Obesity
What is obesity?
Obesity is defined by the World Health Organisation (WHO) as abnormal or excessive fat accumulation that presents a risk to health. A body mass index (BMI) over 30 is considered obese in adults. (World Health Organisation, 2023)
The interpretation of BMI in children up to the age of 18 is based on age and gender using reference graphs that can be found in the child's health record to the girls' graph, the boys' graph). Obesity is when the BMI is above the 97th percentile or 2 standard deviations on the graph according to age and gender.
Body Mass Index (BMI) and other measurements
BMI (Body Mass Index) is a simple measurement of weight in relation to height commonly used to estimate if an adult is overweight or obese. It corresponds to weight divided by height squared, expressed in kg/m2. (World Health Organisation, 2023)
Abdominal circumference or waist size is a better measurement as an increase defines abdominal or central obesity, which is a marker of cardiometabolic risk. (HAS, 2018)
The risk depends above all on the type of fat and how it is distributed, and is specific to each individual.
Dietitians translate your targets into a plan that meets your nutritional needs and suits your lifestyle. Reimbursement is possible according to certain criteria.
Causes
Obesity is recognised by the WHO as a complex, multi-factor chronic illness. Obesity can be caused by several factors:
- Genetics
- Prenatal exposure
- Illness and medication
- Eating disorders
- Eating habits
- Lack of physical activity and a sedentary lifestyle
- Environment
- Social determinants
- Stress, lack of sleep, night work
- Feelings of hunger and satiety
- Composition of the microbiota
The causes of obesity are complex, and an understanding of the onset of the disease of obesity, with its many facets and complications, calls for in-depth research to be able to develop effective treatments.
Consequences
Obesity is generally a precursor of other chronic diseases such as type 2 diabetes, cardiovascular diseases and certain types of cancer.
Other complications include respiratory diseases such a sleep apnoea, hormonal disturbances and orthopaedic and psychological illnesses.
Is obesity a common disease?
According to the European Health Interview Survey (EHIS) conducted in Luxembourg in 2019, the proportion of obese adults increased between 2014 and 2019 from 15.6 % to 16.5 %. In 2019, the proportion of obese men (18.4 %) is higher than that of obese women (14.6 %). 40 % of men and 24 % of women in the Grand Duchy of Luxembourg are overweight.
The 2022 Health Behaviour in School-Aged Children study shows that the proportion of young people aged 11 to 18 in Luxembourg who are overweight or obese is 21 %, a slight increase since the 2018 study, in which the equivalent figure was 19 %.
School medical data also shows a slight increase in overweight children and adolescents.
School medical staff monitor the weight of pupils. Pupils can then be directed to the relevant services for their needs.
Department for School Medicine of the Health Directorate (Division de la médecine scolaire de la Direction de la santé)
The fight against obesity: actions at several levels
The fight against obesity is a challenge faced by all of society, the public authorities, charities, companies, education and research. It involves health in all policies.
There are 3 main areas we can work on:
Health promotion
This seeks to maintain health and adopt healthy lifestyles or promote factors that protect health such as a balanced diet and regular physical exercise. The two pillars of health promotion are Health Literacy and structural changes to the environment in order to make healthy choices the easiest choices.
De Programme GIMB gëtt Tipps an Tricks, wéi een sech equilibréiert ernäert a reegelméisseg beweegt.
Preventing obesity from a young age
The aim of primary prevention is to eliminate or reduce risk factors for health, by tackling excess weight for example.
In the case of people who are overweight, weight reduction is easier than for those who are obese. Regular weight monitoring, at home or in a health centre, is recommended. Following this screening, the GP, occupational doctor, school doctor or other healthcare professional can steer patients towards appropriate treatment.
Speak to your GP.
Medizinische Sportgruppen für Personen mit orthopädischen & metabolischen Störungen offers appropriate physical activities for overweight or obese individuals.
The League offers professional help to overweight children and adolescents. (Personal dietary consultation, monitoring, information, advice, cooking lessons, free service)
Obesity: what treatments are available?
Treatment encompasses all aspects of healthcare, multidisciplinary behavioural therapy, obesity-focused health cures, medication and surgeries.
At MONDORF, an interdisciplinary team provides support and guidance to obese patients, working to improve their health and quality of life by teaching them about healthy everyday habits.
The precise criteria for the treatment are defined in the recommendations of the Luxembourg Scientific Health Council (Conseil scientifique du domaine de la santé) on the medical and surgical treatment of obesity.
Group psychotherapy for eating disorders in the context of obesity using the cognitive behavioural therapy model, schema therapy, hypnosis and EMDR.
There are several levels to treatment:
- Behavioural therapy with a psychological, dietary and physical activity programme with gradual transformation of eating habits and physical activity
- Obesity-focused health cure
- Medication
- Surgery
The CNS has established criteria for reimbursement of the various treatments.
In all cases, the patient's therapeutic education remains at the heart of the treatment.
The multidisciplinary team of the CHEM Obesity Clinic offers a surgical pathway according to the legal criteria in force, as part of a personalised and individual dietary and psychological approach.
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