Obesity is a complex, chronic disease defined by excessive fat deposits that can impair health.[1] Obesity isn't just a cosmetic concern. It's a medical problem that increases the risk of many other diseases and health problems. These can include heart disease, diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea and certain cancers.[2]

In 2022, 2.5 billion adults aged 18 years and older were overweight, including over 890 million adults who were living with obesity. This means that 43% of adults aged 18 and over were classified as overweight. The worldwide prevalence of obesity more than doubled between 1990 and 2022.1

Causes and Risk Factors of Obesity

Overweight and obesity occur due to an imbalance between energy intake (diet) and energy expenditure (physical activity).1

In most cases obesity is a multifactorial disease due to obesogenic environments, psycho-social factors and genetic variants. In a subgroup of patients, single major etiological factors can be identified (medications, diseases, immobilization, iatrogenic procedures, monogenic disease/genetic syndrome).1

The obesogenic environment exacerbating the likelihood of obesity in individuals, populations and in different settings is related to structural factors limiting the availability of healthy sustainable food at locally affordable prices, lack of safe and easy physical mobility into the daily life of all people, and absence of adequate legal and regulatory environment.1

Additionally, the lack of an effective healthcare response to detect excess weight gain and fat accumulation in early stages exacerbates the progression to obesity. 1

Preventing and Managing Obesity

Both overweight and obesity, along with their related noncommunicable diseases, are largely preventable and manageable.1

At the individual level, people may be able to reduce their risk by adopting preventive interventions at each step of the life cycle, starting from pre-conception and continuing during the early years. These include:1

• ensure appropriate weight gain during pregnancy;
• practice exclusive breastfeeding in the first 6 months after birth and continued breastfeeding until 24 months or beyond;
• support behaviours of children around healthy eating, physical activity, sedentary behaviours and sleep, regardless of current weight status;
• limit screen time;
• limit consumption of sugar sweetened beverages and energy-dense foods and promote other healthy eating behaviours;
• enjoy a healthy life (healthy diet, physical activity, sleep duration and quality, avoid tobacco and alcohol, emotional self-regulation);
• limit energy intake from total fats and sugars and increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts; and
• engage in regular physical activity.1

Conclusions

Continuous effort is needed to control obesity because it is a relapsing disease process.[3] There are many background genetic factors related to body weight and body fat that modify the responses to the tasty, inexpensive and convenient food in the environment. Eliminating barriers to physical activity offers another approach, comparable to the role of antibiotics in treating infectious diseases. With continuous and comprehensive efforts, the obesity epidemic will be gradually brought under control.3

The World Obesity Federation takes the position that obesity is a chronic, relapsing, progressive disease process and emphasizes the need for immediate action for prevention and control of this global epidemic.3

References:

1.    https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

2.    https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742

3.    https://onlinelibrary.wiley.com/doi/full/10.1111/obr.12551