Obesity in the context of "Dieting"

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⭐ Core Definition: Obesity

Obesity is a medical condition, considered by multiple organizations to be a disease, in which excess body fat has accumulated to such an extent that it can have negative effects on health. People are classified as obese when their body mass index (BMI)—a person's weight divided by the square of the person's height—is over 30 kg/m; the range 25–30 kg/m is defined as overweight. Some East Asian countries use lower values to calculate obesity. Obesity is a major cause of disability and is correlated with various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.

Obesity has individual, socioeconomic, and environmental causes. Some known causes are diet, low physical activity, automation, urbanization, genetic susceptibility, medications, mental disorders, economic policies, endocrine disorders, and exposure to endocrine-disrupting chemicals.

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In this Dossier

Obesity in the context of Public health

Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the determinants of health of a population and the threats it faces is the basis for public health. The public can be as small as a handful of people or as large as a village or an entire city; in the case of a pandemic it may encompass several continents. The concept of health takes into account physical, psychological, and social well-being, among other factors.

Public health is an interdisciplinary field. For example, epidemiology, biostatistics, social sciences and management of health services are all relevant. Other important sub-fields include environmental health, community health, behavioral health, health economics, public policy, mental health, health education, health politics, occupational safety, disability, oral health, gender issues in health, and sexual and reproductive health. Public health, together with primary care, secondary care, and tertiary care, is part of a country's overall healthcare system. Public health is implemented through the surveillance of cases and health indicators, and through the promotion of healthy behaviors. Common public health initiatives include promotion of hand-washing and breastfeeding, delivery of vaccinations, promoting ventilation and improved air quality both indoors and outdoors, suicide prevention, smoking cessation, obesity education, increasing healthcare accessibility and distribution of condoms to control the spread of sexually transmitted diseases.

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Obesity in the context of Abdominal obesity

Abdominal obesity, also known as central obesity and truncal obesity, is the human condition of an excessive concentration of visceral fat around the stomach and abdomen to such an extent that it is likely to harm its bearer's health. Abdominal obesity has been strongly linked to cardiovascular disease, Alzheimer's disease, and other metabolic and vascular diseases.

Visceral fat, central abdominal fat, and waist circumference show a strong association with type 2 diabetes.

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Obesity in the context of Malnutrition

Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is a deficiency, excess, or imbalance of energy, protein and other nutrients which adversely affects the body's tissues and form.

Malnutrition is a category of diseases that includes undernutrition and overnutrition. Undernutrition is a lack of nutrients, which can result in stunted growth, wasting, and being underweight. A surplus of nutrients causes overnutrition, which can result in obesity or toxic levels of micronutrients. In some developing countries, overnutrition in the form of obesity is beginning to appear within the same communities as undernutrition.

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Obesity in the context of Spontaneous abortion

Miscarriage, also known in medical terms as a spontaneous abortion, is an end to pregnancy resulting in the loss and expulsion of an embryo or fetus from the womb before it can survive independently. Miscarriage before 6 weeks of gestation is defined as biochemical loss by ESHRE. Once ultrasound or histological evidence shows that a pregnancy has existed, the term used is clinical miscarriage, which can be "early" (before 12 weeks) or "late" (between 12 and 21 weeks). Spontaneous fetal termination after 20 weeks of gestation is known as a stillbirth. The term miscarriage is sometimes used to refer to all forms of pregnancy loss and pregnancy with abortive outcomes before 20 weeks of gestation.

The most common symptom of a miscarriage is vaginal bleeding, with or without pain. Tissue and clot-like material may leave the uterus and pass through and out of the vagina. Risk factors for miscarriage include being an older parent, previous miscarriage, exposure to tobacco smoke, obesity, diabetes, thyroid problems, and drug or alcohol use. About 80% of miscarriages occur in the first 12 weeks of pregnancy (the first trimester). The underlying cause in about half of cases involves chromosomal abnormalities. Diagnosis of a miscarriage may involve checking to see if the cervix is open or sealed, testing blood levels of human chorionic gonadotropin (hCG), and an ultrasound. Other conditions that can produce similar symptoms include an ectopic pregnancy and implantation bleeding.

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Obesity in the context of Breastfeeding

Breastfeeding, also known as nursing, is the process where breast milk is fed to a child. Infants may suck the milk directly from the breast, or milk may be extracted with a pump and then fed to the infant. The World Health Organization (WHO) recommend that breastfeeding begin within the first hour of a baby's birth and continue as the baby wants. Health organizations, including the WHO, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than vitamin D, are typically given. The WHO recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond. Between 2015 and 2020, only 44% of infants were exclusively breastfed in the first six months of life.

Breastfeeding has a number of benefits to both mother and baby that infant formula lacks. Increased breastfeeding to near-universal levels in low and medium income countries could prevent approximately 820,000 deaths of children under the age of five annually. Breastfeeding decreases the risk of respiratory tract infections, ear infections, sudden infant death syndrome (SIDS), and diarrhea for the baby, both in developing and developed countries. Other benefits have been proposed to include lower risks of asthma, food allergies, and diabetes. Breastfeeding may also improve cognitive development and decrease the risk of obesity in adulthood.

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Obesity in the context of Shift work

Shift work is an employment practice designed to keep a service or production line operational at all times. The practice typically sees the day divided into shifts, set periods of time during which different groups of workers perform their duties. The term "shift work" includes both long-term night shifts and work schedules in which employees change or rotate shifts.

In medicine and epidemiology, shift work is considered a risk factor for some health problems in some individuals, as disruption to circadian rhythms may increase the probability of developing cardiovascular disease, cognitive impairment, diabetes, altered body composition and obesity, among other conditions.

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Obesity in the context of Childhood obesity

Childhood obesity is a condition where excess body fat negatively affects a child's health or well-being. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI. Due to the rising prevalence of obesity in children and its many adverse health effects it is being recognized as a serious public health concern. The term overweight rather than obese is often used when discussing childhood obesity, as it is less stigmatizing, although the term overweight can also refer to a different BMI category. The prevalence of childhood obesity is known to differ by sex and gender.

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Obesity in the context of Non-alcoholic steatohepatitis

Metabolic dysfunction–associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is a type of chronic liver disease. This condition is diagnosed when there is excessive fat build-up in the liver (hepatic steatosis), and at least one metabolic risk factor. When there is also increased alcohol intake, the term MetALD, or metabolic dysfunction and alcohol associated/related liver disease is used, and differentiated from alcohol-related liver disease (ALD) where alcohol is the predominant cause of the steatotic liver disease. The terms non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH, now known as metabolic dysfunction associated steatohepatitis (MASH)) have been used to describe different severities, the latter indicating the presence of further liver inflammation. MASLD may progress to MASH, with the risk of progression estimated as 7-35% per year. MASH may also regress to MASLD, especially with healthy diet, exercise and medications. Both MASLD and MASH have liver related complications such as cirrhosis, liver cancer, liver failure, as well as liver independent complications such as cardiovascular disease. These complications are much more common with MASH.

Obesity and type 2 diabetes are strong risk factors for MASLD. Other risks include being overweight, metabolic syndrome (defined as at least three of the five following medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum HDL cholesterol), a diet high in fructose, and older age. Obtaining a sample of the liver after excluding other potential causes of fatty liver can confirm the diagnosis.

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Obesity in the context of Cardiovascular disease

Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, arrhythmia, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.

The underlying mechanisms vary depending on the disease. It is estimated that dietary risk factors are associated with 53% of CVD deaths. Coronary artery disease, stroke, and peripheral artery disease involve atherosclerosis. This may be caused by high blood pressure, smoking, diabetes mellitus, lack of exercise, obesity, high blood cholesterol, poor diet, excessive alcohol consumption, and poor sleep, among other things. High blood pressure is estimated to account for approximately 13% of CVD deaths, while tobacco accounts for 9%, diabetes 6%, lack of exercise 6%, and obesity 5%. Rheumatic heart disease may follow untreated strep throat.

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