Types of obesity: characteristics and risks

The obesity It is a chronic disease with a high prevalence worldwide that, generally, is associated with a multitude of health complications.

Scientific data show that this phenomenon seems to be increasing in recent years, which is why it has become a public health problem, especially in developed countries.

Being overweight: a worrying reality ...

The World Health Organization (WHO, 2015) states that there are 1.9 billion adults in the world who are overweight, of which, more than 600 million suffer from obesity. In Spain, obesity has also become a serious problem, and this is confirmed by the data of the ENRICA study, which conclude that 39% of the Spanish population is overweight and 22.9% obesity.

Due to the complexity of this phenomenon, the most effective treatment to combat this condition is made up of three basic pillars: nutrition, psychological aspects and physical exercise.

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Causes of obesity

Obesity is a multicausal phenomenon and, therefore, the causes are due to several factors:

those of genetic and endocrine origin, which account for 30%, and those of environmental origin, which represent 70%.

The latter include excessive food intake, especially unhealthy products, lack of physical exercise and, in general, a sedentary lifestyle.

Obesity and serious health problems

Obesity brings with it serious problems for the health of people affected with this condition. As Miguel Soca and Niño Peña conclude in an investigation carried out in 2009: “Obesity can cause a set of metabolic abnormalities, called metabolic syndrome (MS): a series of disorders characterized by intolerance to glucose, diabetes, alterations in blood lipids and increased blood pressure ”.

Likewise, obesity negatively affects hope and quality of life, as well as aesthetics body which, consequently, can cause social and psychological problems for the individual with this condition.

Diagnosis of obesity

Obesity is diagnosed, more than by weight, by the percentage of body fat of the individual. In general, in adult men, approximately 12-20% of their body weight is made up of fat. In the case of women, the percentage is slightly higher, 20-30%, mainly due to hormones such as estrogen.

Currently, there are different methods that exist to quantify the percentage of body fat. Biompedance, X-ray engineering or densitometry are some examples. However, one of the most used methods is the Body Mass Index (BMI), obtained by the relationship between weight expressed in kilograms and height in meters squared (BMI: Weight / height2). With the result of this index Overweight is defined as individuals with a BMI equal to or greater than 25 Kg / m2 and obese those who have a BMI equal to or greater than 30 kg / m2.

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Calculating body fat percentage

BMI is an easy measure to obtain, with a high correlation with body composition, and is useful as a diagnostic value. What's more, the higher the BMI an individual has, the greater the possibility of developing morbidities associated with excess fat. However, BMI has its limitations and has been criticized for not allowing differentiation between the percentage of fat and muscle mass.

If the percentage of fat mass is considered, obesity corresponds to a fat percentage greater than 25% in men and 30% in women. To estimate the percentage of body fat, skinfolds are a very valid option. With this method it is necessary to do the summation of four folds: the bicipital, tricipital, subscapular and suprailiac

Finally, another of the measures used for the diagnosis of obesity is the waist index hip (ICC), a specific anthropometric tool to measure fat levels intra-abdominal. This formula allows dividing the waist circumference by the hip circumference (ICC: waist circumference in centimeters / hip circumference in centimeters). The WHO establishes normal levels for the waist-hip index of approximately 0.8 in women and 1 in men.

Types of obesity

Obesity can be classified in different ways depending on the criteria established. One of the most used classifications is based on the distribution of body fat, in which there are three categories. According to the SEEDO Consensus (2007), they are the following:

1. Homogeneous distribution obesity

Excess fat does not predominate in any area of ​​the body, which is why it is called obesity with a homogeneous distribution.

2. Gynoid or peripheral obesity (pear-shaped)

Fat is basically located on the hips and thighs. This type of distribution is mainly related to venous return problems in the lower extremities (varicose veins) and knee osteoarthritis. Women are more likely to suffer from this type of obesity.

3. Android, central or abdominal obesity (apple-shaped)

The excess fat is located in the area on the face, chest and abdomen. It is associated with an increased risk of dyslipidemia, diabetes, cardiovascular disease, and mortality. This type of obesity is more common in men than in women.

Other classifications of obesity

In addition to the previous classification, there are others such as the following:

Types of obesity according to degree of risk

According to the consensus of the Spanish Society for the Study of Obesity (SEEDO 2007), obesity can also be classified as follows, taking into account the BMI:

• Insufficient weight: Weight is below normal. The BMI is less than 18.5 kg / m2. It is not considered overweight.
• Normal weight: It is the normal weight of a person with respect to his height. The BMI is the ideal: 18.5-24.9 kg / m2. It is not considered overweight.
• Overweight: Overweight occurs when the person weighs more than he should weigh according to her height. BMI 25-26.9 kg / m2.
• Overweight II: The person weighs more than they should be for their height, but without being obese. BMI 27.29.9 kg / m2.
• Type obesityI: First degree of obesity. BMI 30-34.9 kg / m2.
• Type II obesity: Second degree of obesity BMI 35- 39.9 kg / m2.
• Type III obesity: This type of obesity is also called morbid obesity. BMI 40-49.9 kg / m2.
• Type IV obesity: This type of obesity is also known as extreme obesity. BMI greater than 50 kg / m2.

Types of obesity according to the cause

Depending on the source of obesity, it can be:

• Genetic obesity: the individual has received genetic inheritance or predisposition to have obesity.
• Dietary obesity: characterized by a sedentary lifestyle and unhealthy food intake.
• Obesity due to mismatch: The person never feels satiated by a maladjustment in the hunger regulation system.
• Thermogenic defect obesity: The body does not burn calories efficiently.
• Nervous type obesity: It is obesity caused by psychological problems such as anxiety, stress and depression.
• Obesity due to endocrine diseases: It is obesity caused by hormonal diseases, for example, hyperthyroidism.
• Chromosomal obesity: This type of obesity is associated with chromosomal defects.

Bibliographic references:

• Rodríguez Artalejo F. (2011) Epidemiology of obesity in Spain: ENRICA study. V NAOS Convention. Madrid: Center for Biomedical Research in Epidemiology and Public Health network.