Genetic obesity: its causes and treatment | LebanonFiles

Amman Today

publish date 2021-06-19 08:46:02

Health professionals say it is time to consider obesity a disease related to genetics, biology and the way we live today.

New research adds to the growing scientific view that “healthy obesity” does not exist.

The results show that people who are significantly overweight have a 66 percent greater risk of developing chronic kidney disease than those of normal weight.

Many obese people say they not only have to live with stigma and prejudice but also struggle to get proper treatment.

wrong bleives
The 39-year-old has lived with obesity her entire life, and her body mass index (BMI) is over 40 which means she is medically classified as ‘morbidly obese’ and is overweight enough to put her health at risk.

“People think you’re unintelligent, lazy, binge-eating, that you did it yourself, and that’s optional,” she says.

“I just want to scream as loud as I can and tell them that everything you’re saying is not true,” she adds.

Sarah has spent most of her life trying to control her weight through diet and exercise, and says that her obesity is something she thinks about all the time.

When Sarah was a child living on the English island of Jersey, she said, she was a normal body size, but as she entered high school and began to transform like a girl in puberty, she began to feel different from many of her friends.

In her early teens, she was aware that her mother was always overweight and had tried a lot of diets, so Sarah did the same when she gained weight too.

At the age of 16, I decided to go on a diet that limited me to just 800 calories a day. During the summer holidays, she had reduced her clothing size from 14 to 10, and she was very happy to achieve that result, but this did not last long, as she gained weight and reached the size of her clothes to 20 within three years while studying in college, and the different diets that were Follow it, it works.

This was the beginning of her struggle with her weight, which continues to grow until now, she says.

Scientists have found that people’s genes are linked to their weight change even if they eat the same number of calories.

Obesity is hereditary
After graduating from university, Sarah worked in the pharmaceutical industry. Her job as a sales representative for diabetes meds was doing well, but she was surprised by her manager’s comment when, remembering their first meeting, he said he thought this young woman would be a good salesperson given how she did her job selling diabetes drugs.

Sarah says that making comments about body shape and size is now against the law.

When she turned 30, Sarah was obese and desperately needed to do something about it for her mental and physical health.

She embarked on a year-long project with a personal trainer, completed an Olympics exercise that included swimming 1.5 km, cycling 40 km and running 10 km, losing 55 kg.

Later, she conducted some tests that focused on her genetic makeup. The results showed two important things:

First, it has a different type of FTO gene that is linked to being overweight and increasing the risk of obesity.

Second, there is a mutation in the MC4 receptor that is related to binge eating.

Shaw Somers, Consultant Surgeon specializing in slimming procedures, has been treating obese people for many years.

Somers says that people like Sarah, who have certain genetics, are more likely to be obese than those who don’t.

But he says obesity is not just about genetics, it’s about psychology, inequality, and the food environment in which we live as well.

Historically, he says, people like Sarah with such genetics have had better chances of starvation throughout history, but with the abundance of high-calorie food today, they gain more weight “if they lack the strong will to help”.

“perfect storm”
Dr. Dennis Ratcliffe, a clinical psychologist who supports patients through bariatric surgery, says people’s past experiences can play an important role.

For example, she says, many people who have experienced trauma, abuse or neglect end up in a troubled relationship with food.

“I think there is something to do with the psychological experiences that people have, and the relationships that they start to form with food become as close to a storm as possible.”

The genetic and psychological factors associated with obesity are amplified when fatty foods rich in sugar are easily accessible and available at affordable prices.

Jade, a friend of Sarah’s who is obese, believes that areas like the one he lives in can have a huge impact on the health of those who live in them, as eight out of 20 fast food outlets where he lives.

Jade says he recently signed a petition to try to prevent more fast food outlets from opening.

Jade lost 56 kg of weight after hard training, Sarah continued her training and dieted regularly but it didn’t make any difference in her weight.

Many people are “biologically designed to store energy” as fat, says Dr. Abid Tehrani, senior lecturer in obesity medicine at the University of Birmingham.

He explains that signals from the brain’s hypothalamus that control appetite bombard a person with feelings of hunger and the desire to eat, and it’s almost impossible to resist them.

Therefore, even if a person successfully loses a few kilograms of weight by following a diet, his body remembers his base weight and strives to return to it.

The records of medical clinics in the United Kingdom showed that the chances of surviving annually to achieve a normal weight in people with morbid obesity is one in 700 to 1000 people.

After a long search, Sarah realized that her body was working ‘against her’.

Obesity is a disease
New research by a team of specialists at the University of Birmingham, Birmingham University Hospitals and Warwick Medical School has found that people who are obese have a 66 percent greater risk of developing chronic kidney disease than those of normal weight. This percentage applies even to people who do not have underlying health problems, such as diabetes or high blood pressure.

The study was published in the American Journal of Nephrology, based on the records of 4.5 million patients in the UK over a 20-year period.

Professor Indranil Dasgupta, Consultant Nephrologist at Birmingham University Hospitals and lead author of the paper, said: “This adds to a growing body of scientific research that has confirmed that ‘healthy obesity does not exist’.

Previous studies by the same team have found that those who are obese but do not have other health problems, have a higher risk of cardiovascular disease and stroke.

what is the cure?
In the United Kingdom, the National Health Service recommends treating four levels of obesity.

Encouraging eating healthy foods and an active lifestyle.
Exercising in gyms designated for slimming, and the expenses of these two cases are paid by the relevant local authorities.
The National Health Service offers Level III treatment, administering medications to patients and helping to plan the desired behavior and lifestyle.
As for the fourth level, it includes supporting patients through surgical intervention to carry out weight loss surgery.
And Sarah discovered when she earlier sought help from her doctor that the necessary care for obese patients is not available in all areas of the UK. The services provided vary, according to the administration of each region.

Each year in the UK around 6,000 people undergo surgery to help reduce their weight and dramatically improve their health.

England has one of the highest rates of adult obesity and one of the lowest per capita expenditures for this type of surgery compared to other European countries.

The most common bariatric surgery

Gastric banding: A band is placed around the stomach, which makes you feel full faster.
Installation of a gastric bypass by connecting the upper part of the stomach to the small intestine, which makes a person feel full faster, absorb fewer calories from food intake and improve metabolism.
Gastric Reduction: Part of the stomach is removed, so it is not possible to eat a lot of food and the person feels full sooner and the metabolism improves.
The UK government says it has launched a strategy to tackle obesity, and plans to increase overweight services so that more people with it can get NHS support.

It will also proceed to end the promotion of foods high in fat, sugar and salt.

The UK’s National Health Service says it will focus on supporting those suffering from obesity and other health problems such as type 2 diabetes and high blood pressure.

According to Dr. Abid Tehrani, research into drugs that suppress appetite, such as Saxenda and Semaglutide, is moving forward.

Sarah is focused on keeping her as healthy as possible and is determined to make the most of her life. She is professional in her work and successful and says that her self-confidence is high in all areas regardless of her weight, but despite everything she knows about obesity, she still wants to become thinner simply because she wants to adapt to her surroundings and not be the center of attention.

Being big, she says, means you’re thinking about the possibility of a misunderstanding or something wrong, even the thought of meeting a friend at the next bar, it might be a concern, “What will the chairs be like? Will there be chairs that will break as soon as I sit on them?”

“body positivity”
But for some obese people, Sarah’s acknowledgment of dissatisfaction with her size contradicts their argument that it is time to reject stigma and accept living happily as they are.

This is called “body positivity”. Sarah respects her, but says it doesn’t suit her.

“I look at some ‘body positivity’ members with a kind of jealousy for their self-love. They are a small group, but the wider community in the world has a completely different view.”

Sarah and her baby
Given that Sarah’s weight problems are mainly genetic, she does not know how this might affect her two-year-old daughter.

After a long struggle with obesity, Sarah hopes things will be better for her daughter.

“I just want her to know that everyone is born with a different shape and size. We have different skin and hair colors. It doesn’t matter what she looks like. I just want her to understand what she is and what I am. That’s all my concern.”

Sarah is setting up a charity to support obese people who feel stigmatized and misunderstood, and says the goal is to be a voice for why they are not.

For the many scientists and clinicians who have developed a deep understanding of obesity, the condition is a complex disease driven by a combination of factors. They say that blaming someone for suffering from this disease contradicts the scientific evidence.

“If blaming pays off, we would have an entire community of skinny people,” says Abed Tehrani. “Every obese person has been blamed time and time again, either by their doctors, their neighbours, their families or the wider community. It doesn’t work, so please, please. Stop it.”

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Source : اخبار الاردن

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