Obesity is defined as an abnormal increase in body fat, which usually leads to pathological changes. The so-called Body Mass Index (BMI) is usually used for classification:
According to the World Health Organization WHO, a BMI of 25.0-29.9 kg/m² is called pre-adipositive. As of a BMI of ≥ 30 kg/m² an obesity disease is present, which is divided into different degrees of severity.
Classification
|
BMI [kg/m²]
|
Risk of second diseases
|
Under weight
|
< 18,5
|
|
Normal weight
|
18,5 - 24,9
|
|
Overweight/Preadipositas
|
25,0 - 29,9
|
slightly increased
|
Obesity grade I
|
30,0 - 34,9
|
increased
|
Obesity grade II
|
35,0 - 39,9
|
significantly increased
|
Obesity grade III
|
≥ 40
|
greatly enhanced
|
The BMI is quickly determined and thus allows a quick assessment of the nutritional status. However, it is not very meaningful for assessing the extent to which obesity leads to secondary diseases. Obesity alone is not decisive for secondary diseases, but also for the localisation of excessive body fat. Two patterns of fat distribution are distinguished in obesity:
1. Visceral obesity
In visceral form, also known as abdominal or central obesity, excessive body fat is located in the abdominal cavity. For a better visual understanding, this fat distribution is also called "apple type". The increase of visceral fat masses is a decisive risk factor for the development of cardiovascular diseases.
2. Subcutaneous obesity
In this form of obesity there is an increase in subcuteanous fat mass mainly in the area of the hips, buttocks and thighs, therefore the term "pear type" is used here.
 |
| Apple Pear |
The fat distribution pattern in obesity can be determined by circumferential measurements. If the ratio of waist to hip is greater than 0.85 in women and greater than 0.90 in men, abdominal obesity is present; if the ratio is lower, peripheral obesity is assumed.
Bilbiography sources:
Lean ME, Han TS, Morrison CE (1995) Waist circumference as a measure for indicating need for weight management. BMJ 311: 158–161
Robert Koch-Institut (2014) Übergewicht und Adipositas. Faktenblatt zu GEDA 2012: Ergebnisse der Studie „Gesundheit in Deutschland aktuell 2012“.
Wirth A, Hauner H (2013) Adipositas Ätiologie, Folgekrankheiten, Diagnostik, Therapie. Springer, Berlin Heidelberg
Ng M, Fleming T, Robinson M, et al. (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980 – 2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384: 766–781
WHO Global InfoBase team (2005) The SuRF Report 2. Surveillance of chronic disease risk factors: country-level data and comparable estimates. World Health Organization.
