Overweight

Being overweight and obese (severely overweight) means that too much excess fat is stored in the body. Overweight people run more health risks than people with a healthy weight. The more overweight the more the health problems occur and the more serious they are.

Diseases related to overweight and obesity are type 2 diabetes (diabetes), high blood pressure, gallstones, cardiovascular disease, back and joint complaints, sleep apnea, and certain types of cancer.

In the case of overweight and obesity, the advice is to go to the doctor to identify other risk factors for health problems.

How does obesity arise?

Overweight and obesity (severe overweight) 

occur when the amount of energy that someone takes in through food and drink is higher than the body burns for a longer time. With overweight and obesity, too much excess fat is stored in the body, which can eventually lead to health problems. Several factors can contribute to the development of obesity and the difficulty of losing weight. These are the obesogenic environment, individual causes, and genetic influences.

Obesogenic environment as a cause of obesity

We are dealing with an environment in which energy-rich food is available everywhere and all day long. The temptation to eat and drink too much and too often is therefore great. The availability of a good road network and public transport also creates an environment in which the need to move is minimal. This is called the obesogenic environment. The obesogenic environment is cited as an important cause of the increase in the number of overweight and obese people over the past 40 years.

Individual causes of overweight

Everyone gains weight for different reasons, for example, because of too much (unhealthy) food and drink.

Think about:

-Eating too large portions.

-Eating too many foods and/or meals with a high energy density.

-Eating and snacking too much.

-Drinking too many sugary drinks such as soda and juice.

-Drinking too much alcohol. Alcoholic drinks contain a lot of calories. Too much alcohol can therefore lead to obesity. But eating while you are distracted (such as watching television while eating) can also cause you to eat more than your body needs.

-Less exercise and sports, for example, due to illness, injury, or lack of time.

-Change of lifestyle (eating more and/or exercising less), for example, due to living together, having children, unemployment, or retirement.

-Quitting smoking can also lead to weight gain. Since quitting smoking is very important for health, it is advisable to start weight loss only after quitting smoking, if necessary. A GP can refer you to a smoking cessation course.

-After pregnancy, it can be difficult to get back to your pre-pregnancy weight, especially if you gain more weight than you need to.

-Certain types of medications can have weight gain as a side effect, for example, antidepressants, anticonvulsants, and antipsychotics.

-Mental problems, such as unprocessed experiences and mental trauma, can cause binge eating, which can cause weight gain in a short time. In addition, there seems to be a connection between depression/depressive symptoms and being overweight. This may be caused by the hormone cortisol, a more unhealthy lifestyle, and the use of antidepressants.

Genetic influence on obesity

Weight is partly determined by genetic factors. However, except for several rare forms of severe obesity, overweight rarely arises solely through the influence of genes. There is an interaction with the (often obesogenic) environment as described above. This can be seen, among other things, in the short time in which the percentage of overweight and obese people has increased. This time frame is too short to point to gene mutations as a cause, leading us to conclude that the living environment plays an important role.

People with a genetic predisposition to obesity gain weight more easily if they eat a lot and exercise little. It may also be more difficult for them to lose this weight. For people with a genetic predisposition, the obesogenic environment is extra stressful. But it also applies to them: healthy eating and sufficient exercise are the most important basis for a healthy weight.

The role of sleep and stress in obesity

A lack of sleep or reduced sleep quality may be related to being overweight, partly because little or poor sleep can affect your energy intake and therefore your body weight. Further research is being done into the precise effect of sleep deprivation on obesity. The long-term experience of stress (chronic stress) may also be related to being overweight. Although the relationships that scientists find between stress and being overweight are small and there are still many uncertainties.

The possible relationship between stress and weight gain can be partly explained by increased production of the hormone cortisol, which is associated with fat storage in the abdomen (abdominal obesity) and changed food preferences (more appetite for unhealthy choices, such as high-fat and sugary foods). In addition, stress can lead to less exercise. Conversely, being overweight and obese also cause physical and psychological stress. It is therefore difficult to determine which comes first: chronic stress or excess weight.

When are you overweight?

The BMI is a measure of weight to height. The BMI of children and adults aged 2 to 70 years is calculated by dividing the weight in kilograms by the square of the height in meters. Suppose you weigh 80 kilos and your height is 1.70 meters. Then your BMI is 80/(1.70x1.70) = 27.7 kg/m2. The BMI meter calculates the BMI.

Different limits apply to different age groups:

-Children, 2-18 years: Children have different limits for overweight and obesity than adults. Children are growing and therefore height, weight and therefore also BMI depends on age. National cut-off values ​​for boys and girls have been established for the age groups 2 to 18 years.

-Adults, 19 to 70 years: For adults, a BMI of 25-29.9 kg/m2 is considered overweight and a BMI of 30 kg/m2 or higher is considered obese. There are some exceptions when these cut-off points are not a good measure of overweight:

-For example, a fanatical strength athlete can have a high BMI, while there is no question of a too-high fat mass. In this case, waist circumference is a good additional measure to map out the health risk. The dietitian can also determine fat and muscle mass to determine whether the body composition is healthy.

-People of Asian descent (South Asia, Indonesia, China, and Japan) have a higher fat mass with a comparable BMI. This also applies to people from Suriname and the Antilles with an Asian background. The World Health Organization (WHO) maintains that a BMI of 25 (overweight) corresponds to a BMI of 23 in people of Asian origin. A BMI of 27.5 is considered obese.

-The BMI also seems less reliable if you are short or tall.

-Finally, the BMI is not a reliable measure when you are pregnant or breastfeeding because of the changes in body weight and body composition.

-Older people aged 70 and over: Compared to young and middle-aged adults, the optimal BMI (where the risk of disease and premature death is lowest) is at a higher level. That is why a BMI of 22-28 kg/m2 is seen as a healthy weight and a BMI of >28 kg/m2 as overweight.

-The disadvantage of BMI is that it does not take into account the fat distribution over the body. That is why waist circumference is an important additional measure for estimating health risk.

Waist circumference is important in determining health risks

In addition to BMI, waist circumference is also used as a measure of fat distribution. Fat in and around the abdomen is detrimental to health. Belly fat is an important risk factor for type 2 diabetes and cardiovascular disease. Someone with obesity and a lot of belly fat is referred to as 'abdominal obesity'. In practice, the BMI and the waist circumference usually give the same result: if your BMI is too high, this often also applies to your waist circumference. However, is there overweight, but a healthy waist circumference? In that case, we advise you to make an appointment with your GP to check the risk of illness. Except for fanatic strength athletes. Then the BMI can fall into the overweight category, while there is no question of a high-fat mass. By having the fat and muscle mass determined by a dietitian, it is possible to check whether the body composition is healthy in this case.

Waist circumference men Waist circumference women

Raised Circumference between 94 and 102 cm Circumference between 80 and 88 cm

Too high Circumference greater than 102 cm Circumference greater than 88 cm