, high blood pressure, high cholesterol, heart failure and arrhythmia, kidney disease, fatty liver disease, gallbladder disease, reflux, sleep apnea syndrome, osteoarthritis (joint stiffness and pain) and gout are other friends frequently accompanying obesity.

To Lose Weight: Eat Less, Follow a Healthy Diet, Exercise and, of Course, Stay Determined…

Lifestyle changes should be the most important step in tackling excess weight and obesity, which pose so many dangers to our health. Two very simple recommendations—changing eating habits and increasing physical activity—will help you not only lose weight healthily but also avoid many additional disease risks caused by obesity. They will also substantially improve your quality of life. With today’s technology, various applications and tools help us learn foods’ nutritional value and calorie content and calculate energy expended during physical activities. In particular, the Mediterranean Diet combined with regular exercise will steadily bring you to your ideal weight. Support from your doctor and other healthcare professionals will help ensure that weight-loss programs and exercise do not harm your health. There are also limited medication options for weight loss and bariatric surgery (obesity surgery), but although these methods appear effective in the short term, they carry serious side effects and risks. Discuss with your doctor which approach is most suitable for you.