If in France, the proportion of obese French people has continued to increase in recent years, the latest figures are not the most reassuring. According to a new study, conducted by the Journal of Clinical Medicine, 18-24 year olds are particularly affected by this excess weight. According to the Organization for Economic Co-operation and Development (OECD), obesity and related diseases will reduce global life expectancy by 0.9 to 4.2 years over the next 30 years (2.7 years on average compared to current life expectancy) (OECD, 2019). This trend is worrying to say the least. Explanations.
Definition: what is obesity?
L’obesity is a chronic disease characterized by a excessive accumulation of fat masslikely to have
consequences on physical, psychological and social health. Overweight and obesity are determined from body mass index (BMI), obtained by dividing weight by height squared. This simple indicator is widely used to assess a person’s build.
There are three main types of obesity:
- Android obesity (abdominal) : fat especially in the stomach, more at risk of cardiovascular disease;
- Gynoid obesity : fat especially on the hips, buttocks and thighs;
- Mixed obesity : abdominal and peripheral distribution.
How to interpret BMI?
If the BMI is:
- < 18.5 kg/m², this is underweight;
- = or > 18.5 and < 25 kg/m², build is normal;
- = or > 25 and < 30 kg/m², there is a overweight ;
- = or > 30 kg/m², this isobesity.
Overweight is defined by a BMI between 25.0 and 29.9 kg/m².
Obesity is defined by a BMI equal to or greater than 30.0 kg/m².
If BMI is included:
- between 30.0 and 34.9 kg/m², this ismoderate obesity (or class I) ;
- between 35.0 and 39.9 kg/m², it is a severe obesity (or class II) ;
- more than 40 kg/m², we are talking aboutmassive obesity (or class III).
THE waistline is a key indicator to assess abdominal obesity and the associated health risk. Unlike BMI, which measures overall body size, waist circumference measures body size. fat around the abdomenoften the most dangerous for the heart and blood vessels.
Thresholds to know
The waist circumference is considered too high if it is greater than or equal to:
- Women :
- ≥80cm
- Men :
- ≥94cm
A high waist circumference is linked to greater risk of cardiovascular disease, type 2 diabetes, hypertension and certain cancerseven if the BMI is within the norm.
What are the causes of obesity?
Obesity results from a complex combination of genetic, environmental, hormonal and behavioral factors. It mainly develops when energy intake exceeds the body’s needs, leading to excessive storage of fat in adipocytes, the cells specialized in storing triglycerides. Over time, these cells increase in size, and their number may also increase, especially when obesity begins early or becomes significant. The regulation of this process depends on nutritional, hormonal factors and the location of fats in the body. Some people have a
particular predispositioninfluenced by heredity, sedentary lifestyle, stress, psychological or eating disorders (such as overeating and bulimia), as well as lifestyle changes, smoking cessation or certain drug treatments.
Organic causes can also intervene: endocrine disorders such as hypothyroidism, type 2 diabetes, Cushing’s syndrome, growth hormone deficiency or insulinoma, as well as neurological disorders affecting eating (trauma, encephalitis, tumors or infections such as syphilis). To this are added rare genetic formssuch as Alström or Bardet-Biedl syndromes, characterized by obesity associated with hypogonadism, reduced height and sometimes mental retardation.
Beyond these specific causes, obesity is mainly
multifactorialwith a familial predisposition linked to eating habits, appetite regulations and the initial number of adipocytes at birth. In predisposed people, certain events
can promote weight gain: stress, depression, eating disorders, sudden cessation of physical activity, smoking cessation or hormonal episodes in women.
The fight against obesity essentially involves reducing risk factors (diabetes, high blood pressure, cardiovascular and respiratory diseases, etc.).
What diseases can make you gain weight and become obese (men, women)?
Several medical illnesses or conditions can lead to unintentional weight gain or promote obesity. Often, they act by disrupting the
metabolism, appetite or hormones. Here are the main ones:
Hormonal or endocrine disorders
- Hypothyroidism
- Cushing’s syndrome
- Polycystic ovarian syndrome (PCOS)
- Poorly controlled type 2 diabetes/insulin resistance
- Insulinoma
Psychiatric or neurological disorders
- Depression, anxiety : certain antidepressants or anxiolytics can stimulate the appetite;
- Sleep problems (sleep apnea, insomnia): hormonal disturbance (leptin, ghrelin): increased hunger;
- Prader-Willi syndrome : rare genetic disease: hyperphagia (excessive hunger) from childhood.
Chronic and inflammatory diseases
- Nephrotic syndrome : water and protein retention: swelling and weight gain;
- Heart failure : water retention, edema: apparent weight gain;
- Certain liver or kidney diseases : accumulation of fluid and disturbed metabolism.
Side effects of treatments
Some drugs can promote weight gain:
-
- Corticosteroids (e.g. prednisone)
- Antidepressants or mood stabilizers
- Antipsychotic treatments
- Certain hormonal treatments
What is the obesity rate in France?
47% of French people are overweight
According to the study, carried out by survey of around 10,000 people aged 18 or over, 47% of French people weigh too much (thus including overweight and obesity) compared to current health recommendations.
Among them, 17% of French people suffer from obesity, a disease characterized by an abnormal accumulation of fat, which is harmful to health (BMI greater than 30).
As for the youngest, if 18-24 year olds represent the least affected age group with only 9.2% obese, this share has quadrupled over the past twenty years.
“It is clear that contrary to the hopes of both public authorities and health professionals, since the implementation of the National Nutrition and Health Program in 2001, obesity in France has only increased, year after year.reveal Annick Fontbonne, researcher at Inserm and David Nocca, doctor at Montpellier University Hospital, both authors of the study.
Another interesting point of the survey: the most popular regions seem to be the most affected by this scourge. Thus, obesity would affect a significant part of the population (20%) residing in Hauts-de-France or the Grand Est.
And for good reason: the poorest inhabitants seem to consume more junk food.
“People are not “addicted” to bad food, but they are encouraged to buy it because it is cheaper“, reveals Annick Fontbonne during a press conference.
How do you know if you are overweight or obese?
The symptoms are essentially linked to excess weight on the body, which “suffers” excess fat. They include:
-
Shortness of breath on exertion
; - Rheumatological and joint pain
; -
Sleep problems
(apnea) ; - Menstrual problems in women ;
- Blood circulation problems in the legs.
What are the consequences of obesity (moderate, severe, morbid, mortality)?
Untreated obesity can have numerous health consequences:
- Increased risk of cardiovascular diseasesespecially in people with android fat distribution;
- Increased risk ofhigh blood pressureheart failure, myocardial infarction and stroke;
- Respiratory complications: sleep apnea syndrome which can cause daytime sleepiness;
- Damage to the musculoskeletal system,
leading to osteoarthritis of the knees, hip or spine, as well as herniated discs. - The liver and digestive system may be affected, with an increased risk of fatty liver, gallstones or hiatal hernia;
- Higher frequency of cancers,
particularly of the esophagus, in obese people.
Beyond the physical consequences, obesity strongly impacts the quality of life and mental health. It can lead to a loss of self-confidence, linked to the stigmatization of the disease, as well as poor body image and low self-esteem. These factors can result in difficulty finding employment, inequality at work, anxiety, depression or eating disorders. Fear of judgment can also limit the practice of physical activities and access to care. According to WHO Europe, nearly 19% of people with disabilities experience form of stigmaand school-aged children who are overweight are 63% more likely to be victims of harassment or bullying.
“The French are being hit hard by the economic crisis”
These results, worrying to say the least, do not greatly surprise Arnaud Cocaul, a nutritionist doctor whom we interviewed.
“The prevalence of obesity continues to increase at a rapid pace and this phenomenon risks increasing. The French are being hit hard by the economic crisis and disadvantaged social categories are unable to understand the fact that eating a balanced diet can be inexpensive. They favor junk food and large portions, full of fat, salt and sugar, even though it is precisely these ingredients that are responsible for weight gain.“, affirms the expert, before adding “LLack of sleep among young people also plays an essential role in obesity, as do the incentives for junk food in supermarkets and cinemas..”
In fact, to prevent obesity, “We should set up campaigns showing that it is possible to eat balanced and inexpensively. And, of course, distributors should also play the game by stopping the promotion of oversized industrial products: bags of candy near the checkouts or even popping XXL popcorn at the cinema.”