Press Release
Influenza and infections, obese people get sick more often
When people are obese their immune defences are reduced
so they are more susceptible to infections
Obesity is a real disease, responsible for developing severe conditions
such as diabetes, heart attacks and strokes
35 percent of cancers could be prevented with a correct diet and
the maintaining of body weight within the norm.
In subjects with severe obesity, bariatric surgery has proved to be
effective in determining the remission of diabetes
Parma, 14 April 2014 - Obesity as a real disease, responsible for developing severe conditions such as diabetes, heart attacks and strokes but also for reducing the immune defences. A global problem - hence the origin of the term “globesity” - addressed on occasion of the symposium “Globesity and its metabolic and digestive consequences” organised in Parma by the Fondazione Internazionale Menarini. "In the presence of obesity the immune defences are reduced, which means that obese subjects are more susceptible to infections as they have a lower antibody response to vaccinations, including the most common one, the influenza vaccine", explains Carmelo Scarpignato, Professor of Clinical Pharmacology at the University of Parma and Chairman of the Symposium. "In this sense obesity assumes social importance because the obese patient gets sick more easily and as a result spreads infectious diseases more frequently than a person of normal weight".
Even though obesity is the cause of various diseases, its influence in developing these conditions is still underestimated. "Obesity is not considered a disease, however today we know with certainty that excess adipose tissue at a visceral level activates a physiopathological mechanism capable of triggering high blood pressure and cardiovascular diseases, heart attacks and strokes, but also kidney and metabolic diseases, the most serious of which is without doubt diabetes", warns Michele Carruba, Professor of Pharmacology at the University of Milan. "Numerous diseases are considered independently and therefore they are treated accordingly, when they could instead be eliminated by intervening on the original cause, and namely, obesity. For example, at least 35 percent of cancers could be prevented with a correct diet and the maintaining of body weight within the norm".
By keeping obesity under control it would be possible not only to reduce the incidence of various diseases, but also to contribute towards their prevention. "We know that two out of three people who suffer from gastro-oesophageal reflux are either overweight or obese", continues Scarpignato. "This makes subjects who suffer from this symptom go to the doctor, and therefore - on this occasion – it is possible to monitor their glycidic and lipidic metabolism, heart, and blood pressure for early detection of diabetes, dyslipidemia and cardiovascular diseases. In this way the reduction of body weight would help reduce the reflux symptoms, but also prevent diseases (such as type 2 diabetes mellitus and cardiovascular diseases), which occur later than the gastrointestinal symptoms".
However, one of the problems surrounding the treatment of obesity concerns the lack of pharmacological treatment. "That is why we now know that the approach to obesity must always be multidisciplinary. The treatment begins with a diet associated with physical energy and a behavioural approach, if possible in association with pharmacological therapy. It has been demonstrated that these approaches are synergic and lead to a greater weight loss than each of these treatments can produce by themselves", adds Scarpignato. "In severely obese patients, that is with a body mass index higher than 35, bariatric surgery has proved to be extremely effective (1), especially the malabsorption type, which, by creating a state of permanent malabsorption allows for a weight loss of various kilograms. Nevertheless, two important elements must be borne in mind: it is necessary to make a careful selection of the subjects who can undergo surgery and this must be carried out in qualified centres".
In this regard it is not sufficient just to calculate the body mass index. "Today the severity of obesity is not calculated merely on the body mass index, or the number of excess kilos, instead, the consequences of this disease are taken into consideration", confirms Nicola Scopinaro, Professor of Surgery at the University of Genoa and creator of the biliopancreatic diversion, a variation of bariatric surgery that now counts for more than half the operations on obesity conducted worldwide each year. "Obese subjects may not have any complications and therefore they are just considered as people with a body alteration, not sick people, even though it is more than likely that they will suffer complications linked to obesity later on in life. Conversely, there may be people with only mild obesity who instead suffer from serious complications due to the excess kilos. Amongst these complications, the most common which determine whether a person is suited to undergo surgery or not are the metabolic diseases, above all diabetes ".
On the subject of diabetes, bariatric surgery can give rise to remission of this disease. "Studies of new approaches to diabetic treatment are underway and we are studying the action mechanism underlying this phenomenon", explains Geltrude Mingrone, Professor at the Catholic Sacred Heart University of Rome. "Intestinal hormones that determine insulin-resistance have been isolated in an attempt to create pharmaceutical products that mimic this mechanism. Other studies are experimenting with certain devices and instruments that give rise to the same consequences as bariatric surgery without being so invasive. In other trials, materials are used that isolate the intestinal mucosa against certain nutrients, as well as cauterisation of intestinal mucosa to reduce the number of hormones that determine insulin-resistance. This demonstrates how out of all the metabolic sectors, bariatric surgery is one of those which is evolving most rapidly".
Our hope is that the experts will find solutions that help reduce this problem, even though the decisive turning point should come from a change of lifestyle of the population. "Obesity is now a global problem, a “global epidemic” that affects the whole world. It is estimated that 500 thousand adults worldwide are obese, and one and a half billion are overweight. And if this trend continues at the same rate, within fifteen years 60 percent of the population, equal to 3.3 billion people, will be obese or overweight. This is a trend that we must fight against", concludes Scarpignato.
(1) There are currently three main type of surgery in use:
- Gastro-restrictive type surgery (the formation of a smaller-sized gastric pouch) that reduces the gastric capacity;
- Malabsorption type surgery that drastically reduces the absorption of food and energy;
- Mixed surgery that combines the gastro-restrictive component with that of reduced food absorption.