MAINZ – With regard to obesity, i.e. being overweight, doctors are already talking about an epidemic. Obesity has now even overtaken malnutrition in terms of its medical significance. ‘Obesity is a major challenge for modern medicine. Many disciplines deal with the secondary disorders of obesity. While obesity itself is not generally considered a disease, its consequences for health are classified as a disease,’ explains Prof. Dr. med. Dr. h. c. Christian Wüster, Head of the Hormone & Metabolism Centre in Mainz. The consequences of obesity sometimes affect not only the biomedical, but also the psychological and social sphere of life of those affected.
Obesity is still on the rise. The British ‘Children of the 90s’ study[1] showed that one in five participants in their mid-20s already had a fatty liver. This is a liver disease that is mainly caused in wealthier countries by a so-called hypercaloric diet. As it progresses, it can lead to liver cirrhosis. ‘The consequences of obesity are often underestimated.
Non-alcoholic fatty liver disease (NAFLD) is responsible for around one fifth of currently known liver cirrhoses and is therefore one of the most common indications for a liver transplant,’ explains Prof Wüster.
The Mainz-based endocrinologist is seeing an increasing number of obesity cases in his practice, even among younger patients. From an endocrinological point of view, the first step is to rule out a metabolic disorder as the cause of the obesity. In particular, disorders of sugar and fat metabolism can lead to obesity. Hormonal causes may also play a role. This is the case, for example, in the context of an underactive thyroid or an overactive adrenal cortex. Endocrinologists refer to the latter condition as Cushing’s syndrome. Tu-more, trauma or surgery can also be ruled out as factors influencing weight. ‘From a diagnostic point of view, we endocrinologists come into play when the cause of the excess weight is not clear. In unexplained cases of obesity, those affected should consider visiting an endocrinologist,’ recommends the specialist.
[1] Lancet Gastroenterology & Hepatology (2020; doi: 10.1016/S2468-1253(19)30419-4)