20 Septmber 2025, Saturday

Overweight and obesity are among the most pressing global health challenges. They significantly increase the risk of developing and worsening chronic non-communicable diseases, such as:

• Type 2 diabetes
• Arterial hypertension
• Ischemic heart disease
• Non-alcoholic fatty liver disease (NAFLD) and others

According to global data, over 250 million people suffer from some degree of obesity, which represents approximately 7% of the adult population.

 

Types (by origin)

 

1. Primary (Alimentary) Obesity

Caused by an imbalance between energy intake and expenditure, often in the context of genetic predisposition.

Main contributing factors:

• Low physical activity
• Frequent consumption of high-calorie, fat-rich foods
• Irregular eating patterns

 

2. Secondary (Symptomatic) Obesity

Results from underlying diseases or pathological conditions, or the use of certain medications (e.g., corticosteroids, antidepressants).

 

Weight Assessment

 

Obesity severity is determined using the Body Mass Index (BMI) formula:

BMI = weight (kg) / height² (m²)

• < 18.5 — underweight
• 18.5–24.9 — normal weight
• 25.0–29.9 — overweight
• ≥ 30.0 — obesity (Class I–III)

 

Treatment Strategy

 

Goal: gradual and sustained weight loss without harming health.

1. Diet Therapy

• Reduce caloric intake by 500–1000 kcal/day
• Limit fat and simple sugar intake
• Individualized nutritional plan based on sex, age, and activity level
• Diet should be sustainable and realistic, not extreme

2. Physical Activity

• Aerobic exercise: at least 150 minutes/week
• Moderate strength training: 2–3 sessions/week
• Aim to reduce fat mass and preserve muscle mass

3. Pharmacotherapy (only under medical supervision)

Indicated for:

• BMI ≥ 30
• BMI ≥ 27 with comorbidities

Examples:

• Orlistat
• Liraglutide
• Naltrexone/bupropion

4. Surgical Treatment (Bariatric Surgery)

Indications:

• BMI ≥ 40
• BMI ≥ 35 with serious comorbidities

Approaches:

• Stomach volume reduction (e.g., sleeve gastrectomy)
• Surgical removal of excess fat after stabilization

 

Final Notes & Recommendations

• Optimal weight loss: 0.5–1.0 kg per week
•  Avoid “quick fix” or miracle weight-loss products
• Every extra kilogram negatively affects cardiovascular, gastrointestinal, endocrine, reproductive, and nervous systems