Obesity is a growing problem that has reached worrying proportions worldwide, with millions of people suffering from this pathological condition (according to the WHO, more than one billion people worldwide suffer from obesity and the numbers are those of an epidemic). This chronic condition – which has devastating effects on the health and well-being of individuals – affects all age groups, without geographic or social distinction. In many countries, it is considered a leading cause of death and one of the most significant risk factors for a number of chronic diseases, including type 2 diabetes, cardiovascular disease, and certain types of cancer. ‘It is important to prevent and manage obesity from an early age, through diet, physical activity, and appropriate treatment,’ notes Dr. Paolo Piero Limone, a physician specialising in Endocrinology, Diabetology, and Internal Medicine, Chief Emeritus of the Complex Structure of Endocrinology Diabetology and Metabolic Diseases at the Ospedale Mauriziano Umberto I in Turin and of the Centre for Thyroid Diseases.
by Roberta Imbimbo
Dr Limone, obesity is a multidimensional problem. What are the underlying causes of this serious disease?
The causes of obesity are complex and go far beyond the simple question of calories consumed. Genetic, hormonal, environmental and psychological factors all play a key role. Inadequate diet, excess calorie-dense food and sedentary lifestyle are the main factors that promote obesity. Modern societies, characterised by hectic and unphysical lifestyles, are a fertile incubator for the proliferation of obesity. Easy and cheap access to ultra-processed foods, rich in sugar and fat, is a major factor fuelling this pandemic that has a devastating impact on health. According to the World Health Organisation (WHO), obesity in fact increases the risk of developing several diseases, including cardiovascular diseases, diabetes, hypertension, and some forms of cancer such as colon and breast cancer. A major concern of our times is that obesity is increasingly affecting children and adolescents. Data indicate that childhood obesity is on the rise, with consequent effects on the physical and psychological development of young people. Obese children are more likely to become obese adults, creating an intergenerational cycle of health problems.
How then to treat this disease?
Prevention is the key word to stop this epidemic. Changes in eating habits, a greater commitment to physical activity, and raising awareness of the dangers of obesity (by promoting greater dietary and sports education, thus improving access to much healthier lifestyles) are key strategies. A balanced diet (low in simple sugars and animal fats) and regular exercise are the cornerstones of obesity therapy. In addition to lifestyle measures, however, we now have new, highly effective drugs that enable a reduction in body weight of up to 15-20% and are therefore becoming widely used: the problem with these drugs is that they should be used over long periods, if not chronically. In the most resistant cases, bariatric surgery, with interventions aimed at limiting nutrient absorption and food intake, can be a definitive solution to the problem. However, I reiterate that the optimal solution for reducing the impact of obesity on health remains primary prevention through the promotion of a healthy lifestyle from an early age.
Thyroid disorders also affect millions of people worldwide, but are often diagnosed late or confused with other pathological conditions.
What are the main problems you encounter in these cases?
The two main disorders of thyroid function are hypothyroidism and hyperthyroidism. Hypothyroidism occurs when the thyroid gland produces an insufficient amount of hormones. Symptoms include fatigue, weight gain, drowsiness, dry skin, brittle hair and sensitivity to cold, and in women, menstrual irregularities. The most common cause is Hashimoto’s thyroiditis, an autoimmune disease that attacks the thyroid gland. Hyperthyroidism, on the other hand, involves excessive production of thyroid hormones. Symptoms may include rapid weight loss, nervousness, tachycardia, insomnia and excessive sweating. Thyroid nodules are also very common and often benign, but in some cases they can be a sign of cancer. Although thyroid cancer is generally less aggressive than other cancers, a highly specialised approach is essential to ensure effective treatment. A simple blood test to check TSH (thyroid-stimulating hormone) levels can provide important indications of how the thyroid gland is functioning, while for highlighting the presence of nodules and trying to understand their nature, ultrasound is definitely the best and simplest test. Further tests such as targeted blood tests or instrumental tests such as scintigraphy may then be necessary in the second instance. Thyroid disorders are often overlooked because symptoms can be confused with stress or other conditions. It is therefore essential to pay attention to the body’s signals and, if deemed necessary by the doctor, undergo specific check-ups. In case of suspicious symptoms or a diagnosis of thyroid disease, the best option is to consult a specialist, who will be able to assess the best course of action to manage the patient’s problem.
