Do you see obesity as a disease or just a physical disorder? Generally, in our society, obesity is seen as a physical disorder rather than a disease. On the contrary, obesity is a disease that brings with it many diseases. The World Health Organization defines obesity and overweight as abnormal fat accumulation in the body. This disorder, seen in both developed and developing countries, is a chronic disorder that concerns children as well as adults.
Body mass index is the weight/height ratio used to determine overweight and obesity. According to WHO, those with a BMI of 25 kg/m2 and above are overweight, and those with a BMI of 30 kg/m2 and above are obese. For children, WHO published growth reference values for children aged 0-5 in 2006 and for children aged 5-19 in 2007, to be used in the classification of overweight and obesity. These values are used today and are called percentile curves. According to the standards set by WHO, adolescents with a body mass index above the 95th percentile for age and gender are defined as obese, and adolescents with a body mass index between the 85th and 95th percentiles are defined as overweight. Between the 15th and 85th percentile means normal weight, and below the 15th percentile means underweight. The parameters for obesity and overweight status are as follows.
Obesity Prevalence in Adults (18+ years)
• In 2016, 1.9 billion people aged 18 and over were overweight. was. Among them, more than 650 million adults were obese.
• In 2016, 39% of individuals aged 18 and over (39% of men and 40% of women) were overweight.
• In general 13% of the world's adult population (11% of men and 13% of women) was obese in 2016. • The number of obese people has approximately tripled between 1975 and 2016.
How Common is Obesity in Turkey?
When we look at the WHO 2008 general data, the prevalence of obesity is 27.8% in the population (% in women). 34 and 21.7% in men. In the recently announced European Cardiovascular Disease Statistics (ATLAS) research, the rates reported are in our country. It is 35.8% among women and 22.9% among men in our country. These are data outside our country. If we look at the studies carried out in our country; According to the meta-analysis of all studies on body mass index, BMI was generally found to be 27.4 kg/m2. This value is 28.2 kg/m2 for women and 26.5 kg/m2 for men. So, if we were to comment on the percentages, we are generally an overweight society right now. Rather than just body mass index and obesity rate, let's also take a look at the data on excess fat around the waist, called abdominal obesity, which is not widely known but carries great risks. considers waist circumference as very risky. In America, this is defined as 102 cm and above for men and 88 cm and above for women. According to the results of the Metabolic Syndrome Research (METSAR) conducted in our country, waist circumference was generally found to be 91.7 cm in men and 90.1 cm in women, with an average of 90.88 cm. These announced data are very serious and alarming. Obesity is now a global public health problem. The increases are progressing at tremendous rates not only in adults but also in childhood.
How is the Situation in Childhood?
Childhood obesity is the most serious problem of the 21st century, affecting every country in the world. It is one of the global public health problems. According to the World Health Organization (WHO) data,in just 40 years, the number of school-age children and adolescents has increased approximately 11-fold, from 11 million to 124 million. In other words, in 1975, only 10% of children and adolescents aged 5-19 were While less than 1 in 1 is obese, in 2016 this figure increased to 8% in men and 6% in women, reaching 124 million. An estimated 41 million of children under the age of 5 are obese. The total population of overweight and obese children and adolescents between the ages of 5 and 19 is approximately 340 million. If changes are not made in the current situation, the obesity rate of children and adolescents between the ages of 5-19 is expected to be higher in 2022, according to World Health Organization research.
The situation in our country is not encouraging at all. According to research, the data we have shows that the issue of obesity is very serious. . In the Turkey Nutrition and Health Survey (TBSA) conducted in 2010, it was determined that 8.5% of 2567 children in the 0-5 age group were obese/fat and 17.9% were slightly obese. In this study, the regions where obesity is most prevalent are; Eastern Marmara (12.5%), Aegean (11.4%), Mediterranean (11.4%) and Istanbul (10.8%). The regions where obesity is least seen are Southeastern Anatolia (3.4%), Eastern Black Sea (3.6%) and Northeastern Anatolia (4.1%). Since there is not enough research on the prevalence of obesity in school age, there is not enough data, but in a national study conducted in 2009, it was seen that 14.6% of school age children in the 6-10 age group were overweight and 6.5% were obese. There is no recent large-scale research.
Factors That Trigger Obesity
The main risk factors in the formation of obesity are listed as follows, according to the Turkish Public Health Institution of the Ministry of Health: excessive and wrong eating habits, lack of physical mobility, age, gender, education level, income level, hormonal and metabolic factors, psychological problems, very low calorie diet, some medications used (antidepressants, etc.), number of births and interval between births.
Obesity in children and adolescents is mostly caused by wrong eating habits, lack of physical activity, presence of an obese family member, medical illness, medications, stressful life events such as separation from family or parental divorce, family and peer problems, depression or other mental problems. It has been reported that it is related.
Age
Obesity can be seen at any age. Particularly prenatal, 5-7 years and adolescence periods are important in the development of obesity. Adolescence is the last critical period in which permanent fat accumulation occurs. According to a study, 1/3 of obese children and 80% of obese adolescents become obese in adulthood.
Nutritional Habits
The rate of formation of new fat cells is in the first few years of life. Since it is very high, there is a high probability of obesity as a result of improper and irregular nutrition in childhood. As fat storage accelerates, the number of fat cells will also increase. When looked at after puberty, fat cells have almost the same health throughout life. It is reported that he received it. For this reason, it is reported that excessive and improper nutrition of children will cause lifelong obesity.
We Get Fat Without Realizing!
In recent years, fast-food habit has gradually increased in our country. Being low in vitamins-minerals and fiber, which are high in calories, fat, carbohydrates and salt, also paves the way for diseases such as cardiovascular diseases, diabetes, high blood pressure, cancer and deterioration in blood fats.
If we look at the predisposing factors of obesity. It will be easier for us to figure out how to improve the bad developments that follow. Besides counting the endless factor as a factor, the main reason for the increase in obesity in the last 10-20 years is; With industrial development, it is seen as the transition from a lifestyle based on physical activity to an inactive lifestyle and the consumption of high-calorie foods. According to the latest data of the World Health Organization (WHO), 1 in 4 people (1.4 billion people) worldwide, 23% of women and 32% of men are insufficient in terms of activity.
Fast Foods One of Our Biggest Enemies
In addition, the easier access to food increases the consumption of fast foods that we see instantly and practically. Since these foods, which we know as fast food, contain large amounts of carbohydrates, fat and energy, the feeling of fullness at that moment decreases. The brain begins to feel saturation in about 15-20 minutes. When this satiety is met with foods that are easy to access, small in volume and high in energy density, too much energy is taken into the body without realizing it. For this reason, the importance of home-cooked meals, their quantities, eating style, variety and even the size and color of the plate is increasing. Cooking at home is actually a very important factor. While that food is cooking, a product made with effort and love emerges. The result is a meal that is cooked slowly and consumed happily and peacefully with the family. In this way, the food is both enjoyed and sufficient nutrients are taken into the body and psychological satiety is achieved.
The way of eating is also very important here. The energy we get from food is necessary for our daily life and our body to be healthy. an oath a to load up on food; It may cause excessive calorie intake, lack of a feeling of fullness immediately, digestive problems (such as heartburn, reflux, gastritis, indigestion), and excretory problems (such as diarrhea and constipation). Fatigue may occur after meals consumed suddenly. This weakness may occur after a sudden and excessive consumption of food/foods because the body spends energy to digest these food/foods.
In addition, our daily life requires the energy required for daily and body actions such as excretion and absorption. may not remain. Therefore, when eating food, it should be consumed slowly, chewed, savored and in appropriate amounts. As we mentioned, processed foods are high in energy and low in nutrients, meaning they are not nutritious. The fact that transportation is easy, delicious and cheap increases nutritional disorders and various diseases (obesity, diabetes, cancer, etc.) with the consumption of these products.
Obesogenic Environment
Obesogenic environment, It is defined as an environment that facilitates abnormal weight gain. Increasing research on childhood emphasizes that the obesogenic environment is an important criterion. Diet options, the food environment that supports obesity, and the environmental factors that contribute to obesity are seen as obesogenic factors.
The obesogenic social environment includes both advertising and pressure for food. Vulnerable groups and children are targeted to market unhealthy foods. 96% of the advertisements that an average child watches in 1 year consists of sugary cereals, candy, fast food and sugary drinks.
1- Micro Environment
Micro system is the daily life of the child or adolescent. It includes the people with whom he interacts in his life and his interactions and relationships with these people, in short, the interactions and activities in his immediate environment. This system basically covers family and friends. In addition, the environment at school, teachers and relatives are also included in this system. Micro environment; It includes retail food vendors, homes, workplaces, schools, nurseries, and recreational areas for children. In order to understand the environment that affects eating behaviors, all environmental factors should be considered. Be an example of these
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