Hi Everyone,

This is a tricky issue. What are your thoughts? Join the forum. Feel free to write in English (or Italian if you prefer).

i think that obesity is a very important problem in our society because lots of people have this kind of pathology. it could be a real risk for people's health and so we must fight against it. I agree with the woman of the video when she says that there are a lot of causes for obesity, like behaviours, lifestyle and also medical reasons, and  i think that we must not judge who is affected by obesity. In fact very often it becomes a psicological problem and also can cause depression. so we have to help this type of patient in every way we can, with medical and psicological terapies, because it's a matter of life and death.

In my opinion, obesity is a multifactorial problem. It’s usually caused by neurobiological, metabolic, genetic and socio-cultural factors. The medical need is to reduce body weight, to decrease hypertension, hyperglycemia, dyslipidemia, important factors associated to cardiovascular diseases and diabetes of type 2. But it’s also a behavioral problem often connected to family situation, childhood and other different psychological issues. In fact, it’s important to do a nutritional education to learn to eat healthy, respecting the correct portions necessary for its own caloric needs and exercising regularly. We can see that in the video. Jennifer probably was forced to undergo surgery and she seems to get better than before. So, I support her choice and no one has to judge a person by the way she looks, without knowing her struggles.

According to my personal opinion obesity cannot be regarded only as a medical problem, it could depends on many factors that have a psycological and social origin. Listening to Jennifer’s story, I could think that her condition was caused by a social problem that is linked with her adolescence. When she was 14/15 years old, she had the first problems with her body. In the same way, a social factor (her pregnancy) had represented her turning point but only for a few time. Although obesity is not strictly a medical problem, it has a medical solution that is gastric by pass.

In my opinion obesity is a multifactorial disease. The very problem in a “fat” person is his mood. The first cause of the obesity may be found in depression and the no acceptance of the own physical aspects. 

To me, the first step to fight obesity is work on the mood.

One psychological cause of obese individual is gulping down food in uncontrolled way, in absence of hunger stimulus.

I understand the reasons that led Jennifer to take this surgery. The results that derive from it, pushed Jennifer to work even harder in her fight. 

I reckon intervention good if it is the last thing that can push a patient to change for better. Before the chirurgical operation, the patient must do other attempts to improve his health. 

In my opinion, obesity is a problem due to many different factors that, in an inevitable way, could influence a lot a person's quality of life. 

It is partly caused by genetical problems or by some bad habits, even if I do think that the psychology represents a very strong and important factor that has to be considered. Many people in this particular condition of obesity underestimate themselves (or maybe they have lived very particular experiences that have brought them to this point) and, just because they think that there's no way out, they prefer letting it go and eating too much, not taking care neither of their health. In fact, they are not properly aware of the damages they cause to their body until the moment in which they reach the limit, by developing serious cardiovascular or respiratory diseases that put at risk their life. Moreover, obese people live an embarrassing and frustrating life, always forced to face the judges of very little open-minded people, that make them fell uncomfortable.

By taking the example of Jennifer, she never understood the gravity of her condition until the moment in which doctors proposed her a surgical intervention, consisting in a gastric bypass, presenting it as the only way out as an alternative to a worse fate. I agree with Jennifer's choice at all, considering also the fact that, by reaching this goal, she can now live a more comfortable and healthy life.

A biochemical cause for obesity could be "positive energy balance", which means your intake of energy is more than that required to reach the daily calorie needs, even though we must consider many times metabolic disorders play an important role as well. Sadly, this world is populated by many superficial people who judge others upon their appearance or worse, upon their medical conditions such as obesity. There are many factors that brings to obesity¹ and I completely agree with Jennifer when she says people should be more open-minded, maybe thinking to other factors causing this condition other than saying you have a poor lifestyle or bad dietary habits. As to Jennifer's case, she has gone through many ups and downs in her life, and what she says makes us think there is some sort of difficulty keeping a constant weight, not related to lack of will or initiative: she has lost 110 pounds going to the gym and in many other occasions in her life, but unavoidably regained her weight. Surely her surgeon must have carefully assessed Jennifer's situation before suggesting her to undergo a surgery. He surely excluded any other ineffective intervention for Jennifer and found out that the only solution was to offer her a bypass gastric surgery. Who are we to judge Jennifer, perhaps daring to state she is so lazy or lacking of will that the easiest way to get rid of her "burden" is to undergo a surgery? How can someone be so stupid and inconsiderate not to think that surgery is a suffered choice, for there is maybe no other way to solve her condition?  

References

1) http://www.nhlbi.nih.gov/health/health-topics/topics/obe/causes

In my opinion obesity is a medical problem and a behavioral iusses. Infact it can result from a variety of situations both medical (for example hormonal imbalances) both psychological or social. However we need to help people suffering from this condition and we shuoldn't judge them. It's necessary people feel accept as they are and firs of all they accept themselves so they would take care of themselves. 

I think obesity can be treated either as a medical problem that behavioral. medical because it can lead to having severe cardiovascular diseases, respiratory etc. dangerous for the life ; behavioral because it may result in depression: people often do not accept their body and at this contributes sometimes  the model of beauty imposed by society to be respected; but not limited to, other causes of obesity it is to see the food as only outlet in difficult moments of life. we  should therefore not only consider the medical aspect of obesity, but also the psychological and either way to fight to win this problem.

Obesity is first of all a psychological problem and then it can become a medical issue. It is not easy to resolve problems with food espcially in young age. But it is crucial to not grow up with obesity because then it is very difficult to correct it when we are adults. i consider the chirurgical operation only the last step of an ipotetic situation because before it it is possible to start several initiatives.

Obesity is the cause of numerous medical problems , but in rare cases I think it is caused by medical problems . surely there are diseases that include symptoms such as weight gain and feelings of hunger , but as symptoms should disappear with the cure of the disease . in other cases obesity depends on the choice , not always conscious , eating.

Obesity is very diffused, especially in the occidental countries. It's a mistake to consider it only a behaviour issue; obesity creates problemies in the social relationship but, above all, it has a lot of consequence on our health. A lot of pathologies are caused by obesity; hypertension, cardiac failure, and diseases connected to breathing apparatus. Obesity can be attended by a good lifestyle, and workout; this isn't always sufficient and the surgery is the only solution.

I think Obesity is both a medical problem and an issue of behaviour because it is often associated with other diseases or genetic factors. Sometimes it depends on bad behaviors (those have often psychologic roots), as Jennifer refers. In fact Jennifer tries to lose weight many times in her life and she often reaches the success. Her problem was how to keep the weight, even when she became a model for a fitness club. So i think Jennifer’s choice about Gastric bypass surgery was a painful but a right decision because it represented for her a new opportunity to lose weight and reduce other risks associated with obesity (such as cardiovascular diseases), in order to improve her quality of the life. This event marked Jennifer’s life because she feels the need of reducing her portions of food. So she realizes how to control herself and thinks that obesity is as “a matter of life and death”. 

For these reasons, Gastric bypass surgery can represent the first step to solve this problem, but then it is necessary to keep fit, playing outdoor exercises and eating the correct quantity of healthy food, how Jennifer does now.

I think that you can't consider obesity as "a 'medical' problem or a 'behavioral' issue" because i think that it will be more correct to say that both can influence the obesity. Maybe even more correct would be the idea that the obesity is a syndrome that can be manifested like the result of different illnesses (that also could be psychological). 

 As we can see in the case of Jennifer, the "symptom" of the overweight can appear and than disappear, so we can presume that different times an different life stile can cause the overweight. But, in case that the overweight became a danger, we should examine the obesity as an illness case by himself.

As a society we should understand what are the factors that can cause obesity, that we can control. and we have to think how we can minimize those factors.

Obesity is a serious problem especially in childhood level, but also in adults. A child level is much more severe as the child growing up can have serious social problems in comparison with others. Many times you isolate and intensify their problems. The family doctor and parents should prevent to better promote children's lives. In adults the health problems increase especially cardiovascular and motirio nature. Encouraging a healthy diet and sports.

I think obesity is a complex and multifactorial disorder: its causes could be genetic or linked to lifestyle or improper eating habits. I believe that psychological and social problems can influence the sense of hunger and make the appetite insatiable!!! And when the subject becomes more and more fat, he totally loses the control of his weight. I can't express a competent medical opinion about obesity, but I think that surgery should be the last chance to be considered in this case because of its risks. According to me, the way to overcome obesity is difficult: it is necessary the help of nutritionists , personal trainers and psychologists.  Diet and lifestyle should be changed and  the psychological support is important in order to overcome the moments of discouragement! In fact I think that Jennifer was really depressed when she decided to resort to surgery because she seemed to be unable to lose weight! I can't judge her decision and I hope she is finally happy!!

In my opinion obesity is both a medical problem and a behavioral issue. First of all we know there're many diseases related with obesity, for example cardiovascular problems. In fact hearing Jennifer's story, we can see she is afraid to die for it. Furthermore obesity is also a behavioral issue because it is reflected in the behavior of the person. Overweight people have problems with themselves, they are often insecure, they don't trust in themselves, they don't love themselves because of their body and this is also a problem for relationships.. As a matter of facts, they are often lonely. I think that Jennifer made the right choice doing the gastric bypass, because at first she tried to loose weight. But these surgery operations are not the only way to loose weight, first of all every overweight person has to be determined, brave and ready to suffer in order to reach big results. And big results cannot be reached by shortcut, such as surgery.

According to my personal opinion obesity cannot be considered only as a medical problem but also as a behavioural disorder. Obese people find in food the only solution to their problems, they tend to alienate themselves from the social relationships because they don't feel at ease with their bodies. At the same time this disorder is not limited to the "extra pounds" but it can lead to many consequences, even serious ones, falling within the field of medicine.

First of all, I think that overweight people should improve their lifestyle, adopting healthy habits like physical activity and balanced diet. In rare cases, like in Jennifer’s situation, this is not enough: surgery seems to be the only solution.

Obesity can be considered both a medical disease and a behavioral disorder, but i think that the main cause is the psychological aspect. Indeed, lots of people are obese because of metabolic or genetic factors, but there is also a substantial percentage that is overweight because of difficult situations in the past or other people who face this problem only for a short period as it is related to a momentary stress.

For this reason, i think that surgery has been useful for Jennifer, as it could be for lots of similar cases, but it is not the only solution, in fact, it is often more necessary to work on the psyche in order to gain the right motivation to make a change.

I think obesity si both a medical problem and a behavioral issue. If the patient has metabolic disorders that compromise the functioning of the body, it can be considered a disease. If this can be cured but there are no results after treatment, it means that there is a rejection by the patient, a kind of resignation that leads him to not follow a healthy lifestyle that will take him to improve his form, both physical and mental, because he feels to be part of a marginalized social sector, so also he has many difficulties  to convince himself of wanting to get out.

I think that obesity is a real and serious problem.

Unfortunately lots of people think that obesity is linked to lazy, indolent people who don’t care about their healthy body.

Instead it’s important to underline that  this disease is a blend of “ medical and genetic “ and “ psychological” problem.

I agree with Jennifer’s choice, but I think that surgery is not for everyone because it’ll change everyday beheviour and lifestyle.

I think also that surgery has to be accompanied with a psycological support because it’s not a physical change, but mostly a personal and inner change.

According to me obesity is a medical condition commonly caused by a combination of excessive food intake, lack of physical activity, and genetic susceptibility . But It's a mistake to consider it only a medical condition. It’s also a behaviour issue: it has  got an high impact in social life because it is associated with particular mental states like depression, stress  .that's why obesity can be considered as a psicosocial problem.

I consider obesity not only anaesthetical, nobody's perfect, but a real medical disease, that should be treated like an another patology. The cure for the obese patient is a lot of willpower: he has to change his point of view, his lifestyle, and it's difficult. So many people appeal to surgery, applying a gastric bypass, but I think you have to try so many times to do everything on your own before having a gastric bypass.

Word Health Organization defines obesity as abnormal or excessive fat accumulation that may impair health and tells us that worldwide obesity has more than doubled since 1980.

We do know how huge that problem is and nowadays it is still difficult to define it as a medical issue or a behavior and psychological problem too. 
Obesity can sometimes be traced to a medical or genetical cause but often it is possible to find the causes of this particular condition in bad eating habits or inactivity. In fact, a sedentary life and a lack of attention in the diet inevitably bring to weight gain which, if out of control, could develop in a dangerous condition characterized by a number of serious health problems like diabetes, high blood pressure and breathing disorders. 
In my opinion, obesity should be consider as both a medical and a psychological issue because it is a problem which, when it occurs, could be solve through surgery which, at the same time, must be implemented by a psychological support. The aim of the healing process should be to help the patient to improve his relationship with food and with himself and to reeducate him to a healthy lifestyle. If the patient reach a psychological condition that makes him change his habits and behavior, then it will be able to maintain during the time all the positive results that surgery brought. 

'Obesity' is a really complicated issue. As we already know studying Medicine this problem can depend on a large variety of factors and it shouldn't be semplified just as some people often do. Despite all these things to consider, I am almost sure that it should be seen as a behaviour issue. In Jennifer's case it is clear to me that it was about an eating problem because it would be solved just keeping under control what to eat everyday. 

However, these behaviour problems have a much deep cause, which can be both medical both psychological. In these cases it's necesessary descovery the true reason trough specific exams and choise the right treatment.

I think that the obesity occurs for various reasons, maybe medical problems, or a wrong way of life, or a social or psychological distress that somatization and trying to find comfort in food. I think that when you reach exaggerated levels of obesity is important to carry out surgery, because it's very difficult to lose as much weight just by dieting, and you tend to give up. However after that they have to follow an ipocaloric diet, and sport is also important. Lose weight helps these people to feel better both with themself, and to others and so they improve the quality of their lives. 

Obesity is certainly a medical problem, with heavy psychological influences and, in a certain extent, social

repercussions. To begin with: how does one get obese? Of course a sedentary, un-healthy lifestyle plays its

part; a balanced diet and regular exercise are always the best and easier way to prevent not only obesity,

but also all the related illnesses (cardiovascular diseases above all). In my opinion a balanced diet, designed

by an expert and qualified nutritionist, combined with a scheduled exercise routine is the first thing to

advice to an obese patient. If the condition persists, further analysis are required. A psychological

assistance should be provided by a professional to the patient during the treatment. If the condition is

exclusively related to behavior issues then the patient should go under a guided and gradual re-education

in terms of nutrition and self-care. We also have to consider the traumatic effect of the image that the

patient has of himself, especially for women; social alienation and even suicidal attempts are often linked

to obesity, due to the fact that "being fat" is often perceived as a guilt, both from the patient and society

itself.

When there is an actual disease that causes obesity, or a morbid obesity which does not depend on the

lifestyle only, then a pharmacological therapy should be prescribed to the patient. Obesity is of course a

pathological condition and a disease in itself, but I think that a dangerous intervention like a surgery, that as

many side effects and repercussion on the patient life, should be applied only as a last and extreme

instance (like indeed Jennifer did), when everything else has failed or when a pharmacological therapy

would result in severe side effects. Surgery must not be considered as a shortcut and used without the

necessary caution; it indeed requires an active effort of the patient in the above mentioned fields of

nutrition and exercise for a complete recovery and an healthy life after the operation.

In my opinion obesity is both a medical problem and a behavior issue. A medical problem because, as we can read in many scientific publications about eating disorders, obesity is often associated with hearth disease, stroke, breathing problems or certain types of cancer.

A behavior issue, as Jennifer show us, because is easy lose control of himself without even realizing. As Jennifer said, for those who suffer from certain problems it would be useful assistance continues to reorganize their lives towards a healthier way. it is not to be underestimated childhood obesity which could be prevented by thorough education.

In my opinion obesity is a serious form of overweight that may have consequences both aesthetic and health. From an aesthetic point of view it can create social problems especially for the weak temperamentally people. From a medical point of view it may create problems because it damages the cardiovascular system.

i think that obesity is a medical problem and behavioral issue. people need to find a solution for resolve this problem. maybe with psychological support or with a dietician or both. in Jennifer's case she found a solution with gastric bypass because even when she lost weight, she began to eat and she return to the start. the patient must improve his/her lifestyle and start to think with different point of view.

I think that obesity is a real society problem. Sometimes it's ignoring however it represents an important medical problem of our times . In my point of view , at first time obesity is an psychological problem because it determines a person life style , his way of thinking , his state of mind and the way it looks himself. I think that most obese people aren't able to win their battle with obesity because of the certain they never would be changed , so society have to speak more about obesity problem because people have to be supported and encourage. I agree with Jennifer's opinion, some many factors determinate obesity , and I know how difficult is to find a solution . In my opinion , surgery could be an opportunity but not the solution because to reach the gold we have a basically healthy living , we have to do sports and , in first time, we have to think that we can defeat obesity!

Obesity is one of the main public health questions, so it’s a medical problem. It is mostly caused by wrong lifestyles. I personally think that it’s a condition we can definitely prevent. In other cases it’s associated with other diseases and there are also genetic predispositions. However it is difficult and wrong to make a generalisation of this problem, which is widespread.My point of view about Jennifer’s case is that her obesity is a sign of a lack of self-control when she feels hungry.  As she lost weight, she felt good about herself and this should have helped her to keep it but she wasn’t successful. This is a problem, which is linked to a psychological issue, therefore it has to be managed seriously.  The surgery, the willpower and a healthy education can help. I suggest to have a look at http://www.letsmove.gov/ It’s an American initiative, launched by the First Lady, Michelle Obama, to win the challenge of childhood obesity.

I think obesity is both a medical and a behavioral issue.

An unhealty life style or incorrect eating habits can bring to an uncontrolled weight accumulation and these cases are often due to behavioral factors such as: hard working rhythms, self-confidence, unsatisfactory affective life or depression.

Obviously, we are excluding from this discussion obesity cases due to metabolic syndromes or other organic diseases, that are doubtlessly a medical problem.

Obesity, like bulimia and anorexia, is a kind of issue that touches multiple aspects of a patient's life and for this reason it must be treated from different point of view: first of all psychological, supported by a rigid alimentation control with an Health care professional's help. In these cases, I think the doctor's duty (referring to GPs) is to morally support the patient and monitor the possible negative consequences of his physical state.

Surgical measures should only be the last choice, for a deeper and complete healing of the patient.

I personally think that this is quite a tricky subject. In regard to obesity, it is really difficult to draw the line between psychological and physiological issues. In fact, for quite a few people, these two factors are both very important.

But even though some psychological factors are involved I still think it should be considered without a doubt a "medical issue". Psyche is not a second-rate component of one's health. Psychological health is as important as physical health, and thus it requires proper treatment.

Being that said, in regard to treatment, I think that after trying other less invasive techniques to reduce the patient's weight, and if those result in a failure, gastric bypass surgery can be a good tool to try. Anyways I still think that the surgery alone isn't enough and that it should be combined with a behavioral re-education plan. I think that combining both a more strictly "medical" treatment with a "behavioral" one is what would give the best outcome. 

Obesity is a multifactorial problem. A disease that borns from the head and manifests itself in the body. The doctor  should not just treat the symptom but also the cause, which can be a trauma, depression, whatever may have upset the patient. In the case of a disease such as obesity, the doctor should not only worry about seeing a significant weight loss in the patient but also should worry about his mental health and see a change in him. Surgery should be one of the final steps when you see a change. Jennifer's choice was courageous but the right one because she changed the waistcoat life before embarking on it. In fact at the end of video she says it is not a diet but has undertaken a different lifestyle.

From my point of view it is too restrictive to consider obesity as an exclusively behavioral problem, or vice versa, a purely medical issue. Obesity appears to be something multifactorial, in fact it is related to both wrong lifestyle and eating habits, but is also associated with psychological problems. In fact, a patient suffering from obesity should not be seen as someone who has the full blame on the situation in which he finds himself, but he must be helped and cured with every possible means: from simple psychotherapy to surgery, if it represents the only solution.

In my opinion obesity is, just like Jennifer says, a common problem just like many other problems. This means that people who are affected with this disease must be treated like normal patients, and that they must not be leaved to their own devices. Indeed, obesity is a multifactorial illness that also needs a psychological support to make the affected person understand that a healthy lifestyle is very important. Nevertheless, obesity is not just a psychological disease so overweight people must receive the help they need also with surgery, when it is possible. I think that we should consider obesity like a real and a serious disease, not just like a lack of interest of some people for their own life and health.

I think that obesity can be considered at the same time a medical problem and a behavioral issue. As a matter of fact, we know that there are some drugs (like steroids), which can cause obesity, and some diseases, as hypotirodism, which can cause obesity. Moreover, due to its complications, obesity can be considered a medical problem, since it can cause the onset of tumors. Moreover, obesity can lead to pathologies related to the circulatory system, such as coronary artery disease.

On the other hand, obesity can be also caused by some bad dietary habits. The lack of balance in what you eat causes your body not to receive all those resources, which are fundamental for your health. The risk, in this case, is to be affected by the pathologies that I have just mentioned above.

In my opinion obesity is both a "medical" problem and a "behavioral" issue. Obesity can be considered a medical problem, because it may provoke stroke, cardiovascolar disease, diabetes, sleep disorders, cancer. At the same time overweight people could have psychological problems due to what other people may think of them. I think that a healthy lifestyle with a good diet and sports activities could help these people loose weight; but if they don't solve their problem in this way,  gastric bypass surgery would be the best solution.

In my opinion, obesity is a behavioral, medical and cultural problem. The courageous choice of the patient in the proposed video will surely have been dictated by his lifestyle and a fair compromise between costs and benefits. today you hear a lot about obesity, wrapped in ignorance or rather overwhelming the gravity of the situation and perhaps without realizing the real risks (first of all the cardiovascular risks, but not only) and well to emphasize that the food culture must be well structured in our modern society where sedentaryism is one of the major risk factors. Surgical techniques can certainly help overcome the problem, but only if added to proper nutrition and a healthy lifestyle. In my opinion, there should be a lot of prevention on this subject, as the first ring of care for this type of pathology

I agree with Jennifer’s opinion that it is difficult to take into account all the causes which lead to obesity –genetic factors are definitely important, but often it is the psychological aspect which is the most significant. From this point of view, I think that obesity is not “just like any other problem”, as Jennifer says. Personally, I think that the best option would be to try every non-invasive approaches to the disease before resorting to gastric by-pass surgery, which is irreversible and comes with its own health risks. This is what Jennifer tried to do, although perhaps a less intensive exercise regime would have been easier to keep up in the long-term, and ultimately more effective – especially if coupled with the continuous support of professionals: a psychologist, a nutritionist, maybe even a personal trainer. If this approach doesn't work, then a surgical solution is a reasonable and legit option.

I agree with Jennifer’s choice: she had tried to lose weight several times without permanent success, therefore undergoing surgery was basically the only option left. In addiction to his medical advantages, the surgery probably had a psicological impact on Jennifer, making her conscious of the seriousness of her situation.

Obesity is in fact a multifactorial problem, and the way the patient approaches it plays a lead role in recovery: a full change in one’s lifestyle is necessary to fight this disease, and that’s why it’s so hard to defeat it. Therefore, the doctor has to take into account numerous aspects and not only the clinical ones.

 In my opinion, Obesity is as much a psychological as a physical problem. Psychological issues can not only foreshadow the development of obesity, but they can also follow ongoing struggles to control weight.

eating disorders and obesity usually lies in some combination of psychosocial, environmental, and genetic or biological attributes. Individuals who suffer from psychological disorders (e.g. depression, anxiety, and eating disorders) may have more difficulty controlling their consumption of food, exercising an adequate amount, and maintaining a healthy weight.

Food is often used as a coping mechanism by those with weight problems, particularly when they are sad, anxious, stressed, lonely, and frustrated. In many obese individuals there appears to be a perpetual cycle of mood disturbance, overeating, and weight gain. When they feel distressed, they turn to food to help cope, and though such comfort eating may result in temporary attenuation of their distressed mood, the weight gain that results may cause a dysphoric mood due to their inability to control their stress. The resulting may leade to a continuous pattern of “using food to cope with emotions”. This pattern is particularly applicable if there is a genetic predisposition for obesity or a “toxic” environment in which calorically dense foods are readily available and physical activity is limited.

In my opinion, obesity should be treated as a medical and psychological problem. After watching this video, it seems clear to me that every case should be analysed as a different one: Jennifer was able to lose weight but she needed a surgical resolution to her problem. I believe that gastric bypass surgery should be considered as the last choice as it radically affects patient's life for ever ; on the other hand this surgery is really efficient for patients that are not able to maintain their weight steady. In conclution, I do not completely agree with Jennifer because I think that doctors have to show all the other options to solve obesity before suggesting gastric bypass surgery.

Patient's mentality should change first, in order to reach the goal as in Jennifer's case. If  patients  fail in changing their habits, they are destined  to make the same mistakes over and over. In conclusion the problem must be solved not only from a clinical perspective but also from a phycological one.

I agree with Jennifer's opinion. I think that her message is very important: "Obesity is a problem as just another problem and people are entitled to a service that can help them to improve the quality of their lives."

Even though surgery is an effective cure of obesity it has correlated risks. I think that it should be the last treatment to it. Appropriate diet, a healthy lifestyle and a psychological therapy help obesity patients to lose weight in many cases. 

For me, obesity can be considered both a medical problem and a behavioral issue. In fact, it is related to a lot of diseases such as type 2 diabetes, cardiovascular diseases, respiratory problems, arthritis, certain types of cancer and so on. But as we can learn from Jennifer’s story, it’s so simple to gain weight again, and that’s the reason why, for me, obesity is a behavioral issue too. You had to be constantly focused on what are your goals: be healthy, feel comfortable with yourself and among other people; so your nutrition approach changes everything.
In my opinion, we mustn’t underrate this problem and start to teach to the children about nutrition education. In the end, I think that the surgical operation should be the last option, and the patient must improve his/her lifestyle, maybe thanks to the support of who surround him/her.

I partially agree with the thought of Jennifer. In fact I consider obesity both a 'medical' problem, due to genetic causes, and a 'behavioral' issue, determined by people's lifestyle, and I agree with the idea that obesity is given by a set of difficult factors to keep all together under control. But I think that we should get to the 'Gastric bypass surgery' only as a last solution because it can both help a person to improve their lifestyle but at the same time make it more rigid and limiting.

In my opinion obesity has its origin in a neurophysiological pathway: the mesolimbic pathway. It connects VTA in the midbrain to the ventral striatum, nucleus accumbens; sometimes referred as reward pathway or center and it plays a role in the perception of pleasure and the dysregulation of this pathway and its output neurons in nucleus accumbens, plays a significant role in development and maintenance of addiction, like food addiction.

In conclusion the role of this pathway combined with ambiental and genetic factors underpin this complex pathology

I think that most of the time obesity is a behavioral issue but sometimes obesity it's a medical problem too. Maybe the first approach should focus on the  patient's psychology, his diet and sport habits; it's important that these patients relize the implications of an unhealthy lifestyle that could bring to death at a young age. So I think that obese people should change their habits, having a sporty life and this means a great determination. Many times this is not enough and it depends on people's motivation and not only. In this case the surgery could be the solution, but I think that the patient has to understand the importance of a healthy lifestyle after the  gastric bypass surgery too. 

Of course Obesity is a medical problem, but not only that. Obesity is a medical problem because it can cause a lot of health problems: cardiac problems at first, but also cancers and respiratory diseases. I think that obesity has to be considered not only as an excess weight, but also as a result of an uncorrect style of life. Often it due to many psychological and physiological aspects that have to be faced all together in the therapy. In this outlook, surgical operation and psycological therapy can be part of the startegies utilised to solve the medical problem of obesity.

I think that obesity is both a medical and a behavioral issue, because it is related to a lot of different medical problems and illnesses but it probably starts from a psychological distress in most cases. That's why I think it should be treated as a psychological problem first, and if that isn't enough, as a medical issue in order to avoid complications such as type 2 diabetes, cardiovascular diseases, respiratory problems and metabolic syndrome.

Obesity is certainly a medical problem that affects many people of any social status. I totally agree with Jennifer who says that many factors are involved with obesity and that people should be more comprehensive and more open minded when they talk about this medical issue. 

According to Jennifer's words and to my personal knowledge, I think that obesity can be both a medical problem and a behavioral issue. In some cases, obesity is caused by hormonal dysfunctions or other health problems, so that people start gaining weight and they can't oppose this event. In other cases, obesity is the result of a mental disorder or a social discomfort, which leads the patient to eat almost compulsively, so much that they remain trapped in this vicious circle.

I think that obesity is both a  medical disease and behavioral disorder and needs  to be treated as a multifuncional disease; on top of it every case is different , whit it's own causes and characteristics, and has to be evaluated on its own.

Obesity is also a very diffuse social problem ,but in my opinion, as doctors we should concentrate primarly on the "medical side".

I think obesity is both a medical problem and a behavioral issue. It often starts as behavioral disorder, due to psychological problems: depression, anxiety and post-traumatic stress disorder. Sometimes it's not easy to talk about pains so, many people eat to drown their feelings. Other people may feel so hopeless that don’t follow a diet because they think it’s only a waste of time. In fact often those people, in addition to follow a diet, must be followed by a psychologist. Actually obesity is a multifactorial disease: there may be a genetic predisposition, it can be caused by an excessive food’s consumption, sugar and salt's abuse, absence of physical activity. Eating excessively and incorrectly causes: type 2 diabetes, cardiovascular diseases etc. So, in my opinion, obesity becomes also a medical problem: in the most serious obesity’s cases, it’s possible follow a pharmacological treatment or have gastric surgery. Obviously these therapies can be followed only by some people and must be well evaluated: they can present complications. I agree with Jennyfer’s choice, because she has tried many times to lose weight, without success: gastric surgery, in fact, can be considered even if you tried, unsuccessfully, any non-invasive treatment.

The choice of Jennifer to undergo surgery is a corageous choice, but for me it hides an enormous difficult in jennifer to try to resolve his situation only with a change of her lifestyle: in fact, for me, obesity disorder is in primis an important psychiatric disorder, which subtends a personal dissatisfaction for so many reasons, which can be about work or family. this disorder, obviously, if not treated correctly, can cause a lot of disorders, like metabolic syndrome, which coul carry so many problems to the patient and, in according to this, thisi is a psychiatric disorder . which can transofrm in a metabolic disorder, if not correctly treated.

obesity is certainly a medical problem: it represents a very important risk factor for various metabolic pathologies, including type II diabetes mellitus, which is a pathology with very high morbidity, especially in the western world. However, obesity can be considered as a behavioral issue, which depends on the current society, especially in industrialized countries where the Western diet proposes the so-called junk food. In fact it is to be considered a social problem because it is a phenomenon in constant growth since early childhood, seriously endangering the lives and development of children. For these reasons obesity is to be considered as a multifactorial pathology, which includes a genetic, mental and social component.

I think obesity is really one of mayors problem of our "occidental-fast-food" 's society, that paradoxically is obesity-phoebe, but brings mass to the excessive consumismo. This pathology, that obesity really is, is the previous step and the comorbidity of many others; we need to make a great prevention promuving an healthy lifestyle. I agree with Jennifer in many point of view, I think that  the single patient have to be treated by a multidimensional staff, for the psychological aspect, the educational one and eventually by the surgical approach too. 

Obesity is both a medical and behavior problem. It's a medical problem because of the complex management of the several comorbidies, like diabetes, hypertension, atherosclerosis, joints pain and others. It's also a behavior problem because of the lack of food education and healty lifestyle.

I believe obesity should be considered a multifactorial disease. It's not only about a behaviour of eating much and maybe not eating healthy foods. It's also a medical condition that affects obese people and involve habits and also phsycology. I think the mental well-being of the patient should be implemented together with the eating habits to solve the problem. A rigid diet should not be the solution: a combination of a healthy diet, pshycological support and a good amount of physical activity should be considered a winner.

Jennifer's story is useful to open mind on obesity. The "quality of life" is certainly one of the most important negative consequences of obesity. Obese people evaluate the quality of life also from the ability to do small daily gestures that normal-weight people don't mind, such as being able to put on socks and shoes, or pick up their child. It's a poor quality of life the “trigger”to choose an effective and definitive remedy for the problem . The improvement of the quality of life is not automatic after surgery, the sudden decrease in weight is not in itself sufficient. It is necessary to modify all those maladaptive habits, consolidated during the "career" of obese people, who have contributed to maintaining the pathology, as well as redefining the post-intervention expectations regarding the relationship with one's self and with others. For this reason the presence of the psychologist, both in the pre and in the post-operative period, has a fundamental importance not only in the evaluation but also in the support to the patient if not considered momentarily ready for the intervention.

obesity is a really complicated issue. I agree with Jennifer that people should be more open minded, I find that thinking obese people should basically get it together is a very common and easy thing to say, but it's completely false, rude and a very simplistic way of seeing things. obesity is a medical condition so it should be treated as one. obviously the patient's cooperation is key, as with many other diseases, and jennifer is a good example of a patient wanting to be healthier. 

Obesity is both: a medical problem and a behavioral issue. There are multifactorial causes about obesity and each patient must be treated in a specific way. There are genetic, metabolic, related to microbiota, psychological, pharmacological causes. As a medical problem it’s important that the doctor analyzes the patient to find the right therapy, as a behavior issue it’s also fundamental patient’s compliance to reach the aim with a correct lifestyle doing sport, a correct diet and without smoking.

Obesity is a serious problem that involves a lot of people and children too. it's a medical disease with multifactor pathogenesis and also the behavioral issue contributes.In my opinion because of the morbility and the mortality of this disease is very important to fight it and more important is to educate the population  to a healthy lifestyle. The education should start from the primary school because it's more difficult to change the wrong habits in a second moments.   

In my opinion obesity  is a medical problem and behavioural issue and even a social issue it involves so many factor’s that needs our attention , it includes even traditional behaviour of a society and how much they put an effort to inform there people about the importance of eating clean , with simple educational guide lines we can improve the health of our society and reduce the medical costs.

Obesity, as a life-style behaviour disease, it has been defined as a recurrent chronic disease as a whole, with genetic and endocrine causes, given the case that the adipose tissue has been  revaluated as an endrocrine organ. However the economical and social aspect such as the hedonic function of food, the cultural level, the rising cost of healthy products, have a fundamental role in the distribution of the pathology; The therapy difficulty has its seed in the psichological aspect, in fact only 4% of patients actually heal from the disease. The surgery, for example the gastric bypass that Mrs Jennifer chose, is an adequate method both for the aim of losing weight and for the improvement of the psichological aspect, useful for the conservation of the weight lost. Anyway, the nutrition education is important from the youth, even because the obesity is often originated from the domestic environment.