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Obesity, disease or choice?

22 February 20246 January 2024 by Renato Torlaschi

In 2013, theAmerican Medical Association (AMA) declared obesity a disease, requiring a range of interventions to promote its prevention and treatment.

Five years later, U.S. health care professionals are still not fully aware of this, the surprising results of a survey conducted for Medscape, the well-known medical portal, reveal.

When asked whether obesity should be considered a disease, only 57 percent of respondents answered in the affirmative, and more than one-third of health professionals do not consider it a disease state, a percentage that is even higher among primary care physicians.

According to experts, the persistence of this belief is an obstacle in finally addressing a situation that is reaching pandemic proportions. “It’s time for us to recognize obesity as a disease, ” says endocrinologist Akshay Jain. Until we medical professionals take obesity seriously, we will be ineffective in treating its biopsychosocial and economic consequences. Defining obesity as a disease is the first step toward objectively assessing the factors that cause it and its prevention and treatment.”. There are several reasons why obesity is to be considered a disease: first, it is associated with impaired body function; second, it results from the dysfunction of a complex system of physiological regulation, fostered by multiple factors particularly present in today’s societies.

Finally, it should not be forgotten that obesity causes, worsens, or accelerates more than 160 comorbid conditions that arise as metabolic, structural, inflammatory, degenerative, neoplastic, or psychological complications of obesity itself, significantly affect the quality of life and also its duration.

So that the misconception that obesity is simply a choice can be overcome, the American Association of Clinical Endocrinologists has proposed to change its name and rename it as “chronic adipose disease,” so that it is readily recognized as a real health threat and not just a cosmetic problem.

Itching: all causes (often unknown)

17 February 20246 January 2024 by Redazione My Special Doctor

In addition to being a sure annoyance, itching can be a telltale sign of a more or less severe disease, a reaction of the body to particular substances or treatments, nutritional deficits, or conditions of anxiety or intense stress. Whenever it presents in a persistent, localized, or diffuse manner, without easily recognizing its origin, therefore, it is a good idea to seek medical attention for further diagnosis and to find an effective solution. But what are the possible causes of itching? Find out about them here.

Time change: the effects on the gut

15 February 20246 January 2024 by rosanna.feroldi

The transition from daylight saving time to daylight saving time and vice versa causes some transient discomfort for many people, especially in terms of resynchronization of sleep-wake rhythms and mealtimes, fatigue or feeling slightly unwell/nervous during the day. Generally, for those with no health problems, everything works out in less than a week, the maximum period needed to realign one’s biorhythm to the legally mandated time.

For those with risk factors or specific diseases, however, changing the time every six months can result in far greater inconvenience. Numerous epidemiological studies have long indicated that the incidence of severe acute cardiovascular events (heart attack and stroke), as well as episodes of depression or anxiety in predisposed people, increases in the weeks after the hands of the clock move.

Recent data have, moreover, shown a correlation between the transition from daylight saving time to summer time and the risk of seeing worsen chronic inflammatory bowel disease (IBD), such as ulcerative colitis and Crohn’s disease, with a significant increase in the number of flare-ups in the following 30 days in patients who were under control in the previous month. An observation entirely in line with the knowledge regarding the link between circadian rhythms and the regulation of gastrointestinal activity and the immune and inflammatory response.

In addition, it should be considered that the abrupt change in the amount of daylight to which one is exposed, resulting from the fake “time zone,” has a not insignificant impact on mood, and this aspect can also significantly affect the gastrointestinal symptoms of IBD or irritable bowel syndrome (IBS), which are also known to have a psychosomatic component.

Considering the considerable discomfort associated with IBD flare-ups (not infrequently disabling for several days/weeks), as well as the acute cardiovascular events already mentioned, and the expenditure of health care resources required to treat them, one frankly wonders whether it is ethically permissible and economically viable to continue to maintain the ritual change of the time twice a year, even in view of the now limited energy savings it makes in the face of the drastic change in the population’s living and working habits.

In Europe, the situation is expected to improve from 2021, when a recent decision by the European Commission envisaged the final switch to the single, year-round timetable. In other areas of the world, legislative changes along these lines have yet to be considered, to the detriment of those with health problems that may be exacerbated by a transient mismatch between the internal and external clocks.

Source Föh B et al. Seasonal Clock Changes Are Underappreciated Health Risks-Also in IBD? Front Med (Lausanne) 2019;6:103. doi:10.3389/fmed.2019.00103