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Obesity: symptoms, causes and therapy

by Josephine Andrews
Published: Last Updated on 374 views

In the so-called industrialized nations, obesity is a growing health problem. In Germany, more than half of all adults are already overweight. Many children also weigh excessively many kilos. Obesity causes various complaints and promotes the development of chronic diseases. Read everything you need to know about the symptoms, diagnosis, consequences and treatment of obesity here!  

quick overview

  • Symptoms: exhaustion, reduced resilience, frequent tiredness , profuse sweating , back and joint pain (eg in the knees), sleep disorders , snoring , shortness of breath (up to shortness of breath with high exertion)
  • Diagnosis: Determination of the BMI value, physical examinations including determination of the ratio of waist to hips, blood pressure measurement, electrocardiogram (ECG), blood tests and ultrasound examination
  • Course and prognosis: Possible consequences are metabolic diseases such as type 2 diabetes mellitus, chronic cardiac insufficiency ( heart failure ), angina pectoris (“chest tightness”), heart attack and psychological problems such as depression.
  • Causes and risk factors: Genetic factors, excessive and high-calorie diet, lack of exercise, mental illness, diseases of the thyroid and adrenal glands, medication such as cortisone or the pill, social factors
  • Treatment: Treatment is usually not necessary if you are slightly overweight. If you are overweight or obese , nutritional advice, behavioral therapy and, in some cases, surgery (eg a stomach reduction ) can help.
  • Prevent: Regular exercise, healthy and balanced diet, stress reduction, maintaining hobbies

What is obesity?

The term “overweight” describes the increase in body weight due to an increase in body fat that goes beyond the normal range. If you are overweight, doctors speak of obesity.

Where are the fat pads?

In the case of obesity, doctors distinguish between two types of fat distribution – depending on where on the body the excess fat tissue tends to accumulate:

  • Android type (“apple type”): The fat pads are mainly located on the trunk, especially on the abdomen. This distribution of fat is often seen in men.
  • Gynoid type (“pear type”): The excess fat is increasingly deposited on the buttocks and thighs. This type is found especially in women.

The android type is associated with a higher risk of secondary diseases (such as diabetes and cardiovascular disease) than the gynoid type.

How common is obesity?

In Germany, around two thirds of all men (67 percent) and around half of all women (53 percent) are overweight. About a quarter of them (23 percent of men and 24 percent of women) are even severely overweight (adiposity).


You can read more about the causes, symptoms, diagnosis, therapy and prognosis of obesity in the article  Obesity .

obesity in children

The development of obesity in children and adolescents is proving to be problematic worldwide. The number of overweight children has increased in recent years.

You can read more about this topic in the article  Obesity in children .

What are typical symptoms?

Overweight people are usually less physically resilient, tired more quickly and often sweat more. Being overweight puts a strain on the entire organism, and the greater the excess kilos someone weighs.

The high body weight weighs heavily on the joints, especially on those in the lower spine area and on the hip, knee and ankle joints. The joints wear out faster and hurt ( knee pain , back pain, etc.).

More body tissue also means a higher demand for oxygen. The lungs therefore work harder in people who are overweight. Nevertheless, it often does not manage to take in enough oxygen for all body cells. Chronic oxygen deficiency develops. The fact that many overweight people often have short breathing pauses at night ( sleep apnea ) also contributes to this, which also impairs oxygen uptake. Snoring, less restful sleep and daytime sleepiness are the consequences of a disturbed night’s sleep.

When are you considered overweight?

For a more precise clarification of obesity, the doctor first talks to the patient in detail. Among other things, he inquires about his diet, his physical activity, any complaints and underlying diseases as well as mental stress.

This is followed by the physical examination. Above all, this includes the doctor measuring the patient’s height and weight in order to calculate the body mass index (BMI). The BMI value indicates the relationship between body weight and height. Doctors use this value to determine the degree of obesity. However, the calculation of the BMI does not include gender or age, which is why the BMI is only a guideline. The distribution of body fat, which has a decisive effect on the risk of secondary diseases, is not reflected in the BMI value. It is therefore helpful to calculate the ratio of waist to hip circumference (waist-to-hip ratio, WHR). With this measure, the distribution pattern of body fat (android or gynoid) can be determined more precisely.

The BMI as a guide

In order to determine whether and to what extent you are overweight, the doctor usually first calculates the BMI value. He divides the body weight (in kilograms) by the square of the height (in square meters).

According to this classification, a person with a BMI value of 25 kg/m 2 or more is considered overweight. Some physicians refer to being overweight with a BMI of 25 to 29.9 kg/m 2 as pre-obesity, which describes a precursor to obesity. However, this term is not universally applicable.

The problem is that the physique and muscle mass are included in the weight and influence the BMI value. However, they are not taken into account in the calculation, nor is age and gender. In some cases, this means that very muscular people are incorrectly considered overweight according to the BMI. This means that the BMI value is only suitable to a limited extent as the sole criterion for overweight.

Click here for the BMI calculator for adults.

Further investigations

Doctors use other examination methods to get a more precise picture of the existing concomitant or secondary diseases such as high blood pressure , diabetes or dyslipidemia and to classify the risk. These include, for example, blood pressure measurement, electrocardiogram (ECG), blood tests and an ultrasound examination of the liver and gallbladder .

Obesity and its consequences

Being overweight doesn’t happen suddenly. It usually develops over months or years. During this time, the body changes and gradually adapts to the changed demands caused by the higher weight. The more complex these changes are and the longer they last, the more difficult it is to treat. Obesity sometimes leads to a variety of health problems and secondary diseases. These include, for example, arteriosclerosis (hardening of the arteries) and subsequent cardiovascular diseases (such as heart failure, angina pectoris or “chest tightness”, heart attack and stroke ). That’s because the heartdoes more for overweight people than for people of normal weight. This is the only way to ensure adequate blood flow to the large amount of fatty tissue. This constant extra work puts a strain on the heart, as does the increased blood pressure, which is also a result of being overweight. In addition, body weight increases the risk of type 2 diabetes mellitus (diabetes), dyslipidemia (such as high cholesterol), fatty liver, flavor and gallstones , and joint wear and tear (arthrosis).

Being overweight also increases the risk of cancer: in women, for example, the risk of cervical, ovarian and postmenopausal breast cancer increases. Overweight men have an increased risk of prostate and colon cancer .

Depression and social withdrawal are also more common in overweight people.

What are the causes and risk factors?

Overweight occurs when the body is supplied with more energy than it needs in the long term. This positive energy balance has no single cause. Experts assume that several factors play a role in the development of obesity.

genetic predisposition

Studies suggest that obesity is largely genetic, as several members of a family are often overweight. This indicates that genetic factors also play a role in the development of obesity. For example, the so-called basal metabolic rate seems to be genetically determined, among other things. The basal metabolic rate is the amount of energy that a person burns at rest, ie required solely for the maintenance metabolism (maintaining organ functions and body heat, etc.). Some people have a high basal metabolic rate. Your body burns more energy overall. Even if they eat a lot, they don’t gain weight without being physically active.

On the other hand, people with a low basal metabolic rate burn fewer calories at rest, so they gain weight quickly if they eat a little more than they need. These people are therefore at a higher risk of becoming overweight.

Another factor that is genetically anchored and influences eating behavior is the feeling of hunger or satiety. Both are regulated by various signal substances that the body releases in the course of food intake. These signal substances include, for example, hormones and proteins, the function of which is often disrupted in overweight people.

An important hormone is leptin, which is formed in adipose tissue and released into the blood . Eating normally raises the level of leptin in the blood and it makes the brain feel full. In overweight people, where the level of fat in the blood is constantly elevated, the brain no longer responds properly to leptin and the feeling of satiety is absent.

eating behavior and nutrition

If the stomach fills up more and more while eating and the stomach wall stretches, nerves in particular report this to the brain. The brain evaluates this state as a feeling of satiety and signals this to the body. The hunger subsides. Other messenger substances are also involved in the saturation process. When the blood sugar level rises, the pancreas releases the hormone insulin. The more insulin gets into the blood, the more the feeling of hunger decreases. Hormones are also used as signal transmitters in the gut.

In some people, the transmission of information via the nerves, the supply of hormones or the signaling pathways of the hormones is disturbed, so that the feeling of satiety sets in late: Those affected therefore eat more than they need, which increases the risk of obesity

The fast food industry is making a further contribution to the growing prevalence of obesity in society, offering fast food with its mostly high-calorie meals and snacks – a welcome offer for people who are pressed for time. Because of the hasty consumption, for example on the way to the next appointment or while sitting at the desk, the body often does not register the feeling of satiety in time – one eats more than the body actually needs.

Lack of exercise

Many professionals have a (mainly) sedentary job. Many people use their car to get to work, to the supermarket or to the cinema. They also often spend their free time at home in front of the television or computer. For many people, the modern way of life is associated with a lack of exercise, which not only promotes the development of obesity. It also promotes other health problems such as cardiovascular diseases.

psychosocial factors

The influence of psychosocial factors in the development of obesity is sometimes large. So many people look for distraction and comfort in food when they are worried, stressed, bored, frustrated or lacking in self-confidence. Mental illnesses such as depression and anxiety disorders are often associated with being overweight. Apparently there is a connection between traumatic events such as experiences of violence or bullying and the risk of being overweight. Such events increase the risk that children and young people in particular will develop low self-esteem, which in turn triggers frustration and depression and, as a result, disturbed eating habits.

Upbringing rules and norms also have a major influence on the development of obesity, such as always eating your plate empty – even if you are already full. Equally important is obviously the behavior of the parents, which is regarded as a role model. If they do not eat consciously or show little interest in exercise, children usually adopt these behaviors.

social factors

Overweight and obesity are more common in lower social classes than in higher ones. Experts suspect that there are several reasons for this. With a lower income, for example, it is more difficult to finance a healthy diet with enough fruit and vegetables. In some cases it is a question of knowledge. There is a lack of knowledge about healthy food and how to prepare it.

In addition, people from lower social classes engage in sporting activities less frequently, for example in the context of clubs. As some studies have shown, this is partly due to financial reasons. People with lower incomes only use sports offers if they are free or cheaper.

Other underlying diseases

Diseases of organs that produce hormones often contribute to the development of obesity. These include, for example, an underactive thyroid gland (hypothyroidism) and tumors of the adrenal glands.


Some medications increase appetite, causing people to eat more than usual. This sometimes contributes to the development of obesity. Examples of such drugs are primarily hormone preparations such as the pill, medication for allergies, some psychotropic drugs and cortisone preparations.

treatment of obesity

Not every obesity needs to be treated directly. If the BMI is between 25 and 30 and there are no obesity-related diseases (such as high blood pressure, diabetes, depression, etc.), weight loss is not absolutely necessary. However, experts recommend not gaining any more weight.

Obesity with a BMI between 25 and 30 should be treated if:

  • Illnesses exist that are caused by being overweight and/or
  • illnesses that are aggravated by being overweight, and/or   
  • an android fat distribution type is present or
  • there is considerable psychosocial suffering.

If you are severely overweight (adiposity) with a BMI over 30, doctors generally recommend therapy.

Possible treatments for obesity

Experts advise patients who are overweight and who are already suffering from consequential damage to change their diet and exercise habits in the long term. The primary goal of obesity therapy is to lose weight and then maintain the weight.

In order to avoid excessive weight fluctuations when losing weight, it is advisable to lose weight slowly. This requires a coordinated therapy concept, which usually involves a comprehensive change in lifestyle. Since the therapy is individually tailored, it takes place in consultation with the doctor and/or a nutritionist.

The focus of these therapies is usually to first determine the reason for the overweight. If, for example, other diseases are involved in the development of obesity (such as hypothyroidism ), it is necessary to treat them first.

diet change

Patients learn a healthy diet as part of therapy. Whether overweight or normal weight – experts recommend a balanced, varied diet. Cereal products and potatoes (good feeling of satiety!), vegetables and fruit, milk and milk products should be on the daily menu.

Meat, sausages and eggs should only be consumed in moderation. It is recommended to eat fish once a week. Overweight people and people who tend to be overweight should eat little fat and rarely high-fat foods, and only consume sugar and salt in moderation.

It is also important to drink enough fluids, for example in the form of tap or mineral water or unsweetened tea. Lemonades and similar drinks are less cheap: they usually contain a lot of sugar and too few minerals. You should also be careful with alcohol, partly because it provides a lot of calories.

A healthy diet also includes preparing food that is tasty and gentle and eating it in peace. 

One-sided diets that promise rapid weight loss are not recommended. For one thing, you don’t learn a healthy diet that allows you to maintain it over the long term; on the other hand, as soon as you eat normally again, you usually quickly gain weight again – and often a few kilos more than before the lightning diet.

Physical activity and exercise

In addition to the change in diet, an exercise program is part of therapy to lose weight in a healthy way and then maintain the weight. Endurance sports such as walking, jogging, cycling and swimming are particularly suitable for people who are overweight. Any form of physical activity in everyday life, such as climbing stairs and going for a brisk walk, is also helpful.

Weight loss is a good way to counteract the loss of muscle mass. Fitness studios offer different options for this.

behavior therapy

Those who are severely overweight (adiposity), in particular, often suffer from mental disorders or are mentally stressed by stigmatization. In these cases, it is advisable to carry out the diet and exercise program as part of behavioral therapy. It also supports those affected in the treatment of mental disorders that trigger or exacerbate obesity.

drugs and surgeries

Drugs that support weight loss are usually only used to treat severe overweight (obesity) and surgical interventions (such as stomach reduction).

How to prevent obesity?

In most cases, obesity can be prevented with regular exercise in everyday life, through sport and with the help of a healthy and balanced diet. For example, if stress has a negative effect on weight, it is advisable to reduce it. Sometimes relaxation exercises help reduce stress. Hobbies also offer positive impulses.

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