The prevalence of obesity (BMI >30 kg/m2) in Israel, among 17-20 year old in 2013 was 24%, and similar in 2014. In parallel, the rate of diabetes in the 18-year above population increased from 9.53% to 9.71%. These rates highlight the high prevalence, the severity, and the correlation between obesity and diabetes in Israel.
Obesity is recognized as a disease by many professional organizations around the world. Even so, only about 70% of obese persons are reported to have the metabolic disease of obesity. Obesity disease is perceived as the basis of complications in a number of life domains: metabolism, mental health, malignancy, everyday function and finances. For many years, adipose cells were considered “inactive”, inert; their physiological function was recognized as triglyceride storage: to accumulate fat during satiety and to release it during hunger. Nowadays, it is clear that beyond the role of maintaining the body’s energetic balance, adipose tissues are active endocrine cells that secrete hormones, cytokines, and other vasoactive and peptide factors. Therefore, adiposity has implications in a wide range of cardiometabolic risk factors including diabetes hypertension and atherogenic hyperlipidemia. Insights from several studies have linked increased adipose tissue mass, which results in hypoxia, necrosis, infiltration of macrophages, infectious cells, and fibrosis, to the pathological reaction of the formation of adipose tissue. This pathological process results in chronic inflammation and insulin resistance. Understanding this process and its consequences has substantiated the notion that the degree of association between risk factors for cardiometabolic illness and obesity disease is not dependent on the overall amount of fat accumulation as reflected by body mass, but rather on the distribution , function and health of adipose cells in various tissues. Stemming from this view are the surprising results of the Swedish Obesity Subjects Study, which demonstrated reduction of 50% in cardiovascular mortality during an 18-year follow up after bariatric surgery. This finding supports the notion that obesity disease has a key role in general and cardiovascular health hence should be primary target for treatment