Obesity in 5 received ideas

In France, 17% of the adult population is obese, i.e. more than 8 million people. A chronic progressive disease ranging from simple obesity to severe and/or complex obesity, it is a major risk factor for a number of pathologies (cardiovascular diseases, type 2 diabetes, etc.). And has psychological and social consequences, including low self-esteem, depression, stigma.

Severe obesity is increasing in France. According to the Ministry of Health, there is an increase in the proportion of people progressing to very severe obesity, which corresponds to a body mass index BMI > 40 kg/m². In 2016, 2% of women (1.3% in 2006) were severely obese and 1% of men (0.7% in 2006), i.e. more than 500,000 adults.

In video: the report of Top Santé TV

Covid and obesity: a risky situation

The virus spares no one and particularly affects populations at risk, including people suffering from obesity. Moreover, obese people have priority for vaccination.

The link is indeed proven between Covid-19 and obesity. Physiologically, overweight and obese people are statistically more likely to develop severe forms of Covid-19. And 47% of patients infected with Covid, entering intensive care, are overweight, while obesity concerns 40% of deceased people.

In this context, change the obesity management is urgent, just like “do a real job of prevention, patient support but also raising awareness among the general public, caregivers, and public authorities in order to finally be able to change things“, lamented Anne-Sophie Joly, president of the National Collective of Obese Associations (CNAO). On the occasion of World Obesity Day on March 4, she calls for recognition of obesity as a a real disease.

Because for now, obesity is still associated with many received ideas.

We become obese by eating anything

It’s hard to imagine a obese person seated in front of a small green salad. If the obese has a body mass index (BMI) greater than 30, it is “necessarily” that he stuffs himself with hamburgers all day long, that he devours 25 croissants for breakfast ‘and that he swallows a slice of Nutella XXL morning, noon and evening.

“It’s an aberrant prejudice, reacts Eugénie Auvinet, dietician and nutritionist in Paris. Obesity is a multifactorial disease. And if the lifestyle is (obviously) one of the 3 main causes of obesity, we must not neglect the impact of the two other major factors in the development of the disease, namely the lack of sleep and the little physical activity.

In addition, other factors (which do not concern lifestyle) can also lead to obesity. First, the diseases. Take for example the case of thehypothyroidism, a pathology that affects on average 1% of the French population and especially women. Due to the malfunction of the thyroid gland, the basic metabolism is slowed down: in short, the body burns fewer calories at rest. “This means that you will gain weight, while your diet has not changed”, analyzes Eugénie Auvinet. Which can lead to obesity.

In addition, age also matters when it comes to obesity: at menopause, the hormonal disruption leads to muscle loss and (once again) a slowing of the basal metabolic rate. Result: the body has more difficulty burning the calories absorbed and, while we continue to eat “normally”, the pounds settle.

” What’s more, certain medications (including antidepressants), repeated hospital stays or genetic factors can also lead to obesity, adds Eugénie Auvinet. It’s not just about food! »

Obese people can’t control their hunger

“If obese people are fat, it’s because they can’t stop eating. The logic is unstoppable: if we suffer from obesity, it is because we do not know how to control ourselves. And despite the snacks, lunches, snacks and dinners, we are never satisfied… So much for the received idea.

“Of course, sometimes obesity is linked tohyperphagia, confirms Eugenie Auvinet. But these cases remain quite marginal. Hyperphagia is an eating disorder that comes under psychiatry: in short, it is an irresistible (and almost permanent) desire to eat. “We can not generalize: not all obese people suffer from hyperphagia, far from it”, analyzes the dietician. Moreover, hyperphagia affects “only” 600,000 people in France, while obesity affects more than 6 million French people.

However, obesity could well and truly be (partly) linked to a dysfunction of the feeling of hunger. In any case, this is the conclusion of a French study carried out in 2013 by researchers from the University of Rouen. In a healthy person, the feeling of hunger is triggered when the stomach begins to secrete a hormone called ghrelin. While we eat (to calm hunger), an area of our brain (the hypothalamus) will assess our body’s energy needs. And when these needs are met, it sends “signals of satiety » to our body: the level of ghrelin decreases until the next meal.

In obese people, if the level of ghrelin is normal, the researchers however discovered that this hormone disappeared less quickly when sending the first “signals of satiety” by the brain. Result: the obese would be hungry longer, and would therefore eat more.

Obesity: some people are safe

Hamburgers, pizzas, croissants… For most people, the slightest difference almost instantly turns into a cellulite. Yet some people never seem to gain a gram, no matter what they swallow… “Sure, they’ll never be obese!” we then say to ourselves.

“On the contrary, I think that no one is immune to obesity, reacts Eugenie Auvinet. Casually, the BMI (body mass index) climbs quickly and you can quickly become obese if you are exposed to certain factors. »

The factors in question are lack of sleep, physical activity and lifestyle. But it is also enough to catch a disease, to start a new drug treatment or even to make a stay in the hospital to see its weight curve skyrocket to overweight… even obesity.

“To date, researchers have not discovered any gene that would protect against obesity,” concludes the dietician. However, we are (unfortunately) not all equal when it comes to this disease. Thus, the geneticists estimate that, on average, an individual with a family history of obesity is 5 to 8 times more likely than others to become obese…

Diets protect us against obesity

Natman, Dukan, 5:2, Cohen, Paléo… Obsessed with your figure, you chain the diets since your earliest adolescence. So obesity… that’s for sure, it’s not for you. But you have it all wrong. In work published in 2009, Dr. Luc Périno, general practitioner, affirmed that “the excess of weight loss diets is a factor in the development of obesity”.

The culprit, we know him well: it is the yo yo effect. Indeed, diets (and especially those that promise “express” weight loss without stabilization phase) have a perverse effect: as soon as you stop tightening your belt, the pounds come back in force… “Often, you even gain more weight than you managed to lose,” analyzes Eugénie Auvinet. Thus, from diet to diet, the pounds add up without you realizing it. Which can lead to obesity.

“Diets, especially if they are drastic, disturb our personal hygiene, adds Eugénie Auvinet. This can have consequences on our body, such as eating disorders. Moreover, according to the results of a French study conducted in 2013 on more than 630 women, 95% of cases of moderate obesity are due to weight loss diets. A statistic that sends shivers down your spine…

“Don’t go on a diet if you’re not in a position to overweight, concludes Eugenie Auvinet. And especially not without medical follow-up. »

Obesity is easily cured

“Frankly, it’s not difficult to get out of obesity. We just pay attention for two weeks and presto, we find a normal weight. “” It is false, reacts Eugénie Auvinet. Obesity is not a disease that can be cured with the snap of a finger: in general, it takes months or even years to achieve a convincing result. »

There are several reasons for this: first, in some people, obesity is linked to psychological factors (depression, trauma, etc.). Therefore, even before starting a diet, these problems must be solved, which can take time. “We regularly work in collaboration with psychologists”, explains the dietician.

Moreover, physiologically, our body reacts to weight loss: if the first 10 kilos are relatively easy to eliminate (don’t expect to lose them in two weeks either: on average, it takes two months to see these 10kg disappear too much permanently), it’s after that things get tough. “After a while, the body slows down weight loss, explains Eugénie Auvinet. This is a difficult step in the treatment: this slowdown can indeed have an impact on the self-esteem of the person being treated. “In short, impossible to lose 30kg in a month… even by “being careful”!

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