These diseases are all related to obesity! If your weight exceeds this number, you are in danger!

How many obese people are there in China? After 14 years and six large-scale surveys, The Lancet estimated the number of obese people in China to be 85 million. Among them, there are 48 million adult men and 37 million adult women. There are 11 million more obese men than obese women.

What makes us fat? What health problems are hidden behind obesity? Let's talk about the problem of "getting fat"~

01

The history of obesity in China

According to the standards of the World Health Organization, a normal body mass index (BMI) is generally between 18.5 and 24.9 kg/㎡. If it exceeds 28 kg/㎡, it is considered obese.

The obesity of Chinese people is not something that has only emerged in recent years. Since the early 1980s, the average body mass index and obesity rate of adults have been rising steadily.

Take 2004 as an example, the total number of obese people in my country was 28 million, and this number tripled by 2018. In these 14 years, the average BMI of Chinese people has increased from 22.7 in 2004 to 24.4 in 2018, and the obesity prevalence has increased from 3.1% to 8.1%, which shows the growth rate.

The only good news is that the growth rate of obesity during this period did not soar out of control. Data shows that the average BMI increase slowed down from 2010 to 2018, which is most directly reflected in the decline in the increase in obesity prevalence after 2010.

Image source: Reference [4]

But the slowdown in growth rates does not mean we are free from the problem of obesity.

While everyone is trying to maintain a low BMI, there is one group whose average BMI remains high.

Urban middle-aged men aged 30-49.

A survey by The Lancet showed that Chinese men, whose average BMI and obesity prevalence were lower than those of women in 2004, completed a "comeback" in terms of body shape in 2018 and became the fattest group in the country.

Among all male groups, the obesity prevalence among men with higher education is more than 100% higher than that among men with lower education.

What happened in the meantime that caused more and more people, especially highly educated Chinese men, to become fat and never turn back?

In fact, if we compare life 30 years ago with today, we can easily find the answer. Since the 1990s, the dietary patterns of Chinese residents have undergone tremendous changes:

In addition to a significant increase in fat intake levels and an increase in the frequency of dining out, more and more people are engaging in occupations that require light physical activity and are beginning to rely on motor vehicles for travel.

In short, life has become better and busier. With an unhealthy lifestyle and insufficient awareness of physical exercise, over time, weight has become excessive.

02

The consequences of obesity are seriously underestimated

Looking at the waist circumference and weight of people around you, it is not difficult to find that obesity has become an "epidemic."

It is precisely because there are fat people all around us that many people ignore the real harm that obesity does to the body.

The scientific definition of overweight and obesity is that the body has excessive total fat content and/or increased local fat content and abnormal distribution. It is a chronic metabolic disease caused by the combined effects of genetic and environmental factors.

Excessive fat accumulation can cause many kinds of damage to health. Many studies have shown that there are more than 200 comorbidities associated with obesity. And the risks vary depending on the population and type of obesity:

1. Abdominal obesity is a hotbed for cardiovascular disease and chronic diseases

Abdominal obesity, as the name implies, means that fat is mainly accumulated in the abdomen, especially in the abdominal viscera. It is also called "central" or "centripetal" obesity. Clinical data have confirmed that it is an important risk factor for cardiovascular disease and diabetes, as well as dyslipidemia and hyperuricemia. Compared with people of normal weight, this type of obese and overweight people have a 2 to 5 times higher risk of developing four chronic diseases.

It is worth mentioning that many people think that abdominal obesity is exclusive to men, but this is not the case.

In 2009, the prevalence of abdominal obesity among Chinese adult men and women was 27.8% and 45.9% respectively, and is becoming younger.

2. Female obesity is a disruptor of the reproductive system

As many people have observed in their lives, women are more likely to be obese than men, and the obesity is mainly concentrated in the abdomen and buttocks. Once women are overweight, the most special harm is reproductive endocrine disorders, which can lead to menstrual disorders, infertility, breast cancer, endometrial cancer and other diseases. Among them, endometrial cancer is the most worthy of attention.

Studies have shown that among obese women aged 60 to 69 with a BMI between 25 and 29, the relative risk of developing endometrial cancer is more than twice that of normal women. The risk of developing endometrial cancer increases more than three times when the weight exceeds the normal level by 15%.

If the pregnant woman is obese, the risks she faces are even greater, including but not limited to miscarriage, congenital malformations of the newborn, stillbirth, etc.

3. Muscle-reducing obesity, one of the main causes of falls in the elderly

As people age, even if their weight remains the same, their body tissues will gradually change: the fat ratio will increase, and the overall muscle mass and quality will decrease. When more and more fat accumulates in the abdominal viscera and between the organs, sarcopenia will form.

Literature reports show that the prevalence of sarcopenia obesity among the elderly in my country is 4% to 20%. Compared with simple obesity, elderly people with sarcopenia obesity are more likely to suffer from physical disability and balance disorders, and their risk of falling increases accordingly.

China is one of the countries with the fastest aging population in the world, and sarcopenia obesity directly affects the quality of life of the elderly, so it is an issue that deserves great attention.

Image source: Reference [4]

03

What should you do to get rid of obesity?

Although obesity is causing different problems for different groups of people, we are not helpless about it.

Numerous clinical data have shown that even a small amount of weight loss can improve the comorbidities mentioned above.

Since the main cause of overweight and obesity is the imbalance between energy intake and consumption, if you are an obese person who wants to lose weight, it all comes down to these two tricks - control your mouth and move your legs.

1. Diet management: Eat more meat and reduce staple food intake

A high-protein diet refers to a daily protein intake that exceeds 20% of the total daily energy but does not exceed 30%. Since the ingested protein cannot be stored by the human body and needs to be metabolized and utilized immediately, appropriately increasing the intake of proteins such as eggs and fish can increase satiety and resting energy expenditure, significantly reduce weight and waist circumference. A low-carbohydrate diet reduces the proportion of carbohydrates such as rice and noodles in the daily diet to ≤20% of the total daily energy. Studies have shown that it can effectively control the weight and body fat of overweight and obese patients in the short term (≤6 months).

In addition, improving the bad habit of eating too fast and removing sugary drinks and snacks from the diet can effectively help lose weight.

2. Physical exercise: not only to lose weight, but also to prevent rebound

Lack of physical activity is one of the important risk factors for overweight/obesity. Appropriate exercise can achieve negative energy balance by increasing energy consumption. It is recommended to combine aerobic exercise (brisk walking, jogging, cycling, etc.) with resistance training (squats, push-ups, sit-ups, etc.) as a way to lose weight.

The "Dietary Guidelines for Chinese Residents (2022)" recommends that at least 150 minutes of moderate-intensity physical exercise per week can reduce the risk of excessive weight gain and prevent an increase in BMI.

For those who don’t have the habit of exercising, you can use your spare time to accumulate multiple short-term exercises. As long as you stick to it, the effect will be even better than a continuous long-term exercise at the same amount of exercise. If you have achieved a certain weight loss effect and want to prevent weight rebound, you should do more than 300 minutes of medium-to-high intensity (ball games, mountain climbing, fast cycling, etc.) physical exercise per week.

"Gaining weight is like a mountain falling down, losing weight is like pulling a thread." Many people gain weight without realizing it, but if you want to control your weight, you need self-control accumulated over time. Maybe the effect of losing weight is not that fast, but as long as you integrate good habits into the details of your life, remind yourself when you want to give up: losing weight is not only for good looks, but also for health! Persevere, and life will definitely live up to your efforts.

References:

[1] Nutrition and Metabolic Management Branch of China Medical Health International Exchange Promotion Association. Guidelines for Medical Nutrition Therapy of Overweight/Obesity in China (2021)[J]. Chinese Journal of Medical Frontiers (Electronic Edition), 2021, 13(11): 1-55.

[2] Wang L, Zhou B, Zhao Z, et al. Body-mass index and obesity in urban and rural China: findings from consecutive nationally representative surveys during 2004-18[J]. The Lancet, 2021;398(10294):53-63.

[3] Li Yaoyue, Wang Guixin. Impact of socioeconomic factors on obesity among Chinese residents[J]. Population and Development, 2022, 28(5): 107-125.

[4] Chinese Nutrition Society. Scientific Research Report on Dietary Guidelines for Chinese Residents (2021)[M]. People's Medical Publishing House, 2021.

[5] He Xiangyang, Liu Zheng, Xu Ying, Peng Ji, Zhao Rencheng. Correlation analysis between obesity and four common chronic diseases[J]. Preventive Medicine, 2020, 32(7): 692-697.

[6] Liu Fei, Pu Lili. Research progress on the impact of obesity on female reproductive health[J]. Chinese Journal of Eugenics and Genetics, 2006, 14(10): 1-5.

[7] YANG Yue, WANG Yan. Research progress on sarcopenia obesity[J]. Chinese Journal of Modern Medicine, 2018, 20(3):98-101.

[8] SANADA K, CHEN R, WILLCOX B, et al. Association of sarcopenic obesity predicted by anthropometric measurements and 24-yall-cause mortality in elderly men: The Kuakini Honolulu Heart Program[J].Nutrition,2018,46:97-102.

[9] TIAN S, XU Y. Association of sarcopenic obesity with the risk of all-cause mortality: A meta-analysis of prospective cohort studies[J]. Geriatr Gerontol Int, 2016,16(2):155-166.

[10] Obesity in China: time to act[J]The Lancet Diabetes & Endocrinology,2021,9(7):407.

[11] Lu Yanyu, Guo Huilan, Shen Fang, Huang Xiaoxu. Research progress on low-carbohydrate diet in controlling overweight and obesity[J]. Preventive Medicine, 2021, 33(12): 1231-1235.

Author: jting

Reviewer: Gao Chao, Associate Researcher, Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention