Stigmatisation Obesity. What does that mean?

Dr. med. Jörg Zehetner on the problem of obesity and what it means for those affected.

As part of the lecture series of Helvetius Holding AG, Dr. med. Jörg Zehetner, Professor USC, took a stand on the stigmatisation of overweight people and the resulting consequences for those affected. In his lecture in the Saaser-Stube Saas-Fee, the experienced physician, who also deals intensively with obesity problems, described the circumstances that obesity patients have to live with practically every day.

They are among us

At the beginning of the lecture, Dr Zehetner made it clear that practically everyone knows the overweight. In one’s own family, in one’s circle of friends or in the circle of colleagues, they exist everywhere and the number of those affected is constantly increasing. And the lives of patients with obesity are not easy.

Where stigmatisation begins

Look at the fat guy! Oh, she’s fat. The fat man should exercise more. Look what he’s got in his shopping basket, and he’s already fat enough.

This is how the stigmatisation of overweight people begins. Without asking why or wherefore, without taking into account how people are personally affected, they are consciously or unconsciously pigeonholed into a category in which they neither belong nor can free themselves from it. Besides the flippant remarks, there are also those that really hurt and don’t help the people concerned at all.

Reduce prejudices

Anyone who has studied the problems of obesity and adiposity in depth knows that those affected suffer greatly from their current life situation. A first step towards at least reducing this unfortunate situation would be to dismantle popular prejudices. It’s always the best moment for that.

The fight against obesity requires a professional network

Hardly any overweight person with a serious problem will be able to successfully face the disease alone in the long term. Even though overweight surgery is now a proven and successful means of fighting the extra pounds, it requires targeted networking before, during and after the medical intervention. For this purpose, a professional network has been established under the umbrella of Helvetius Holding AG, which provides advice, support and assistance to patients in all phases.

Large social alliance against stigmatisation necessary

The topic of obesity is present everywhere. Not only in everyday life, but also in the media, people are encountering this topic more and more frequently and intensively, in addition to the commonly known jokes and remarks about being overweight. From stigmatisation, the path to discrimination is usually a very short one. Obese people are associated with a conceptual world that is anything but pleasant or appreciative. Especially when you don’t know these people personally. This stigmatisation extends far into the personal and social lives of those affected. Even professional life is not excluded. To change this, a large social consensus is needed.

Steps out of stigmatisation

If the spiral of stigmatisation and discrimination against overweight people is to be broken, a clear line is needed. And this begins precisely where obesity is understood as a disease and thus also as treatable and curable. Only then can an active approach be made to these people, who can then actively face their problems themselves without having to continue to hide.

A further step would be to significantly rethink the approach to these patients. And in every area of life and in every encounter with overweight people. Only when the stigma is taken away from these people will they themselves be able to actively enter into the process of their recovery. Dignity, respect and tolerance are exactly the right keywords here.

It is important to also perceive overweight people as valuable members of our society and to recognise that they are not lazy, sedentary, unpleasant and low performers, but sick. And something can be done about diseases, including morbid obesity.

Define obesity as a disease

Anyone who takes a closer look at overweight and obesity will quickly be able to understand them as actual diseases. As with any organic disease, there are clear definitions and developments, but also therapeutic interventions that clearly speak for a clinical picture. A first indication of this is the division into different classifications of overweight, starting from the Body Mass Index, BMI.

Although obesity surgery is a helpful intervention, it does not by itself solve the problem. Being morbidly overweight is and remains a chronic disease that requires lifelong attention, but not disparaging stigmatisation.

More in-depth information on the topic is available in the video recording of the lecture (LINK) and directly on the Swiss1Chirurgie website.

Hardy Walle, MD, at the 4th Helvetius Holding AG symposium

The focus of the 4th Helvetius Holding AG symposium at the Talent Campus Bodensee in Kreuzlingen on 22 October 2021 was the topic of liver health. All speakers agreed that fatty liver is a major cause of many diseases of civilisation in modern society. What could be more natural than to invite the co-founder of liver fasting with HEPAFAST® to the event? In his impressive and scientifically supported lecture, the nutritional physician and internist Dr. med. Hardy Walle not only established the connection between non-alcoholic fatty liver and diabetes, but at the same time proved the previously unattained effectiveness of the BODYMED HEPAFAST® concept for liver fasting. In the detailed report you will learn a lot about the topic and receive further information about liver fasting with HEPAFAST®.


Lecture:


Interview:


Liver Fasting with HEPAFAST® – The Effective Way to Liver Health

A healthy liver has extensive effects on a person’s state of health and has a lasting impact on many functions, especially metabolism. Hardy Walle, MD, was a very special guest at the 4th Helvetius Holding AG symposium at the Talent Campus Bodensee in Kreuzlingen.

Hardy Walle, MD, together with Prof. Nicolai Worm, is known as the founder of liver fasting with HEPAFAST®. The system, specially developed by both nutritional physicians, has been proven to have a positive effect on liver health and offers excellent opportunities for keeping the liver healthy. Even after severe liver diseases, but also used preventively, liver fasting according to Dr. Walle brings about the full functionality of the liver and thus contributes decisively to a healthy lifestyle. In his lecture, the internist and nutritionist and founder of BODYMED AG will present liver fasting with all its effects on liver detoxification and interactions on a healthy life.

Why liver fasting and what is special about it?

The core of the considerations here are the differences of liver fasting compared to other diet programmes. The starting point is provided by data on the development of overweight and the spread of obesity in Germany. It is clear that obesity with a BMI over 25 has spread significantly in the last 20 years or so. This applies especially to obesity with a BMI of 30 and above. In Germany, it is currently assumed that more than half of the total population is overweight. This leads to the logical conclusion that being overweight is now considered the normal thing to be. At the same time, almost a quarter of the population with a BMI of over 30 can be classified as obese. When we talk about obesity, we clearly mean obesity. This also makes it clear that in the case of overweight we are essentially looking at the ratio of fat to total weight. Last but not least, it is also about body fat distribution, i.e. where the fat is located on the body.

It is also interesting to note in the assessment of obesity that with the increase in overweight people, the proportion of people with type 2 diabetes is also increasing at more or less the same rate. It is interesting to note that diabetes mellitus type 2 has nothing to do with people’s age, as was once assumed. People of any age can be affected by type 2 diabetes, with obesity playing a particularly decisive role. Also among young people. So there is a clear correlation between obesity and secondary diseases.

It is all the more astonishing that light overweight is repeatedly communicated as not being so bad and that there are specialist journalists who believe that people “with light to medium overweight live the longest and get the fewest diseases …”. What is often meant is that the connection between BMI and mortality is not so significant.

Accordingly, there is a study in which, for once, not the BMI but the body shape, here specifically the waist circumference, was taken as a yardstick for the assessment among high-risk patients. Surprisingly, in the test group of around 15,000 volunteers, the group that turned out to be more mortal when measured within five years was the one that only had a BMI of 22. However, a closer look revealed that this group showed exactly the same waist circumference as the group of obese volunteers with a BMI 30. The waist circumference was 101 centimetres in each case. However, while the BMI 22 volunteer only had a belly, the BMI 30 volunteer also had a lot of fat distributed over his body.

The volunteers with the highest mortality were quite thin except in the abdominal area and had hardly any muscles. This also explains the relatively low weight despite a 101 abdominal girth. If we know that muscles also have a protective factor, then the increased mortality in this comparison group can also be explained by the lack of a protective function of the muscles. If one follows this thought, then it becomes clear that the ratio of muscle mass to fat mass is of great importance.

Conversely, this also means that BMI alone does not indicate how muscle and fat are distributed. So looking at BMI alone distorts reality, although it can provide initial signals. So it is not the BMI alone that is decisive. It definitely depends on the abdominal girth. Nevertheless, most people may know approximately their weight, but hardly anyone can quantify their abdominal circumference relatively clearly. An increased abdominal girth (women over 88 cm, men over 102 cm) is a clear risk factor for heart attacks, for example. Here, the risk increases by a factor of 4.5.

While there are tablets against high blood pressure, you can only influence your abdominal girth with your own activity. And this is exactly where liver fasting comes in. It is not one-sidedly about weight reduction, but quite clearly about belly reduction. In conclusion, this means getting rid of belly fat. But not only the fat around the organs, but especially the fat in the organs. This refers to the liver, pancreas, kidneys and, more broadly, the heart and bone structure.

Belly fat is the dangerous fat

It must be clear that the liver, for example, is not made to store fat. For that, there is rather the subcutaneous fat tissue. Belly fat has clear potential dangers. These show up as risk factors for

  • Diabetes type 2
  • High blood pressure
  • Heart attack
  • Stroke
  • Potency disorders
  • Circulatory disorders
  • Dementia

All these can be consequences of too much belly fat. In principle, this is also where bariatric surgery comes in, which can certainly also ensure rapid defatting of the liver with obesity surgery.

A renowned German researcher puts the basic statement in a nutshell: “Without a fatty liver, there is no diabetes”. (Professor Norbert Stefan, Tübingen)

In most cases, it is the fatty liver that is the trigger and cause of many secondary diseases. Knowing this is important, because only then can cause, symptom, effect be clearly determined, which ultimately has clear implications for the right therapy.

Non-alcoholic fatty liver (NAFLD) can be considered the cause of many manifestations of pathological processes. For example, for infections caused by free radicals, for gout caused by increased uric acid, increased blood sugar levels, lipid metabolism disorders, high blood pressure or for thrombosis and finally the metabolic syndrome. Liver cancer is not negligible here and is increasing explosively, especially in the USA with the large proportion of obese people.

Generally speaking, 30 to 40 percent of the total population in Germany is affected by a fatty liver. In the overweight group, this proportion is already 70 percent. If we take only type 2 diabetics, around 90 percent of those affected are “equipped” with a fatty liver. From this, the connections between fatty liver, obesity and diabetes become even clearer. This makes non-alcoholic fatty liver one of the most common liver diseases. But even 15 percent of outwardly slim people are affected by a fatty liver.

How can non-alcoholic fatty liver be diagnosed?

Basically, a non-alcoholic fatty liver is a fatty liver that is not caused by alcohol or other causes. In industrialised nations, it is considered the most frequently diagnosed liver disease. Just as no typical complaints can be detected, pure laboratory values alone hardly provide a meaningful basis.

We speak of a non-alcoholic fatty liver when more than 5.5 to 6 percent of the liver cells are fatty. This portion cannot be detected on ultrasound alone. Here, something can only be seen from a fatty degeneration of about 20 percent. The most accurate diagnosis can be made with a liver biopsy, but this is unlikely to be the first step in the diagnosis.

One value has become established in Europe. We are talking about the Fatty Liver Index (FLI). This results in a validated algorithmic numerical value that is also well suited for progress monitoring. With the FLI, a fatty liver can be diagnosed quite well and reliably.

Statistics show that mortality is significantly increased in fatty liver patients. Fatty liver is therefore not a cosmetic problem or characterised solely by increased blood fat levels etc., it is a real high-risk factor in terms of life expectancy and mortality.

Main causes for the development of a fatty liver

In the past, the causes of fatty liver were simply summarised by saying that people eat too much fat. The real cause, however, is an excess of ingested carbohydrates. Another cause may be the intake of a lot of fructose, i.e. fruit sugar. The main fatsifier of the liver is even found here.

Carbohydrates are broken down into sugar in the body. At the same time, the pancreas produces insulin. However, insulin has two effects: On the one hand, insulin ensures that the sugar reaches the muscles, and on the other hand, some of the sugar reaches the liver to regulate the blood sugar level there. If the liver releases too much sugar, insulin slows down this release. In addition, insulin ensures that excess sugar is stored in fat tissue.

Under certain conditions, organs begin to no longer respond adequately to insulin. A kind of insulin resistance develops. Then the liver is also no longer properly regulated by insulin. In the prediabetic course, the blood glucose level then rises even in fasting volunteers. Such a process develops slowly, so that in individual cases diabetes only develops after ten to twelve years. This process can even take up to 20 years. During this time, the liver is less and less regulated by insulin and becomes increasingly fatty. This process is accelerated when the subcutaneous fat tissue cannot form any more fat cells because it is literally flooded with fat. More and more fat and sugar move in the blood. Out of a natural reaction, the organism then builds up additional fat stores in the liver.

In the long term, however, it is not only the liver that becomes fatty, but also the pancreas, the kidneys, the muscles, the heart and even the hypothalamus in the brain.

The basics of liver fasting

The basic idea behind liver fasting is to simply go backwards from the rather unhealthy path taken so far. The most important step is the defatting of the liver. This usually requires a strict diet.

This means:

  • less than 1’000 kcal per day
  • few carbohydrates
  • Absorption of high quality protein
  • Only “good” fats if possible
  • special liver-active agents and dietary fibres

All this is combined in HEPAFAST® in a well-tolerated and easy-to-use formula. The programme is easy to implement in everyday life. It is easy to digest, fills you up and meets all the requirements of a good liver-healthy diet.

HEPAFAST® is taken three times a day, prepared with a milk product. In addition, twice daily vegetable preparations with a total of maximum 200 kcal per day. This means one HEPAFAST® preparation for breakfast, one HEPAFAST® and one vegetable preparation for lunch and one HEPAFAST® and one vegetable preparation for dinner. No more, but also no less.

Due to this suitability for everyday use, there are hardly any dropouts in the HEPAFAST® liver detoxification programme, which significantly increases the success rate.

The reset for the metabolism causes:

  • Normalisation of the function of the pancreas and the insulin sensitivity of the liver
  • Promotion of insulin secretion
  • Normalisation of glucagon regulation
  • reduces the uncontrolled release of glucose from the liver into the blood
  • improves metabolism and facilitates weight loss

For whom is liver fasting useful?

In principle, liver fasting with HEPAFAST® is useful for all patients with the following constellation:

  • Fatty liver (NAFDL, NASH)
  • metabolic syndrome
  • Type 2 diabetes
  • Overweight and obesity
  • Lipometabolic disorders
  • High blood pressure
  • preventive as a “metabolic cure” for the prevention of diseases
  • prior to bariatric surgery

It makes no sense to wait until you have a BMI of 30 or an abdominal circumference of well over 100 centimetres. You can always start a liver fast with HEPAFAST® even without such symptoms.

Further information

You can watch the entire live video stream with Hardy Walle, MD, with additional research results, statistics and a concrete case study here.

In addition, you will also find further contributions from Helvetius Holding AG’s specialist conferences here.

Belching, obesity and diabetes – recognising connections

Only those who recognise the connection between reflux, obesity and diabetes can find the right therapeutic approach. This is what emerges from the expert lecture by Dr. Med. Jörg Zehetner, Professor (USC), about which you can read the full article here.

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