OBESITY

Obesity: A Global Health Challenge

Obesity is a condition characterized by abnormal or excessive fat accumulation that may impair health. It is a major risk factor for many chronic diseases, such as diabetes, cardiovascular disease, cancer, and osteoarthritis. Obesity is also associated with reduced quality of life, psychological distress, and social stigma. According to the World Health Organization (WHO), obesity has nearly tripled since 1975 and affects more than 650 million adults and 340 million children and adolescents worldwide. In this article, we will explore the causes, consequences, treatments, and challenges of obesity.

Causes of Obesity

Obesity is mainly caused by an imbalance between energy intake and expenditure, due to a combination of genetic, environmental, behavioral, and metabolic factors. A few of the common causes of obesity are:

• Genetics: Some people are more prone to obesity due to inherited genes that affect appetite, metabolism, and fat distribution³.
• Physiological influences: Hormonal imbalances, such as hypothyroidism, Cushing’s syndrome, and polycystic ovary syndrome, can affect weight regulation³.
• Food intake and eating disorders: Overconsumption of high-calorie, low-nutrient foods, such as fast food, processed food, and sugary drinks, can lead to obesity. Eating disorders, such as binge eating disorder, bulimia nervosa, and night eating syndrome, can also contribute to obesity³.
• Weight history: Repeated cycles of weight loss and gain, also known as yo-yo dieting, can lower the metabolic rate and increase the tendency to store fat.
• Hereditary: Having obese parents or relatives increases the likelihood of obesity³.
• Unhealthy diet: Overeating, too often, or too fast, skipping meals, or following fad diets can lead to obesity.
• Sedentary lifestyle: Lack of physical activity, spending too much time on screen-based devices, or having a desk-bound job can reduce energy expenditure and increase obesity risk³.
• Drugs: Some medications, such as steroids, antidepressants, and antipsychotics, can cause weight gain as a side effect.
• Pregnancy: Women tend to gain weight during pregnancy and may have difficulty losing it after childbirth.
• Lack of sleep: Sleep deprivation can disrupt the hormones that regulate appetite and metabolism, leading to increased hunger and reduced energy expenditure³.
• Quitting smoking: Smoking cessation can increase appetite and reduce metabolic rate, resulting in weight gain.

Consequences of Obesity

Obesity can have serious health, social, and economic consequences, such as:

• Health consequences: Obesity can increase the risk of various diseases and complications, such as:
• Type 2 diabetes: Obesity can impair the body’s ability to use insulin, leading to high blood sugar levels and diabetes¹.
• Cardiovascular disease: Obesity can raise blood pressure, cholesterol, and triglyceride levels, and cause inflammation and blood clotting, leading to heart disease and stroke¹.
• Cancer: Obesity can alter the levels of hormones, growth factors, and inflammatory markers, and affect the immune system, increasing the risk of certain cancers, such as breast, colon, endometrial, and liver cancer.
• Osteoarthritis: Obesity can put extra stress on the joints, especially the knees, hips, and lower back, causing cartilage damage and pain.
• Sleep apnea: Obesity can cause fat deposits around the neck and throat, obstructing the airway and causing breathing difficulties during sleep.
• Fatty liver disease: Obesity can cause fat accumulation in the liver, leading to inflammation, scarring, and liver failure.
• Infertility: Obesity can affect the reproductive hormones and impair ovulation in women and sperm quality in men, leading to reduced fertility¹.
• Social consequences: Obesity can affect the psychological and emotional well-being of individuals, as well as their relationships and interactions with others, such as:
• Low self-esteem: Obesity can cause negative body image, low self-confidence, and poor self-worth².
• Depression and anxiety: Obesity can trigger or worsen mood disorders, such as depression and anxiety, due to hormonal changes, chronic stress, or social isolation².
• Discrimination and stigma: Obesity can expose individuals to prejudice, bias, and harassment from others, such as employers, health care providers, peers, and media.
• Reduced quality of life: Obesity can limit the physical, social, and occupational functioning of individuals, affecting their daily activities, hobbies, and opportunities.
• Economic consequences: Obesity can impose a significant burden on the health care system and the society, such as:
• Increased health care costs: Obesity can increase the demand for and expenditure on health care services, such as medications, hospitalizations, surgeries, and consultations².
• Reduced productivity and income: Obesity can reduce the work performance and attendance of individuals, affecting their income and career prospects².
• Increased environmental impact: Obesity can increase the consumption of food, energy, and transportation, contributing to greenhouse gas emissions and climate change.

Treatments for Obesity

Obesity can be treated by various methods, depending on the severity, causes, and complications of the condition. The main goal of obesity treatment is to achieve and maintain a healthy weight and prevent or manage obesity-related diseases. Some of the common methods of obesity treatment include:

• Lifestyle changes: This is the first-line and most effective obesity treatment, involving modifying the diet, physical activity, and behavior of individuals. A healthy diet should consist of balanced, varied, and nutritious foods, such as fruits, vegetables, whole grains, lean proteins, and healthy fats while limiting the intake of processed, fried, and sugary foods and beverages. Physical activity should include at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week, as well as muscle-strengthening activities on two or more days per week. Behavior modification should involve setting realistic and specific goals, monitoring and recording the progress, rewarding the achievements, and seeking support from family, friends, or professionals.
• Medications: This is an adjunct treatment for obesity, used in combination with lifestyle changes, for individuals with a BMI of 30 or more, or a BMI of 27 or more with obesity-related complications. Medications for obesity work by suppressing the appetite, increasing the feeling of fullness, or reducing the absorption of fat from the diet. Some of the common medications for obesity include orlistat, phentermine, liraglutide, and bupropion-naltrexone. However, medications for obesity may have side effects, such as nausea, diarrhea, headache, and insomnia, and may interact with other drugs, such as antidepressants, anticoagulants, and anticonvulsants. Therefore, medications for obesity should be prescribed and monitored by a healthcare professional.
• Surgery: This is a last-resort treatment for obesity, used for individuals who have a BMI of 40 or more, or a BMI of 35 or more with obesity-related complications, and who have failed to lose weight with lifestyle changes and medications. Surgery for obesity, also known as bariatric surgery, involves altering the digestive system to limit the amount of food intake or absorption. Some of the common types of surgery for obesity include gastric bypass, sleeve gastrectomy, adjustable gastric banding, and biliopancreatic diversion with a duodenal switch. Surgery for obesity can result in significant and long-term weight loss and improvement of obesity-related diseases. However, surgery for obesity may also have risks, such as bleeding, infection, leakage, malnutrition, and gallstones, and may require lifelong follow-up and supplementation.

Challenges of Obesity

Obesity is a complex and multifaceted problem that poses many challenges for individuals, healthcare professionals, and society. Some of the challenges of obesity include:

• Prevention: Obesity prevention is a challenging task, as it requires addressing the underlying causes and risk factors of obesity, such as genetic, environmental, behavioral, and metabolic factors, as well as the social and economic determinants of health, such as poverty, education, and access to health care. Obesity prevention also requires a multisectoral and multidisciplinary approach, involving the collaboration and coordination of various stakeholders, such as governments, healthcare providers, educators, media, the food industry, and civil society.
• Management: Obesity management is a challenging process, as it requires a long-term and individualized approach, taking into account the needs, preferences, and circumstances of each person. Obesity management also requires a comprehensive and integrated approach, involving the assessment and treatment of not only weight status, but also obesity-related diseases, psychological issues, and social factors. Obesity management also requires a supportive and respectful environment, where individuals are motivated and empowered to make positive life changes.
• Research: Obesity research is a challenging field, as it requires exploring the complex and dynamic interactions among the biological, psychological, and social aspects of obesity, as well as the mechanisms and outcomes of obesity and its treatments. Obesity research also requires developing and evaluating new and innovative methods and tools for obesity prevention, diagnosis, and treatment, as well as translating and disseminating the evidence and best practices to the relevant audiences and settings.

Conclusion

Obesity is a serious and growing health problem that affects millions of people worldwide. Obesity can have detrimental effects on the physical, mental, and social well-being of individuals, as well as the health care system and society.