Head of the FMBA Center for Bariatric Medicine in Rostov-on-Don, surgeon, bariatric surgeon
“According to the latest data from the World Health Organization, today around one billion people in the world suffer from obesity. In a quarter of a century, their number has doubled. In 2022, scientists estimate that around 43% of adults will be overweight. There are also many more children between the ages of five and 19, whose bodies are prone to pathological fat accumulation.”
Let’s find out to what extent genetics is to blame for the excessive accumulation of adipose tissue and which branch of medicine deals with this problem.
How to define obesity?
The main way to detect obesity is to calculate the body mass index (BMI). It is equal to a person’s weight in kilograms divided by their height in meters squared. For example, a person’s mass = 74 kg, height = 172 cm, therefore, BMI = 74: (1.72 x 1.72) ≈ 25.01 kg/m².
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This calculation does not only apply to athletes and pregnant women. For everyone else, the following is true: if the BMI is less than 18.5, then the weight is undernormal; from 18.5 to 25 – normal; Values from 25 to 30 indicate the presence of excess weight, if the BMI is above 30, then we are talking about obesity.
When the patient has concomitant diseases (type 2 diabetes, hypertension, apnea, etc.) or a BMI greater than 40, this condition is called morbid obesity and is a reason to prescribe bariatric surgery.
Causes of obesity: environment or genetics?
Social factors play an important role in the fact that the modern human body expends fewer calories than it consumes. A sedentary lifestyle, stress that is accompanied by impulsive eating, high-calorie foods with a lot of sugar and trans fats, uncontrolled snacks – all this creates favorable conditions for the accumulation of excess fat in the body. However, the role of genetic predisposition to obesity should not be underestimated.
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Scientists have discovered that between 200 and 500 different genes and their combinations influence how the body absorbs nutrients, stores fat, and sends signals that it is full. Almost 43% of the population has the FTO gene (fat mass and associated obesity), which can cause problems such as increased hunger, difficulty achieving satiety, compulsive overeating, a tendency to be sedentary and the accumulation of fat in the body.
Several studies of twin groups have shown that the contribution of genetic factors to BMI variability can reach 70-80%. Thus, it turned out that the inheritance of obesity is not affected by whether twins live together or apart. And among adopted children, body mass index correlates with the BMI of their biological parents.
About 80 different syndromes have been described that include obesity as one of the clinical characteristics. 30 of them have an established genetic cause of development.
Doctors distinguish between syndromic and monogenic obesity. In the first case, the pathological accumulation of fat in the body occurs due to chromosomal and other genetic syndromes. The second option develops due to a mutation in the gene, which leads to a disruption of the synthesis of proteins that regulate the processes of eating behavior.
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It can also be considered proven, based on a large number of studies, that children who are obese from an early age often have obese mothers. Furthermore, the problem of excess weight affects daughters more than sons.
The general increase in the level of obesity in society is explained by a number of reasons and is caused by a complex interaction of external factors and an individual hereditary predisposition. It certainly plays a role in the development of obesity, as genetics can affect metabolism or cause hormonal imbalances.
However, to a greater extent, the chances of developing the chronic disease “obesity” in individuals increase precisely under the influence of behavioral factors, such as poor diet, lack of physical activity, stress and lack of sleep.
Is it possible to “cross out” obesity from heredity?
The presence of a genetic component suggests that even for parents who have been cured of obesity before conceiving a child, no one can guarantee that the child will not have a tendency to become overweight later.
The risks of having a child who gains excess weight over time can be minimized, even if you are predisposed to obesity or are overweight. Thus, it has already been shown that children whose mothers took nutritional supplements with polyunsaturated fatty acids (fish oil) during pregnancy have an increased BMI at 10 years of age.
Scientists believe that factors such as smoking during pregnancy or maternal diabetes change a growing child’s metabolism, and this later manifests in obesity.
Photo: istockphoto.com/ELENA BESSONOVA
It is impossible to change the genetic predisposition to obesity, but it is quite possible to control weight and improve health. However, if obesity is inherited and begins to appear at an early age, the child needs the supervision of a doctor and, in the case of syndromic obesity, a geneticist who will prescribe an individual treatment plan.
What measures should be taken to reduce the risk of complications and improve the health of an obese child:
healthy eating: more fruits, vegetables, whole grains, proteins, less fat, sugar and processed foods; physical activity – this will help burn excess calories and strengthen muscles; support the child’s psychological well-being, as obesity can affect their self-esteem and confidence level; regular medical exams to monitor weight, cholesterol, blood sugar and other indicators; Discuss obesity and a healthy lifestyle in the family. It is important that all family members support the child and help him achieve his goals.
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How can a child lose weight? 5 recommendations from a nutritionist
Tips for adults who tend to be overweight
Genetically determined obesity may not appear immediately, but may appear later in life. If you know that you are at risk, you have obese family members, especially close ones, you should follow these rules:
1. Eat a healthy and balanced diet. Avoid fatty, high-calorie, and processed foods. Include more fruits, vegetables, beans, nuts, and grains in your diet.
Photo: istockphoto.com/whitebalance.oatt
2. Exercise regularly. It can be cardiovascular training (running, swimming, cycling) or strength exercises (dumbbell training, push-ups, squats).
3. Monitor your weight and, if necessary, consult with a specialist (nutritionist, trainer, endocrinologist).
4. Avoid stressful situations and relax (meditation, yoga, breathing exercises).
5. Get enough sleep, as lack of sleep and hormonal imbalances can lead to weight gain.
6. Avoid alcohol and tobacco: they can contribute to the accumulation of fat in the body.
7. Maintain psychological balance and a positive attitude towards yourself. It is important to remember that each person is unique and capable of changing their life.
Bariatrics for genetic obesity: what is it and how does it help?
Over the past three years, the number of people in Russia who decided to get rid of obesity using bariatric surgery (a method of treating obesity through surgery) has increased by 172%.
Bariatrics is a branch of surgery that deals with the treatment of obesity. It includes surgeries such as gastric banding, gastric bypass, and other interventions that reduce the size of the gastrointestinal tract. In addition, after bariatric surgery, the patient not only loses body weight, but also normalizes the production of hormones associated with intestinal function.
In 98% of cases, obesity is the result of excess caloric intake. Very often, hormonal imbalances are a consequence of excess fat mass and not the cause. Therefore, bariatric surgery or, as it is also called, metabolic surgery, is one of the effective ways to treat obesity. The high effectiveness of operations in the treatment of type 2 diabetes mellitus in people whose BMI is greater than 35 has been proven.
Photo: istockphoto.com/Liudmila Chernetska
Patients with any type of obesity are examined by a whole group of specialists, and the decision on bariatric surgery or its inadmissibility is made for each person separately, taking into account any chronic illness, be it excess hormones or bulimia.
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