Obesity: a puzzling disorder

Abstract

To a certain extent, we may say that the history of humankind has been characterized by struggles against hunger. However, there have been reports and depictions of obese persons since ancient times. In some societies, and even in western societies, in some periods, obesity used to be a sign of good health and beauty. As an example, we have the famous paintings of Flemish and Impressionist artists portraying men and women bearing weights (metaphorically speaking) far greater than those seen as beautiful and appropriate for today’s standards. After the mid-20th century, some evidence began accumulating that obesity could be deleterious to people’s health. Today, it is clearly established that obesity increases the risks for hypertension, type 2 diabetes, and cardiovascular diseases. Although obesity was found to be harmful to health, humankind has witnessed an increase in its prevalence in the last 50 years, being regarded by the World Health Organization as a global epidemic. 1 Some years later, albeit less intensely, we have noted that the prevalence of obesity has been increasing among children and adolescents, in industrialized and developing countries. 2 In Brazil, while malnutrition decreased, obesity started to increase. 3 Even though not all obese adults were obese as a child, it is well established that obese children and adolescents, especially after the age of five years will be obese adults. 4 Nevertheless, several obesity-related problems that used to be characteristic of adulthood are now observed in childhood and especially in adolescence. Obesity-related metabolic disorders are already observed in children. Hypertension, hypercholesterolemia and hyperinsulinism are found in children and adolescents, resulting in cardiovascular diseases and diabetes. Other diseases have been described in obese children: dyslipidemia, tibia vara, insulin resistance, polycystic ovarian syndrome, gallstones, hepatic steatosis, sleep apnea, among others,