What Are Symptoms Of Normal Weight Obesity


What is obesity?

Obesity is an increase in body fat that goes beyond normal. Body weight is estimated using the body mass index, which relates body size to weight. A BMI of over 25 kg / m ^ 2 is considered to be overweight. A BMI of over 30 is considered obesity. Overweight and obesity are chronic diseases that increase your risk of death and the likelihood of complications.

How can you calculate your BMI?

The BMI (body mass index) is the most common method of estimating body weight. Since the size of a person has an influence on the body weight, the quotient of the body weight in kilograms and the body height in meters squared is formed. Body composition, i.e. the distribution of fat, muscles and bones, also influences weight, but it is difficult to determine this precisely. This is why the BMI is used in practice.

To calculate your BMI, you can, for example, use the BMI calculator of the German Obesity Society.

Depending on the BMI, three large weight groups are formed, each of which has different risks of obesity-associated comorbidities:

  • Underweight: BMI <18.5
  • Normal weight: BMI 18.5-24.9
  • Overweight: BMI ≥ 25
  • Pre-obesity: BMI 25-29.9
  • Obesity grade 1: __BMI 30 - 34.9 __
  • Obesity grade 2: BMI 35-39.9
  • Grade 3 obesity: BMI ≥ 40

The risk of obesity-associated diseases increases with the increasing BMI. While the risk is only slightly increased with so-called pre-obesity, it is already high with degree 2 obesity and very high with degree 3 obesity.

Unfortunately, the BMI is only a rough guide for estimating your body weight. Since your height is squared in the calculation, the smallest measurement errors can lead to large changes in the calculated BMI.

The fat distribution pattern also has a major impact on the health risk associated with obesity. Fat that is carried in the abdomen, so-called visceral fat, has a greater impact on the cardiovascular system and thus leads to more complications of being overweight. In contrast to fat directly under the skin, the subcutaneous fat, it releases hormones that have an impact on a wide variety of organs.

To take this factor into account, your waist circumference is also measured in order to estimate the risk of concomitant diseases associated with being overweight. It is considered a good indicator of the amount of visceral fat and is classified based on gender.

  • Increased risk of cardiovascular diseases:
  • Women ≥ 80cm; Men ≥ 94cm
  • Abdominal obesity (Obesity of the abdomen):
  • Women ≥ 88cm; Men ≥ 102cm

Causes of obesity

Many factors influence the development of overweight and obesity. An important factor is the imbalance between energy intake and energy consumption. This can have different causes:

  • Genetic factors
  • Lifestyle: Sedentary lifestyle and malnutrition
  • "Seduction" through constantly available food
  • Lack of sleep and stress: Both factors can not only lead to increased eating, but also have an influence on the hormonal balance.
  • Depressive illnesses can lead to a lack of exercise and increased food consumption.
  • Low social status: It could be shown that people with a lower income and level of education suffer more from being overweight.
  • Eating disorder: Frequent binge eating disorder, frequent nighttime eating (night eating disorder)
  • Disorders of the hormonal balance: Hypothyroidism or abnormally high cortisol levels (Cushing's syndrome)
  • Medication intake: Some medications can make you gain weight.

Metabolic syndrome

The greatest influence on the risk of cardiovascular diseases, besides smoking, is what is known as metabolic syndrome. It's a combination of four different components that often result from overeating and lack of exercise.

  1. Abdominal obesity
  2. high blood pressure
  3. Disorders of lipid metabolism (increased blood lipid levels)
  4. Impaired regulation of blood sugar

What are the Risks of Obesity?

Obesity contributes to increased mortality. This is higher, the higher the BMI and the younger the person who is overweight. A person with a BMI of 22.5 - 24.9 has the lowest risk of death. If you are in the Grade 1 obesity weight class, your life expectancy is 2-4 years lower than it would be for a normal weight. With grade 3 obesity, it would be 8-10 years less. This increased risk of death has many different causes, which can mainly be explained by the changed hormonal balance in obesity.

Some of the complications of obesity include:

  • Diabetes mellitus
  • Gallstones
  • Fatty liver
  • Sleep apnea syndrome
  • Cardiovascular diseases and strokes
  • high blood pressure
  • Joint problems: especially knee and hip problems
  • gout
  • Inflammation of the esophagus
  • Some cancers
  • Polycystic Ovarian Syndrome
  • Back pain
  • Hormonal imbalances and infertility
  • Increased risk in pregnancy
  • Increased risk of surgery and scarring
  • dementia

It is important to realize that obesity is not a purely medical or physical problem. Being very overweight can cause many problems in everyday life. People who are overweight are often discriminated against and suffer from negative stigma. They are often seen as lazy or weak-willed, which can even lead to problems in finding a job. People with obesity are also at increased risk of developing depression.

Diagnosing obesity

To diagnose obesity, your doctor doesn't just use the scales. It is important to learn more about the history of weight change and previous weight loss attempts. While questions about your weight can be difficult to answer, it is very important that you answer your doctor's questions honestly. He is a person of trust whose priority is to offer you the best possible therapy and to accompany you on the path of losing weight. In order to examine the comorbidities of being overweight, some of the possible tests are blood pressure measurement, an examination of the heart using an electrocardiogram (EKG) or ultrasound (heart echo). Blood and / or urine samples can also be taken to get an overview of your hormonal balance.

When should i go to the doctor?

Your doctor should be the first point of contact if you feel you have a problem with your weight. Since obesity complications can have a major impact on your health, they should be treated as soon as possible. Your doctor can help you plan your next steps and, for example, draw your attention to specialized nutritional advice.

What can you do yourself

Many patients report that interacting with others means a lot to them. In self-help groups you can find tips on how to deal with obesity and talk to other sufferers. Internet sites on which you can search for self-help groups in your area are, for example, those of the Obesity Association or at Adiposita.de.

Diet plays a very important role in the therapy of obesity. You can get help from a nutritional counselor or a nutrition therapist, but there are also many things that you can already incorporate into your everyday life. Before you change your entire diet at once, it can help to be aware of what you eat on average each day. The best way to do this is with a nutrition log. By writing down everything you eat in one day, you will get a feeling for a long time which adjustments are easiest to turn. Some changes you can make are for example:

  • Reduce energy consumption: High-calorie foods, such as "fast food", very fatty foods or foods high in carbohydrates, often do not keep you full for long. Short-chain carbohydrates like sugar and white wheat flour are digested quickly and contain few nutrients.
  • Eat slowly: Often the eyes are bigger than the stomach. By avoiding large portions on the plate and taking your food slowly, you are giving your body a chance to let you know when you have eaten enough.
  • Eat colorful: A varied diet is important for a balanced diet. You should eat at least 3 servings of vegetables and 2 servings of fruit a day. These contain vitamins and fiber, which not only contribute to satiety, but are also important for healthy digestion. One principle to follow is that your diet should be based on plant-based foods that you can supplement with animal-based products.
  • Whole grain instead of white wheat flour: Whole wheat flour has more nutritional values ​​than so-called extract flour (light flour), as the shell and the seedling contain most of the fiber, vitamins, healthy oils and minerals.
  • Drinking water: It is recommended to drink at least 1.5 liters of fluids per day. However, this does not mean soft drinks containing sugar. They contain a lot of calories without any nutritional value. Water, unsweetened tea, or coffee are better choices. Alcohol is also very high in calorie density. In order to lose weight, it makes sense to reduce your alcohol consumption.
  • Find your sport: Regular exercise is not only good for losing weight, it also trains your cardiovascular system and aids digestion. Not everyone has to go running. When you find a sport that you like, it's easier to pursue in the long term.

These are just a few tips to get you started. It's hard to keep change going. It might help you set goals with friends or partners so that you can support each other.

Therapy of obesity

The therapy of obesity is based on a basic program of nutrition therapy, exercise therapy and behavior therapy. The goal is to lose weight and maintain this weight reduction in the long term. What is easiest to start with is something you can discuss with your doctor. In the case of extreme obesity and failure of the basic therapy, an operative solution can be considered. Before you decide whether this would be a good choice for you, you should carefully weigh the benefits and dangers of such an operation with your treating doctor.

Overweight in childhood and adolescence

Obesity is the most common nutrition-related health disorder among children and adolescents in Germany. The number of overweight children has increased significantly. In children and adolescents, the increased weight not only leads to problems at school, but it can also lead to long-term health problems. Since children are still growing, the values ​​of adults cannot be used to diagnose obesity. Diet plays a major role in development at this age. In a conversation with a pediatrician, the BMI can be compared with that of children of the same age and the best nutritional therapy can be discussed.

Here's how Kry can help

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  2. German Obesity Society (DAG) e.V., (2019), S3 guideline “Therapy of obesity in children and adolescents”, AWMF register no. 050/002. Available at https://www.adipositas-gesellschaft.de/fileadmin/PDF/Leitlinien/Leitlinie_AGA_S3_2019.pdf (accessed on April 17, 2020)
  3. German Obesity Society (DAG) e.V., (2019), patient guidelines for the diagnosis and treatment of obesity. Available at https://www.awmf.org/uploads/tx_szleitlinien/050-001p_S3_Adipositas_Prävention_Therapie_2019-01.pdf (accessed on April 17, 2020)
  4. Lean ME, Han TS, Morrison CE. Waist circumference as a measure for indicating need for weight management. BMJ. 1995; 311 (6998): 158-61.
  5. WHO Health Topics: Obesity https://www.who.int/health-topics/obesity#tab=tab_1 (accessed on April 17, 2020)
  6. Tomiyama AJ. Stress and Obesity. Annu Rev Psychol. 2019; 70: 703-18.
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