The most frequent questions concerning the topic of adiposity

Therapies, nutrition and health risks with morbid overweight are the most interesting topics.

The IFB AdiposityDiseases presented itself with an information booth at the second health day of the University of Leipzig (6th October 2012) for its employees. The visitors could find out what health risks, body mass index, fat distribution on the body and adiposity therapies are all about. Here you can find the most frequently asked questions:

Is the body mass index meaningful?

The body mass index (BMI) evaluates the body weight in proportion to body height. The BMI shows whether there is a case of under, normal, overweight or even already obesity. But it only serves as a rough guideline and does neither take into account body stature, sex of the person nor the composition of the body mass of water, fat and muscles. This leads to muscular athletes having an increased BMI without having too much fat in their bodies. Doctors speak of adiposity at a BMI over 30 kg/m2.

In order to determine how health damaging overweight is the fat distribution in the whole body should be evaluated. People with abdominally centered overweight (apple type) run a higher risk of suffering from cardiovascular diseases or diabetes than people with hip centered fat pads (pear type). Other tests are also sensible such as blood, blood pressure and metabolism exams in order to notice probable accompanying diseases of overweight early on.

What are the health problems of overweight people?

There are overweight and even obese people who don't have any health complaints. That is mostly the case when the affected have lots of exercise. Some people already display health consequences with a moderate overweight and a BMI of 29 kg/m2, while others don't have any complaints with a BMI of 35. The risk for comorbidities such as diabetes, metabolism disorders, arteriosclerosis, high blood pressure or fat liver is significantly increased with a BMI of    30 kg/m2 and more. Complaints about joints, breathing and sleeping problems are often added with morbidly obese people. In order to notice the early symptoms of a comorbidity it is important to get checked by your general physician and maybe have them make glucose tolerance test. In the image below (in German) numerous comorbidities are listed:

How does an adiposity therapy at the IFB look like?

The IFB outpatient clinic for adults and for children and adolescents are the first contact point for people with a BMI of over 35 kg/m2 that already suffer from comorbidities. You need a referal from a specialist, e.g. an internist. At the first visit the patients should bring all their previous exams' results. A questionnaire determines the living and eating circumstances as well as complaints of the patient. Blood will be drawn in order to detect possibly existing metabolic disorders. During the second visit in the outpatient clinic the patient is examined and counseled by a doctor. The doctor also evaluates the questionnaire and the blood sample and developes an individual therapy plan alongside the patient. This entails a diet and exercise program that will be continuously adjusted during the following six months. Surgery such as stomach stapeling is a last ressort for when none of the conventional therapies show any success. Such a surgical intervention is being decided on at the IFB by an interdisciplinary team of experts and most often is the only remaining treatment option if the comorbidities would gravely worsen without surgery.

Which diet is most suited to lose weight?

Weight loss diets are divided in three groups according to their nutrient composition: the first group consists of low carb diets that reduce the intake of grain products, rice and potatoes. The second goup is the low fat diet. The third possibility is an energy reduced mixed diet that consists of fruits, vegetables, fish, vegetable oils and meat. A reduced energy intake is wanted by a balanced intake of nutrients.

For all diets it is important that they consist of enough proteins since the body would otherwise reduce muscle mass. The success of the diet depends on a negative energy balance. Weight can only be lost if the energy intake is lower than the energy consumption over a long period of time. It is not so much the composition of the main nutrients proteins, fat and carbs that decides whether a diet is successfull, but the ability to maintain those changed eating habits in the long term. "We work without absolute no-goes concerning food. We develop the diet together with the patients," explains Prof. Matthias Blüher who treats patients in the IFB outpatient clinic. "We aim for a calory-reduced healthy mixed diet that also may contain the patients' favourite dish as long as calories are reduced in the long term." Women should aim for 1500 calories daily while 1800 calories a day for men should cover the daily basic metabolic rate but still are below the calory needs, so that the body reaches for its reserves.

In order to prevent the well-known yoyo-effect the calory intake should not be cut down radically; about 500 to 800 kcal less per day. At the same time the pyhysical activity should be increased in order to increase the energy consumption and counter the loss of muscles. While this slows down the weight loss - 0.5 kilos a week are desireable -, the loss is also more permanent and the chance of keeping the goal weight is higher.

The next current topic by the way will deal with sports therapy within adiposity treatment since this is also a topic with many open questions.

Annekathrin Härter

Keywords: nutrition & diet, obesity treatment, causes of obesity, fat tissue & BMI