Obesity – colloquially called overweight – (obesity from Latin adeps “fat”) or obesitas (synonyms: obesity; ICD-10-GM E66.-: obesity) is defined as an excessive increase in body fat. The proportion of fat mass in body weight exceeds 30% in women and 20% in men. Obesity is very widespread in Germany. Only about one third of the population has a weight appropriate to their age and height. In European countries, normal weight – target weight – is determined using a formula according to Broca: Target weight = height (in cm) – 100 (men) or 105 (women); ideal weight = target weight – 10%. This formula can only be used to a limited extent for persons with a height of < 160 cm and > 180 cm. Whether a patient is overweight can be better calculated using the body mass index (BMI): BMI [kg/m2] = weight (in kg) / height (in m)2 The World Health Organization (WHO) has classified overweight according to BMI (see classification below). In order to be able to make a statement as to whether an increased BMI also has clinical relevance, the body fat of the affected person must be determined (measurement of the waist-to-hip ratio (apple type! pear type) or measurement of the waist circumference (pathological (pathological) abdominal circumference: ≥ 80 cm in women; ≥ 94 cm in men)). Especially visceral fat mass correlates with metabolic (“affecting the metabolism”) and cardiovascular (“affecting the cardiovascular system“) health risks. Sex ratio: At younger ages, men are more likely than women to be overweight. After the age of forty, women predominate. Frequency peak: the greatest increase in body weight is observed in men between the ages of 30 and 40 and in women between the ages of 40 and 50. Prevalence (disease incidence) is increasing in industrialized countries according to age. Germany has the highest proportion of obese people in Europe, followed by Great Britain and France. The recently published DEGS study by the Robert Koch Institute (2008-2011) shows that 67.1% of men and 53% of women in Germany are overweight, i.e. have a BMI > 24.9. 23.3% of men and 23.9% of women are obese (BMI > 29.9), with the largest increase occurring in the 25-34 age group. Of children and adolescents between the ages of 3 and 17 in Germany, 15% are overweight (KIGGS study 2003-2009). 6% of children and adolescents are obese. Compared to the reference values, there has been a 50% increase in overweight children and adolescents. As with adults, the number of overweight children and adolescents increases with age: 9% in the 3- to 6-year-old group are overweight, and 15% in the 7- to 10-year-old group. 17% of 14- to 17-year-olds have an increased body weight. Course and prognosis: People with obesity have a lower life expectancy because obesity itself accelerates aging processes and causes the development of numerous secondary diseases such as diabetes mellitus, hyperlipidemia (fat metabolism disorders) and cardiovascular diseases (affecting the cardiovascular system), which in turn accelerate aging processes. Obesity is thus one of the classic diseases of aging. Obesity therapy should always consist of a combination of nutrition, exercise and behavioral therapy. Only if the desired success is not achieved in this way should pharmacotherapy (drug treatment) or surgical treatment be considered. Overweight individuals over the age of 40 have a life shortened by approximately four years compared with normal-weight individuals of the same age (body mass index (BMI): 21-25 kg/m2): patients with a BMI of 25 kg/m2 had the lowest mortality risk (risk of death); each 5 kg/m2 increase in BMI was associated with a 21% increase in mortality risk (hazard ratio 1.21; 95% confidence interval 1.20-1.22).
