Obesity, the most stigmatised chronic disease
Spain is one of the European countries with the highest prevalence of obesity: more than 60% of people are overweight.
Since 1975, obesity has tripled worldwide and it is estimated that in European countries more than 70% of adults are unhealthily overweight. This over-accumulation of fat is highly detrimental to health and one of the causes is the imbalance in energy between calories consumed and calories burned.
In this regard, the World Health Organisation has been warning for years that this situation is a consequence of a diet rich in fat and a new more sedentary lifestyle.
For this reason, the great demand of researchers, medical professionals and patients is to recognise obesity as a chronic, complex and multifactorial disease. But it is also preventable and treatable.
Is obesity a risk factor?
A research study carried out by the Organisation for Economic Co-operation and Development (OECD) confirms that obesity in Spain reduces life expectancy by 2.6 years and it is responsible for 9.7% of health costs.
It also suggests that for every euro invested in obesity prevention in Spain, six would be gained back. The data provided by this report is clear: in our country, 25% of men and 23% of women live with obesity.
The WHO estimates that, by 2035, one in four people worldwide will be obese, a problem that is particularly worrying among children and young people.
In 2016, 41 million children under the age of five were overweight or obese, and nearly 340 million children and young people aged 5-19 were overweight or obese. According to data from the Aladdin 2019 study, 40.6% of the Spanish child population was overweight at that time. And more recently, the World Atlas of Obesity 2023 warned that almost 400 million children will be living with obesity in 2035.
How does obesity affect the heart?
Cardiovascular diseases, mainly heart disease and strokes, are linked to this excessive accumulation of fat. Obesity can be seen as a prelude to many other chronic diseases.
“Although it cannot be said that obesity in itself is strictly speaking a risk factor for cardiovascular disease, it is the cause of the appearance - or worsening - of several alterations that clearly predispose to cardiovascular disease,” explains Dr Silvia Pons, cardiologist at Assistencia Sanitària and member of the Complementary Cardiology Explorations service at Barcelona Hospital.
These pathologies also include diabetes, high blood pressure and hypercholesterolemia. In fact, according to the Spanish Heart Foundation, obesity multiplies the chances of presenting other cardiovascular risk factors such as hypertension. In this regard, it is estimated that high blood pressure is 2.5 times more frequent in obese people than in people of normal weight.
The importance of getting moving
To reverse this situation, it is important to encourage a good diet and emphasise the importance of physical activity. “Unfortunately, we cannot act on some cardiovascular risk factors such as age, gender and individual genetic predisposition, but we can modify others, such as cholesterol, sugar and blood pressure levels.
A direct and beneficial effect of physical exercise has been seen in all of these, so maintaining adequate physical activity and avoiding a sedentary lifestyle would be key. This, together with a balanced diet, makes it possible to achieve and maintain a correct weight,” argues Dr Silvia Pons.
A joint approach is also essential in which the patient is not blamed and in which, in addition to establishing healthy lifestyle habits, the psychological consequences of the disease are addressed, as an example.
Finally, there are several pharmacological and surgical treatments that can be used to combat obesity as a supplementary aid to diet. Dr Pons explains that, currently, “a series of drugs called GLP-1 analogues have appeared that have proven to be effective in reducing weight by reducing appetite”.
The cardiologist points out that their use without medical control can produce a rebound effect, and reminds us that, in the most serious cases of obesity, “there is the option of surgical treatment, which should always be carried out under the control of a specialised team”.
