**: Yakudu
Written by: Gohar
Every country is affected by obesity to some extent, and no exception is it. The global popularity of Novo Nordisk's Wegovy and Eli Lilly's Zepbound illustrates the extent of obesity. Some low-income countries have seen the highest rates of obesity in the past decade. No country reported a decrease in the prevalence of obesity among its citizens, and no country is on track to meet WHO's target of keeping obesity prevalence at 2010 levels unchanged from 2010 levels by 2025. ** seems to be much more difficult than carbon reduction. According to the current trend,Overweight and obesity will cost the global economy more than $4 trillion (1 trillion = 1 trillion) by 2035, accounting for nearly 3% of current global GDP levels.
part 1
Background on obesity
Currently, the most commonly used measure of obesity is the body mass index (BMI, the index obtained by dividing the square of weight in kilograms by height (m) kg m2): BMI greater than or equal to 25 kg m2 is defined as overweight, and BMI greater than or equal to 30 is obese.
Obesity is not just a matter of appearance, but seriously affects people's physical health. For example, obese people have significantly higher rates of cardiovascular disease:
Among men with BMIs of 30 to 39, the incidence of cardiovascular events per 1000 person-years20.21 cases, compared with every 1000 person-years for men with a normal BMI13.72 casesBMI is 30 to 39The incidence of cardiovascular events per 1,000 person-years was 9 percent in women9.97 cases, while the BMI is normal per 1000 person-years for women6.37 cases.Currently, there are five main categories of interventions for obesity management:In obese people, a weight loss of 5% to 10% increases systolic blood pressure by about 3 mm Hg in people with hypertension, while glycosylated hemoglobin may decrease by 06% to 1%.
Behavioral interventions. Nourishment.
Physical activity. Drugs**.
Metabolism and ** surgery.
Commonly prescribed medications such as antidepressants (e.g., mirtazapine, amitriptyline) and hypoglycemic drugs such as glibenclamide or insulin can cause weight gain, and clinicians should review and consider alternative medications. Currently, the FDA has approved six ** drugs for long-term use (Figure 1):
Semaglutide and Liraglutide (GLP-1 receptor agonists).
Tirzepatide (GLP-1 GIP dual receptor agonist).
Phentermine-topiramate (phentermine-topiramate).
naltrexone-bupropion (naltrexone-bupropion).
Orlistat
Figure 16 FDA-approved ** pharmaceutical chemical structures for long-term use.
Of these, tirzepatide was the most effective, with an average weight loss of 21% at 72 weeks. Endoscopic procedures (i.e., intragastric balloon and endoscopic sleeve gastroplasty) can achieve 10% to 13% weight loss within 6 months. At 12 months, metabolic and** surgery (i.e., laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass) can reduce weight by 25% to 30%.
part 2
Obesity trends
Between 1975 and 2014, the global prevalence of obesity in men increased from 32% to 108% and women from 64% rose to 149%。By 2025, 18% of men and 21% of women worldwide are expected to be obese. Projected by 2030, 48Nine percent of U.S. adults will be obese, and racial disparities in obesity rates will increase.
A study of more than 10,000 adolescents and young adults in China found that obesity increased from 10% to 12% during lockdown in early 20205%, and the overweight rate increased from 21% to 25%. According to the latest edition of the World Obesity Atlas published by the World Obesity Federation, current trends are taking placeBy 2035, the obesity rate (BMI greater than or equal to 30) in China will reach about 20% for adult men, more than 15% for women, and a staggering 50% for boys (Figure 2).
Figure 2The increase in the proportion of obese people in China published by the World Obesity Atlas, **World Obestiy Federation
A 5% weight loss can reduce systolic and diastolic blood pressure by 3 mm Hg and 2 mm Hg in hypertensive patients.
Losing 5% to 10% of body weight in people with type 2 diabetes may reduce glycosylated hemoglobin (HA1C) by 06% to 1%. 0% and increased HDL cholesterol levels by 2 mg dl [0.]052 mmol/l]。
Weight loss of 10% to 15% may improve other disease conditions (e.g., hepatic steatosis, obstructive sleep apnea).
Patients who lost more than 15% of their body weight, including those who underwent **surgery, had a reduction in all-cause mortality.
Losing weight can improve quality of life.
part 3
Obesity management pathways
Behavioral interventions.
All patients who are obese (or overweight with cardiometabolic abnormalities) should receive a multicomponent behavioral intervention (Table 1).
Table 1Behavioural interventions for obesity management.
Nutritional approach
It is recommended to reduce caloric intake (500 to 750 kcal per day, adjusted according to individual weight and activity. 2 Two taels of rice are equivalent to 120 kcal), specific strategies include (Table 1):
Control portion sizes.Note that a very low-calorie diet (800 kcal days) should be provided only under close medical supervision, that is, not to go on a self-diet.Reduce or eliminate ultra-processed foods (e.g., sugary drinks).
Increase your fruit and vegetable intake.
Physical activity.
Given that it has little effect on body weight, physical activity is not used as a stand-alone method of obesity**, but rather helps maintain weight and cardiometabolic health. Moderate-intensity aerobic exercise (defined as 50% to 70% of maximum heart rate) helps reduce visceral fat and moderate weight loss (average effect is 2-3 kg);Resistance training ("ironing") preserves "lean mass" during the process.
Clinical guidelines recommend that all patients participate in 150 to 300 minutes per week of moderate-intensity or 75 to 150 minutes per week of vigorous physical activity, as well as resistance training 2 to 3 times per week. Clinicians oppose sedentary behaviour and advocate behaviours such as walking for 2 minutes every 1 hour of sitting, or using stairs. By wearing other tools, such as activity trackers, practitioners can be motivated to add an additional 1,800 steps of physical activity per day and achieve a weight loss of 05 to 15 kg target.
Addendum].Ranking of adult male obesity rates by country (Note: the statistical period of data is not consistent across countries):
1.American Samoa (77.)1%）
2.Tuvalu (707%）
3.Cook Islands (68.)7%）
4.Tonga (66.)8%）
5.Wallis and Futuna (667%）
6.Niue (59.)2%）
7.Tokelau (586%）
8.Aruba (55.)7%）
9.Samoa (44.)8%）
10.United States (42.)2%）
11.Palau (403%）
12.Qatar (395%）
13.French Polynesia (38.)9%）
14.Saint Kitts and Nevis (37.)9%）
15.Kuwait (37.)6%）
16.South Korea (36.)3%）
17.Jordan (36.)1%）
18.New Caledonia (34%)
19.Libya (338%）
20.Bahrain (33%)
China (63% in 2015).
Country ranking of obesity rates among adult women (Note: the statistical period of data is not consistent across countries):
1.Tonga (82.)8%）
2.American Samoa (82.)7%）
3.Wallis and Futuna (73.)7%）
4.Cook Islands (70.)7%）
5.Samoa (68.)6%）
6.Tokelau (678%）
7.Niue (62.)7%）
8.Nauru (605%）
9.Antigua and Barbuda (60%)
10.Kiribati (556%）
11.Tuvalu (552%）
12.Bahamas (54.)8%）
13.Saint Kitts and Nevis (52.)5%）
14.The Federated States of Micronesia (Federated States of) (49.)6%）
15.Kuwait (49.)05%）
16.Egypt (48.)8%）
17.Jordan (482%）
18.Libya (474%）
19.Antigua (46.)5%）
20.Saint Lucia (46.)4%）
United States (41.)8%）
China (679% in 2015 data).
References:
1.world obesity atlas. world obesity federation. mar. 2023.
3.elmaleh-sachs, a. et al. obesity management in adults. a review. jama. 2023;330(20):2000-2015. doi:10.1001/jama.2023.19897
*Disclaimer: This article is only to introduce the research progress in the field of medical diseases or briefly describe the research overview or share relevant information about medicine, and is not and will not make a recommendation of ** or diagnostic solutions, nor does it constitute any recommendation for related investment. If there is any omission in the content, please feel free to communicate and point it out!