Obesity

Obesity is a "condition characterized by excess body fat distributed across the board in the various fatty areas of the body." Definition from the Flammarion Medicine Dictionary. Most often, obesity is assessed by the weight but note that there is no strict equivalence between weight and obesity since the weight involved, in addition to fat, bone, and water the muscle.Obesity is defined by a body mass index (BMI) and Body Mass Index (BMI). BMI is calculated by dividing the weight of the person by the square of height (kg / m2). If this index is greater than or equal to 30, the individual is considered obese. Between 25 and 30, we talk about préobésité. From 40 kg / m2, talkingmorbidly obese. This is the point at which we may see a morbidity secondary to different types of complications.

Epidemiology 
Obesity has become the first non-infectious disease in history. This is an epidemic that affects both the industrialized and developing countries. The current World Health Organization up its prevention and care as a priority in the field of nutritional pathology. 
- About 6 billion people, 3 billion are malnourished and some are becoming obese. 
 - 50% of Americans are overweight and 25% obese frankly. 
- In some Pacific islands, obesity affects nearly two-thirds of the population. 
- Europe has 30% of overweight adults and the number of obese children has doubled in five years.
 - In France there are obese 8 million, from 100 000 to 200 000 massive obesity (BMI> 40). A third of these patients are hypertensive, a diabetic and hyperlipidemic third parties. 
- Nationally, the prevalence of obesity has increased by about 45% between 1987 and 1996.
 - From a regional perspective, there is a very uneven distribution of this phenomenon on the French territory: the campaigns are more affected than cities, the Mediterranean suffers a particularly rapid and unfavorable changes ... Corsica is the region where there is the highest prevalence of France with a maximum of24% obese.
 - A disturbing progression as it relates to individuals increasingly young.

The causes of obesity 
Several factors explain obesity:
 1 / genetic factors: they have an undeniable role but are not the only ones responsibleA small number of genes have a significant impact on body size and the percentage or the regional distribution of body fat.Children aged overweight a decade with at least one obese parent have a 80% risk of becoming obese in adulthood against 10% chance if both parents are poor. 
2 / endocrinological factors: hormonal disorders, glandular 
3 / other medical factors 
4 / environmental factors and behavioral changes
 - Junk food with high dietary (high-fat food).Western populations tend to consume fewer calories and less fat than in 1960 when they grow regularly. This is explained by a change of lifestyle that is becoming increasingly sedentary.
 - Lack of physical activity: there is a real imbalance between ingested food and that expended. 

The risks 
Obesity is a major risk factor associated with the following diseases: 
- Hypertension
 - Non-insulin dependent type II diabetes 
- Heart disease
 - Greater risks for certain cancers such as bowel cancer and breast cancer
 - Other: cholesterol, sleep apnea, osteoarthritis, infertility, venous insufficiency, gastroesophageal reflux, urinary incontinence

Treatments for obesity 
1 / diet associated with physical activity 
2 / MedicationTwo drugs are currently available:

    Sibutramine, marketed in France since May 2001. It acts as an inhibitor of serotonin reuptake and noradrenaline. The main side effects are increased heart rate (3-7 bpm) and blood pressure at rest (2-3 mmHg). It should only be prescribed after revelation of the ineffectiveness of a single plan, and patients with a BMI of at least 30 kg / m2 or 27 kg / m2 and with an additional risk factor such as the type II diabetes or dyslipidaemia.
    The Xenical that blocks a portion of the absorption of ingested fat in the feed (30%). It eliminates 30 g fat per day or the equivalent of 300 calories. It has no side effects on the nervous system, heart or lung. It only acts on the intestine.Recall that the appetite suppressant drugs, appetite suppressants, were withdrawn from the European market in April 2000. They are believed to have serious side effects. 
3 / Cosmetic surgery
4 / Surgical procedures are often indicated in cases of morbid obesity. This is the case of stomach stapling, which aims to reduce stomach capacity by dividing it into two compartments like an hourglass. The narrow passage is created using a ring.The use of laparoscopic surgery avoids a large incision of the abdomen.