WORMS. People with obesity are not only burdened by their excess weight, but also often encounter stigmatisation and a lack of understanding in society. At least that is the experience of Prof Dr med Dr h.c. Christian Wüster, who also treats obesity patients from Worms at the Hormone and Metabolism Centre in Mainz. ‘However, morbid obesity is not an individual lifestyle problem, but a chronic disease with a variety of medical and psychosocial causes and consequences,’ emphasises the endocrinology specialist.
When is obesity medically recognised? The so-called body mass index (BMI) is often used to assess body weight. A BMI of more than 25 kg / m2 is referred to as obesity. From a BMI of 30 kg / m2, the person concerned is considered obese, i.e. morbidly overweight. As abdominal fat in particular is associated with health risks, doctors often also measure the ratio of abdominal to hip circumference. Men should have a waist circumference of no more than 94 cm and women should preferably have a waist circumference of less than 80 cm.
‘At higher values, the risk of secondary diseases increases significantly. Diabetes, cardiovascular diseases and certain forms of cancer can be caused by obesity,’ warns Prof Dr Wüster.
The main causes of obesity are well known: too little exercise and a diet that is too high in energy. However, in some cases, metabolic disorders or hormonal problems are also responsible for the fat deposits. For example, an underactive thyroid or an overactive adrenal cortex can cause the weight to increase significantly, even if the patient does not change anything about their diet. ‘If the causes of obesity are unclear, a thorough endocrinological exclusion diagnosis is advisable,’ recommends specialist Prof. Dr Wüster. As varied as the causes of obesity are, treatment must also be differentiated. Prof. Wüster and his team rely on a multimodal programme consisting of dietary changes, exercise and behavioural therapy. If the obesity is caused by hormonal disorders, the underlying disease must be treated first.