Obesity: the most effective dietary supplements

Obesity is defined as an excess of body fat mass, practically resulting in overweight. In clinical practice, obesity is mainly assessed by the body mass index (BMI), which is calculated by dividing weight in kilograms by height in meters squared (kg/m²). According to BMI, the following are distinguished: • Overweight: BMI between 25 and 29.9 kg/m². • Moderate obesity: BMI between 30 and 34.9 kg/m². • Severe obesity: BMI between 35 and 39.9 kg/m². • Morbid obesity: BMI equal to or greater than 40 kg/m².

Pathophysiology

Obesity is a chronic progressive disease involving progressive alterations of adipose tissue (AT), which plays a central role. Adipose tissue is not simply a fat reservoir, but a true endocrine and paracrine gland. Its dysfunction leads to fat redistribution with excessive storage in unusual sites such as the liver and muscles. This phenomenon can cause metabolic complications, notably type 2 diabetes, arterial hypertension, and cholesterol imbalances. The pathophysiology of obesity is also influenced by genetic, epigenetic, and environmental factors, including dietary habits and lifestyle​.

Epidemiology

Obesity is a major public health problem whose prevalence continues to increase. In France, about 17% of adolescents are overweight, and 4% are obese. This trend is observed in many countries around the world, with a global prevalence of obesity that doubled between 1980 and 2014. This rise is particularly rapid among children and adolescents, which increases the risk of developing obesity in adulthood, with all associated complications.

Complications

Obesity is associated with numerous complications, both metabolic and mechanical. Among the metabolic complications are type 2 diabetes, hypertension, dyslipidemia, and cardiovascular diseases. Obesity can also cause respiratory disorders, such as sleep apnea, and increase the risk of certain cancers. Mechanically, excess weight can lead to joint pain, particularly in the knees, and limit mobility​.

Management

The management of obesity requires a multidisciplinary approach, including dietary interventions, increased physical activity, and psychological support. The goal is to stabilize weight, or even reduce it gradually, while avoiding restrictive diets that can be counterproductive in the long term. Patients can benefit from personalized support to adopt healthy lifestyle habits that include a balanced diet and regular physical activity​.

Prevention

Prevention of obesity, particularly in children, is a major public health priority. To maximize the effectiveness of interventions, it is essential to detect obesity from an early age, which implies careful monitoring of BMI using growth curves. These curves make it possible to identify very early children at risk of developing obesity later. A key aspect of this monitoring is the adiposity rebound, which generally occurs from around 6 years of age, marked by an increase in BMI after a phase of decline. An early rebound, before this age, is a strong indicator of increased risk of adult obesity. Detecting this parameter offers the opportunity to intervene before obesity becomes established permanently. Parental involvement is also crucial in this preventive approach. They should be informed and involved in monitoring their child's growth curve and encouraged to adopt healthy family lifestyles. This involves assessing the child's eating habits and lifestyle, followed by adjustments to correct risky behaviors, such as sedentary behavior or an unbalanced diet. The aim is to stabilize the child's weight while ensuring they continue to grow without excessive weight gain. It is important to emphasize that subjecting young children to restrictive diets is not recommended, as this can disrupt their growth. The emphasis should rather be on adopting balanced eating habits and regular physical activity.