Acting against excess weight

The assessment for the weight classification of adults is based on the calculation of the Body Mass Index. (Photo:

An increasing number of people worldwide are overweight. Children and teenagers are also concerned. But what does being overweight really mean, apart from an aesthetic point of view? And most of all, what can be done to lose this extra weight in a sustainable way?

“Basically, we know that an excess body weight is a sign for energy imbalance, i.e. when the energy taken in and the energy spent are not well balanced over a long period of time. The critical question we must ask ourselves is: “Why”?, says Dr. Hadil Al Tokmachi, specialist for internal medicine at the rehabilitation clinic in Rheinfelden (Switzerland). Very often, the reasons for excess weight are a deficient nutrition coupled with a lack of exercise. The lifestyle in industrial countries is characterised by an overabundance of food and insufficient physical exercise. The composition of the food we eat also plays a significant role. Indeed, industrial manufactured products usually contain many additives and flavour enhancers. “Stress, lack of sleep and of physical exercise, as well as hereditary conditions or environmental factors are all possible causes for excess weight or obesity. This implies that it is not necessarily a question of genetics alone, but also of unfavourable circumstances”.

Normal eight or excess weight?

“The assessment for the weight classification of adults is based on the calculation of the Body Mass Index”, explains Dr. Al Tokmachi. As regards this weight classification, Dr. Heinrich von Grünigen, president of the Swiss foundation for obesity (Schweizerischen Adipositas-Stiftung SAPS), goes on to say: “A BMI of 30 indicates a state of morbid obesity, resp. adiposity. This is caused by an excessive accumulation of fat cells in the abdominal cavity as a result of energy unbalance”. Apart from the degree of excess weight, the fat distribution pattern also represents a major risk to health. “Abdominal fat in particular is closely associated with cardiovascular diseases”, says Dr. Al Tokmachi.

Dangerous consequences

An excess weight can lead to various general illnesses and discomforts. Symptoms such as shortness of breath, snoring or heavy perspiration are quite frequent. Similarly, injuries to the bones or articulations with related pain symptoms can also occur frequently. “The most common accompanying illnesses of obesity are high blood pressure, impaired metabolism, type 2 diabetes, high blood lipid values, resulting in a much higher risk of suffering from a heart attack or a stroke, but also from cancer or articulation problems”, says Dr. von Grünigen.

Regular exercise is beneficial for weight loss. (Photo:

Overweight prevention

Overweight people wishing to lose weight should focus mainly on the following: eat less and more healthy food, drink much and exercise more! Food should be well-balanced, rich in fibres and vitamins while poor in refined sugars and fats. Regular exercise is beneficial for the metabolism, and relaxation techniques help to reduce stress. Furthermore, sufficient sleep is also very important.

Slimming products

Supermarkets and pharmacies offer a wide range of various products that aim at helping to shed pounds. Whether they are fat-absorbing substances, filling agents, or so-called carb blockers, any of these products should be used only in combination with a durable nutrition transition, sufficient liquid input as well as exercise.

Beware of diets!

In the long run, problems related to health issues or deficiencies can appear. Generally speaking, “diets can achieve a rapid loss of excess weight, but also cause a reduction of the muscular mass. The less muscular mass is available, the slower the metabolism functions, which ultimately causes less energy to be burnt. This patterns occurs similarly with every diet, which often leads to the yo-yo effect”, explains Tamara Sick, certified nutritionist.

Therapeutic approaches

Therapeutic approaches should only be implemented under medical supervision. Such therapies aim at stabilising body weight while striving to achieve a stable normal weight. According to the degree of excess weight, an average loss of approx. 5 to 8 kg a year can be considered realistic.

The conservative therapy

With the help a medical nutritionist, a concept can be developed for a so-called “conservative therapy”. This will involve analysing the eating behaviour and identifying nutritional “errors”, in order to establish an individual dietary plan for the patient. Nutritional counselling takes into account the patient’s personal and professional background. Therapies including exercise and behaviour should contribute to sustainably modify behavioural patterns that have lead to excess weight. “Without a durable change of lifestyle with sufficient exercise, diverse and fresh food, no more than 24 g of sugar a day, a regular eating pattern, a good work-life balance as well as stress management strategies and good quality sleep, a sustainable weight loss cannot be achieved”, adds Tamara Sick.

Surgical measures

Under specific circumstances, a surgery can also be performed. “Bariatric surgery distinguishes itself from the two commonly used methods, i.e. gastric bypass surgery and sleeve gastrectomy. Both interventions reduce the quantity of digested food and influence the hormonal metabolism. The gastric bypass surgery is hardly ever performed anymore, as it has often led to complications”, explains Dr. von Grünigen.

Early protection of children

“With adults, weight loss or weight gain is usually accompanied by a transformation of the size of the fat cells. Children, however, can modify the number of fat cells in their body. Furthermore, the number of fat cells increases much more rapidly with already overweight children as with adults”, says Dr. Al Tokmachi.

The fundamentals are, for children and teenagers, a nutrient-rich and well-balanced diet as well as sufficient exercise. Should such efforts not be efficient, it is recommended to seek professional advise before too long.

Text: Medical Tribune public – 08/2017
Translation from German: MyH – 08/2017

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