4 March is World Obesity Day. Meeting with Maya Gianadda, head of the Dietetics Department, and Dr Raffaela Morard Passera of the Valère Obesity Centre speaking about «Metabolism and Surgery.»
Dr Raffaela Morard Passera: Obesity is defined as an excess of body fat with adverse health consequences. The most commonly used indicator for diagnosing obesity is the Body Mass Index (BMI): weight (kg)/height² (m²). Here is the WHO BMI classification:
It can also be assessed by other measurements, such as waist circumference or body composition (fat mass vs. muscle mass). Obesity has been recognised as a chronic disease by several health organisations, including the World Health Organisation since 2008.
Dr Raffaela Morard Passera: Obesity is considered a disease because it is associated with an increased risk of other diseases such as cardiovascular disease, type 2 diabetes, certain forms of cancer and sleep apnoea. These diseases are considered comorbidities when they are linked to obesity. Obesity also has an impact on quality of life, such as sleep, mobility and mental health.
Maya Gianadda: Indeed, weight loss, even moderate weight loss in some cases, significantly reduces obesity-related comorbidities and thus improves health.
A loss of 5% to 10% of body weight, for example, improves insulin sensitivity and can thus reduce type 2 diabetes in some people. This is on condition that we do not enter into a yo-yo effect, which I will discuss in more detail later on, linked to restrictive diets that reinforce obesity, but rather introduce the changes necessary to maintain weight loss over time.
Maya Gianadda: There are many possible answers to this question. Simply put, we could blame an increasingly rich and ultra-processed diet coupled with a sedentary lifestyle. In addition, other factors such as stress, fatigue or depression often lead to eating more, and our environment does not necessarily offer healthy food choices. We therefore live in an increasingly obesogenic environment! However, not everyone is equal in the face of this obesogenic environment. Hormonal and genetic factors come into play. Certain disadvantaged social classes are more affected. In other words, there are many ways to fall into the trap of obesity, and it becomes very difficult to get out of it.
Maya Gianadda : Because losing weight is not just a question of willpower. Obese people are often stigmatised because they are thought not to exercise enough and to eat too much. In fact, severely obese people suffer from a dysregulation of the feeling of fullness and hunger. Some patients express the feeling of always being hungry or increasingly hungry. Logically, the hormones that regulate hunger should block hunger in obesity. Unfortunately, these anorectic hormones can no longer function properly in obesity. The system goes into overdrive and the trap closes.
Dr Raffaela Morard Passera: Lasting and healthy weight loss is based on changes in both eating and physical habits, almost always coupled with a readjustment of hunger regulation.
In other words, it is necessary to attack obesity simultaneously with several weapons and over the long term. Dietetics, psychological support, surgery and certain recent medications are part of this anti-obesity arsenal. Numerous professionals and skills are therefore required in an interdisciplinary approach.
The BMI calculator is an index defined by the WHO and can be an indication of obesity. The BMI provides information about the relationship between height and weight, and age also plays a role in the calculation. It is calculated by dividing the weight by the height squared. The Body Mass Index (BMI) ranges on a scale from 18.5 (underweight) to over 40 (overweight grade 3).
Calculate your personal BMI directly here and find out in which range you are.
Body Mass Index Calculator
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