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Overvekt og fedme

Sist revidert:
Sist revidert av:


Definisjon:
Overvekt defineres som KMI 25,0-29,9 kg/m2, fedme grad I er KMI 30,0-34,9 kg/m2, fedme grad II er KMI 35,0-39,9 kg/m2 og fedme grad III er definert som KMI ≥40 kg/m2
Forekomst:
Hver femte nordmann har en kroppsmasseindeks (KMI) ≥30 kg/m2 (fedme)
Symptomer:
Symptomet er overvekt + ev. overvektsrelaterte tilleggs-symptomer som nedsatt funksjonsevne, redusert fysisk kapasitet, søvnapné, dyspepsi, halsbrann, sure oppstøt, symptomer på angst og depresjon, sosial isolasjon og redusert livskvalitet
Funn:
Klinisk funn er overvekt, ev. søvnapné, høyt blodtrykk, dyslipidemi, diabetes type 2, ikke-alkoholisk fettlever, gallesteinssykdom, PCOS, hjerte- og karsykdom, belastningslidelser i vektbærende ledd, angst, depresjon og overspisingslidelser
Diagnostikk:
Tilleggsundersøkelser: TSH og FT4, HbA1c, leverprøver, lipidstatus. Beregne fri testosteronindeks ved mistanke om PCOS
Behandling:
Først og fremst kalorirestriksjon for vektreduksjon (3-6 måneder), med økende grad av fysisk aktivitet for vektstabilisering (resten av livet). Hvis dette ikke er tilstrekkelig bør medikamentell behandling vurderes. Kirurgi aktuelt ved fedme grad III, eller grad II + tilleggssykdommer, eller etter spesialistvurdering ved fedme grad I + diabetes type 2. 
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  • Jøran Hjelmesæth, professor ved Avdeling for endokrinologi, sykelig overvekt og forebyggende medisin, Universitetet i Oslo. Senterleder ved Senter for sykelig overvekt i Helse Sør-Øst, Sykehuset i Vestfold, og leder ved Nasjonalt råd for ernæring
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • John Cooper, spesialist i allmennmedisin og indremedisin, Medisinsk avdeling, Sentralsjukehuset i Rogaland, Stavanger
  • Stein Vaaler, overlege dr. med., Senter for Klinisk Epidemiologi, Rikshospitalet, Universitetet i Oslo