World Obesity Day – How did obesity become the greatest public health problem?

Obesity is not just a risk factor, but a disease in its own right

The recognition of obesity as a disease dates to 1948. Insufficient awareness over the ensuing 70 years has allowed the number of people with obesity to rise rapidly, particularly in recent years in low- and middle-income countries.

Obesity affects 800 million people worldwide. Rates have risen almost 3-fold since 1975, increasing almost 5-fold in children and adolescents and affecting people of all ages and social groups in both developed and developing countries. Childhood obesity is expected to increase by 60% to reach 250 million in 2030. Spreading worldwide as a pandemic over recent decades, obesity has now become the greatest public health problem of the 21st century.

What is obesity?

The World Health Organization defines obesity as “abnormal or excessive fat accumulation that presents a risk to health.” It can be measured in several ways. The most common measure used to assess whether weight is healthy is BMI (Body Mass Index), a value obtained by dividing weight in kilograms by square meters (BMI = kg /m2). A BMI of 25-29 is considered slightly overweight , while a BMI above 30 is classified as obesity . Obesity can also be assessed with additional measurements such as waist circumference and waist-to-height ratio.

• Related topic: The relationship between obesity and cancer

What causes obesity?

Although defined as a disease 70 years ago, obesity is regarded in many societies as a personal failure rather than a disease. Obesity results from a lack of willpower. Many causes contribute to its development, including biology, genes, mental health, access to healthcare and exposure to highly processed, unhealthy foods.

What are the harms of obesity?

Living with obesity places people at higher risk of other diseases, such as cardiovascular disease, diabetes, joint and bone disorders and certain cancers. COVID-19infection in people with obesity carries a higher risk of severe illness and even death.

What factors increase obesity risk?

1. Biology: The human body is preprogrammed to store fat as protection against possible starvation. This can be a useful survival mechanism during famine, but in current conditions it makes obesity easier to develop.
2. Food and drink: Today, processed products and cheap, energy-dense foods are readily accessible. Obesity develops readily, particularly among people who favor these foods.
3. Genetics: Genetic factors may play a 40% to 70% role in the development of obesity.
4. Not seeking healthcare: Follow-up and treatment by a healthcare center are important for avoiding obesity and achieving long-term weight goals.
5. Life events: The prenatal period, puberty, pregnancy, illnesses and medications can all affect the development of obesity.
6. Marketing: Presenting foods in ways that stimulate appetite, both visually and through taste, promotes obesity.
7. Mental health: Some mental health disorders and unhealthy conditions associated with illness can cause weight gain
8. Sleep disruption: Insufficient sleep and stress affect obesity through hormonal changes as well as an increased tendency to snack.
9. Being stigmatized as fat: Discrimination based on weight can contribute to people with excess weight progressing to obesity.

Public awareness must be increased in the fight against obesity. The importance of exercise habits alongside eating habits should be emphasized from childhood. We live in environments where opportunities for physical activity have diminished, contributing to excessive weight gain. Obesity is therefore a disease developing in response to an obesogenic environment, rather than a personal failure.

Unhealthy lifestyle habits, such as poor diet and low physical activity, are obesogenic factors, creating conditions for obesity.

The high-calorie foods we eat may not be the most important cause of obesity. Studies suggest roles for hormones affecting appetite, such as leptin and ghrelin, and for gut bacteria (the microbiota). Changes in these hormones and our microbiota can persist for years. Obesity is therefore a chronic disease requiring long-term treatment.

It is vital to give the billions of people living with obesity the best chance of recovery. Improving access to nutritious foods while reducing consumption of energy-dense foods, especially among vulnerable children, and supporting policies that promote physical activity as part of normal life are important. Obesity is also a relapsing disease. Creating healthy environments through institutions, organizations and government policies should be a central aim of governments working to halt rising obesity rates.

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