2023-05-19 07:15:26
According to recent United Nations reports, there are more than 1 billion people worldwide who suffer from obesity, including 650 million adults, 340 million adolescents, and 39 million children who are overweight and obese. As the numbers continue to grow, the World Health Organization estimates that by 2025, approximately 167 million people will be less healthy because of being overweight or obese. Obesity has reached epidemic proportions globally and almost tripled worldwide between 1975 and 2016. According to the World Health Organization (WHO), in 2016, more than 1.9 billion adults age 18 or older were overweight.
Obesity and its complications
The Saudi Society for Family and Community Medicine, in cooperation with the Saudi company “Pfizer”, held a press conference as part of the awareness campaign it is currently implementing on “the risks of high blood pressure and obesity”, last Monday evening, May 15th, attended by “Asharq Al-Awsat”. I will discuss here obesity and its two most important complications, diabetes and high blood pressure.
Dr. Hussein Saad Baher Al-Badawi, the American Board of Obesity, a member of the Saudi Society for the Study of Obesity, head of the Diabetes Unit at the My International Clinic Complex in Jeddah, and one of the speakers at the conference, spoke to Sehatak. He explained that excess weight and obesity are defined as an abnormal or excessive accumulation of fat that may It harms health as a disease that affects most of the body’s systems, as obesity affects the heart, liver, kidneys, joints and reproductive system.
He explained that the World Health Organization (WHO) defines obesity as abnormal fat accumulation or excessive fat accumulation that may be harmful to health. The World Obesity Federation (WOF) defines obesity as a chronic, relapsing disease process and stresses the need for immediate action to prevent and combat this global epidemic. The American Medical Association (AMA) recognizes that obesity and overweight are both a chronic medical condition (an actual disease condition) and an urgent public health problem, and it works to define obesity and its complications, and that intervention is imperative as an essential medical service. The US Food and Drug Administration (FDA) warns of the chronic, degenerative health risks of obesity, defined by excess body fat.
He added that the World Health Organization has emphasized that obesity also leads to a group of non-communicable diseases, such as type 2 diabetes, cardiovascular disease, high blood pressure and stroke, various types of cancer, as well as mental health problems. According to the United Nations health agency, obese people were three times more likely to be hospitalized due to COVID-19.
Obesity is classified according to a body mass index (BMI) higher than normal (more than 18.5 – less than 25). Body mass index is measured by dividing the weight (kg) by the square of the height in meters (m2).
The World Health Organization considers BMI to be the most appropriate measure, currently available, at the global population level for overweight and obesity. The average BMI is between (25-30) pre-obesity, more than (30) obesity, and between (30-35) obesity of the first degree, and between (35-40) obesity of the second degree, More than (40) obesity of the third degree.
Obesity rates in G20 countries
Saudi Arabia has the highest prevalence of obesity (37.7 percent) among G20 countries, followed by the United States (37.3), Turkey (32.9), Canada, Australia, Mexico, Argentina and Britain (30.5, 30, 29.5, 29.2, 28.8). , while Italy ranked the lowest in obesity prevalence (20.7), followed by France, Brazil, Germany and Russia (22.4, 22.8, 23.2, 23.5).
Complications of obesity
Dr. Hussein Badawi says that obesity has multiple complications, the most important of which are:
• Cardiovascular diseases: stroke – hyperlipidemia – high blood pressure – coronary heart disease – pulmonary embolism – blood clots – GERD – urinary incontinence.
• Type 2 diabetes: prediabetes.
• Stiffness of the knee joint: gout.
• Cancers – depression – anxiety – sleep and respiratory arrest – asthma – chronic back pain – hypogonadism.
• Polycystic Ovarian Syndrome – Pregnancy Complications – Infertility/ Impairment of Fertility.
• Obesity sufferers have a greater percentage than healthy individuals, which are: 3% stroke – 3.5% congestive heart failure – 8% ischemic heart disease – 9% polycystic ovary syndrome – 19% depression – 21% diabetes Type 2 and myocardial infarction – 35 percent GERD symptoms – 40 percent sleep apnea – 51 percent hypertension – 52 percent knee osteoarthritis.
The most important recommendations for managing overweight and obesity in adults in Saudi Arabia, according to the International Journal of Clinical Medicine 2022:
• Recommendation 13: For obese adults with a body mass index equal to or greater than 30 kg/m2 or greater and with or without comorbidities, liraglutide 3mg or semaglutide 2.4mg may be used, in addition to lifestyle interventions following consideration of individual case.
• Recommendation 14: Certain precautions should be taken when prescribing GLP-RA drugs (Liraglutide 3mg or semaglutide 2.4mg): dose titration is needed and should be smooth. Counseling for gastrointestinal effects, discontinue if pancreatitis is suspected. For liraglutide, use caution in patients with renal disease when starting or increasing doses due to potential risk of acute kidney injury.
And regarding obesity and diabetes. Dr. Hussein Badawi indicated that several studies have found that obesity drug delays type 2 diabetes, as follows:
-60% of patients with prediabetes at screening returned to normal glycemic status following one year of treatment with liraglutide 3.0 mg, compared to 33% treated with placebo.
The improvement was 2.7 times longer with liraglutide 3.0mg compared to placebo, and the corresponding risk of developing T2D within 3 years was reduced by 79 percent with liraglutide 3.0mg versus placebo.
Obesity and blood pressure
Dr. Ashraf Amir, a family medicine consultant at the International Medical Center in Jeddah, Vice President of the Saudi Society for Family and Community Medicine, and one of the speakers at the conference, spoke to “Your Health” and pointed out that blood pressure is the force of blood pushing through the blood vessels and is produced by the contraction and relaxation of the heart muscle, two types of pressure They are the systolic pressure, which is the force with which the heart pumps blood around the body, and the diastolic pressure, which is the blood pressure that occurs between heartbeats.
High blood pressure is the condition in which the blood pressure is measured more than 140/90mHg; This causes the heart to work harder and the blood vessels to work harder. High blood pressure develops over years, and high blood pressure is a major risk factor for heart disease, stroke, and other serious problems. High blood pressure can be detected early to control it.
The ideal blood pressure is less than (120/80) mm Hg, the normal pressure is (120-129/80-84) mm Hg, the pre-hypertension stage is (130-139/85-89) mm Hg, the high blood pressure stage The first (140-159 / 90-99) mm Hg, high blood pressure, the second stage (160 – 179 / 100 – 109) mm Hg, high blood pressure, the third stage (above 180 / above 110) mm Hg.
Diagnosis rates are low (45 per cent), nearly a third (28 per cent) of people diagnosed with high blood pressure do not receive treatment, and approximately 37 per cent have uncontrollable blood pressure. The rates of high blood pressure in Saudi Arabia are approximately 15.2 percent, according to the latest health survey conducted by the Saudi Ministry of Health.
The causes of high blood pressure include:
• The cause is unknown (primary): it is the most common; it develops gradually over several years.
• Cause known (secondary):
• Some kidney or hormone problems – Thyroid problems – Sleep apnea – A congenital defect in the blood vessels since birth.
• Some types of medicines (cortisone – birth control pills – decongestants and analgesics).
• Take drugs.
The most important risk factors: heredity – advanced age – sex. – Obesity – Smoking – Drinking alcohol – Psychological stress – An unhealthy diet by excessive salt – Chronic diseases, such as diabetes mellitus and others – A sedentary lifestyle and lack of physical activity.
Complications of high blood pressure include: hardening of the blood vessels – stroke – heart failure – angina pectoris – kidney failure – vision loss (blindness) – impotence – peripheral artery disease – memory and concentration problems.
As for the symptoms of high blood pressure, they are: that most people with high blood pressure do not have any signs or symptoms, the disease is discovered by chance; That is why it was called the “silent killer”. But some patients may suffer from headache, shortness of breath, and nosebleeds. But these signs and symptoms are not specific, and they usually don’t occur until high blood pressure has reached a serious or life-threatening stage.
Is high blood pressure diagnosed? Including: family history – medical history – monitoring blood pressure readings – laboratory tests – some tests to rule out any cause or risk factor for high blood pressure.
Methods for treating high blood pressure depend on the diagnosis. A treatment plan will be drawn up that includes: a change in lifestyle, such as: practicing physical activity – following a healthy diet – losing weight – quitting smoking – treating stress and anxiety – medication to control high blood pressure.
As for the ways to prevent high blood pressure, Dr. Ashraf Amir confirms that following a healthy lifestyle is one of the most important ways to prevent and control the level of blood pressure, and this includes:
• Practicing physical activity.
• Maintain a healthy weight.
• Follow a healthy diet.
• Control of anxiety and stress.
• Refrain from smoking and drinking alcohol.
• Reduce caffeine intake.
Can high blood pressure be cured permanently? Yes, high blood pressure can be completely cured if it has a known cause and has been treated. The drug dose can be reduced following obtaining the required result (according to the instructions of the attending physician).
Are there specific instructions before measuring blood pressure?
• Check the accuracy of the device.
• Do not measure blood pressure immediately following waking up.
• Avoid eating or smoking 30 minutes before the measurement.
• Sit quietly with the legs and ankles relaxed, and the back resting on the chair, while not speaking during the measurement.
• Ensure that the arm is in the correct position.
• The bracelet should be placed directly on the skin and not on clothing.
• Take the reading more than once and record it in the notebook
Is it possible to stop taking the medicine when the blood pressure readings are in the normal level? The drug can only be stopped when the pressure drops under certain circumstances, such as:
• Low blood pressure with symptoms.
• After reducing obesity to ideal weight levels.
Finally, Dr. Ashraf Amir stressed the need to pay attention to preventive health, which is in line with the “Kingdom’s Vision 2030”, and not to wait until the appearance of disease symptoms that make treatment and recovery difficult.
Community medicine consultant
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