The Obesity Epidemic: Causes, Risks, and Prevention Tips
Introduction
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According to WHO, in the year 2022, out of 2.5 billion overweight adults, 890 million were identified as having obesity worldwide. Since 1990, adult obesity rates have doubled, and adolescent obesity has increased fourfold.
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It would not be inaccurate to refer to it as a global epidemic. This article offers an in-depth exploration of obesity, including its causes, health impacts, and approaches to prevention and management.
What is obesity?
Obesity is the accumulation of excess fat or adipose tissue in the body that adversely impacts overall health.
- It is an intricate health issue with multifaceted origins.
- Obesity is typically defined as a BMI of 30 kg/m² or higher, although the distribution of fat also plays an important role.
- Most health problems have been linked to intraabdominal fat rather than whole-body fat.
- Obesity arises from a disparity between energy consumption (food intake) and energy expenditure (physical activity and BMR) resulting in excessive unhealthy weight gain.
- Various environmental, genetic, and psychosocial aspects and lifestyle choices influence the development of obesity.
- Obesity is a highly heritable disorder, with genetics accounting for 40-70% of body weight variation among individuals.
Causes Of obesity
- Lack of physical activity
- Sleep deprivation, irregular sleeping schedules
- Increased consumption of nutrient-deficient, high-calorie food
- Excessive screen time, especially in children
- Chronic stress can contribute to high levels of cortisol which can enhance appetite and trigger food cravings that are rich in fat and include added sugars.
- Certain medications can cause excessive weight gain such as
- Psychiatric meds (antidepressants, anti-psychotics, anti-epileptics)
- Steroids
- Oral contraceptive pills
- Certain drugs used in the treatment of diabetes (insulin, sulphonylureas).
- Various health conditions that can lead to obesity include
- Cushing Syndrome
- PCOS
- Hypothyroidism
- Genes too play a vital role. Some genetic syndromes associated with obesity are
- Prader-Willi Syndrome
- Bardot Beidl Syndrome
- Alstrom Syndrome
Interpreting BMI: A Tool for Evaluating Weight Status
BMI is the most popular and widely used screening method for assessing obesity. It is calculated as weight in kilograms divided by height in meters squared.
Here is the classification of obesity based on BMI.
BMI | Weight Status |
Below 18.5 kg/m² | Underweight |
(18.5 – 24.9) kg/m² | Healthy weight |
(25.0 – 29.9) kg/m² | Overweight |
(30.0 – 34.9) kg/m² | Obesity Class I |
(35.0 – 39.9) kg/m² | Obesity Class II |
40 kg/m² or above | Obesity Class III |
However, it has its limitations. For instance, a very muscular person may have a high BMI, which is due to his muscle mass and not fat deposit.
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Thus, even though BMI provides useful insights into weight status, it should be paired with other health assessments for a complete picture of overall well-being.
Other techniques include:
- Measuring skin fold thickness in triceps, subscapular, and supra-iliac areas.
- Waist to hip ratio
- Bioelectrical Impedance Analysis
Health Risks of Obesity
Obesity is a complex disorder that presents a multitude of health risks that can compromise an individual’s quality of life. These are outlined below.
- Dyslipidemia– High cholesterol and atherosclerosis can be detrimental to heart health.
- Cardiovascular Diseases– Increased risk of coronary artery disease, hypertension, and stroke.
- Insulin Resistance leading to Diabetes Mellitus Type II.
- Gastrointestinal Disorders– GERD (Gastroesophageal Reflux Disease) is the most prevalent GI complication and the risk of developing gallstones is also heightened due to elevated cholesterol levels and gallbladder stasis.
- Liver Disease– Obesity amplifies the risk of developing Non-Alcoholic Fatty Liver Disease.
- Respiratory Problems like breathlessness, snoring, and Obstructive Sleep Apnea can adversely impact the quality of life.
- Rheumatological Disorders– Being obese puts greater strain on knee joints leading to osteoarthritis of the knee.
- Cancers– There is an increased risk of developing certain cancers such as breast cancer, endometrial cancer, oesophageal cancer, and colorectal cancer.
- Reproductive health– Infertility and pregnancy complications such as gestational diabetes and pre-eclampsia may arise due to obesity.
- Mental health issues such as anxiety, depression, and low self-esteem may develop because of being obese.
Managing Obesity
Managing obesity is crucial for enhancing the quality of life and reducing the risk of chronic diseases, requiring a holistic approach including diet, exercise, behavioral changes, and sometimes pharmacotherapy and bariatric surgery. Treatment strategies are individualized, based on the severity of obesity and the presence of comorbid conditions.
1. Dietary Modifications
Achieving effective weight control requires a reduction in overall calorie consumption. A deficit of about 600 kcal/day is recommended in the initial stages. This can be accomplished through the following approaches.
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- Opt for smaller portion sizes.
- Incorporate more fruits and vegetables in your diet as these are rich in fibre which gives a sense of satiety without affecting calorie consumption.
- Consume more whole-grain cereals and skimmed milk products.
- Diets that feature low energy-dense foods (soups, oatmeal) are shown to effectively curb hunger, leading to a reduction in calorie intake and subsequent weight loss.
- Cut back on fried foods and sugary beverages.
Very low-calorie diets (VLCD) are prescribed to those who are severely obese to promote weight loss in 3-6 months. However, it should always be followed under the supervision of a Healthcare Physician, or else it can lead to more harm than benefit.
2. Physical Activity and Exercise
Integrating dietary modifications with physical activity is the most successful approach and yields the best results. The weight loss achieved with a healthy balanced diet needs to be maintained with regular exercise. A moderate-intensity workout will raise the heart rate and accelerate breathing.
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- Ideally, 150 minutes of moderate-intensity workout or 75 minutes of vigorous-intensity workout spread out evenly throughout the week is recommended.
- Some options for activities include:
- Brisk walking
- Riding a bicycle
- Walking up stairs
- Swimming
- Dancing
- Hiking
- Minimise sedentary behavior and engage in activities that promote movement throughout the day. Take regular breaks from sitting.
- Using a pedometer is recommended to keep track of your step count.
- Choose activities that you enjoy and that fit into your routine to help sustain your habits over time.
3. Behavioral Interventions
Promoting self-awareness and engaging individuals in self-reflection sets the foundation for meaningful behavioral change. Cognitive Behavioral Therapy is instrumental in helping individuals stick to lifestyle changes and dietary adjustments. Here are some key strategies:
- Self Monitoring: Maintaining food diaries to help track calorie consumption and activity logs promote accountability.
- Goal setting: Setting Specific, Measurable, Attainable, Relevant, and Time-bound (SMART) goals to stay focused.
- Stimulus Control: Modifying the environment that stimulates eating (For example: stocking up nutritious snacks and keeping the unhealthy ones out of the house) to facilitate better choices.
- Social Support: Involving family members or friends can be of immense help to keep you motivated throughout the weight loss journey.
- Behavioral commitment: It is crucial to reinforce positive outcomes and reward desirable behaviors to encourage long-term adherence to healthy habits.
4. Pharmacotherapy
Medical treatment is considered when a patient’s BMI is >30 kg/m² or >27 kg/m² with associated comorbid conditions or in whom the dietary adjustments and physical activities have not been successful. These medications either act by controlling appetite, promoting a sense of satiety, or by inhibition of GI fat absorption. Various FDA-approved anti-obesity medications include:
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- Phentermine
- Phentermine/Topiramate
- Naltrexone/Bupropion
- Liraglutide
- Semaglutide
- Orlistat
Make sure you consult your healthcare provider. After considering your obesity status and comorbidities he/she will recommend the most effective treatment tailored to your needs.
5. Bariatric Surgery
For those struggling to lose weight after having tried every available alternative, bariatric surgery offers a potential solution to facilitate lasting weight loss. It is recommended for individuals with BMI >40 kg/m² or >35 kg/m² with comorbidities.
Psychological motivation is an essential prerequisite before undergoing this procedure. Some of the procedures typically undertaken are:
- Adjustable Gastric Banding: Allows to limit the food the stomach can hold and slows down gastric emptying.
- Sleeve Gastrectomy: The stomach is vertically sectioned and stapled, leaving a banana-shaped pouch that promotes weight loss.
- Intraluminal Gastric Balloon: These devices are placed in the stomach endoscopically (RESHAPE, ORBERA devices) to assist in weight loss. These can be used in adults for up to 6 months.
- Roux-en-Y Gastric Bypass: The most accepted and effective procedure. It involves creating a small stomach pouch and re-routing the small intestine to this pouch.
Complications of surgery include post-operative leaks, infections, and thrombosis. Malabsorption and vitamin or mineral deficiencies may also be seen for which adequate supplementation becomes essential.
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Nonetheless, these procedures can significantly improve health conditions like Diabetes Mellitus Type II, hypertension, dyslipidemia, obstructive sleep apnea, and cardiovascular events in the long run and hence enhance the quality of life.
Key Strategies for Preventing Obesity
A proactive stance on obesity prevention involves community support, education, and fostering habits that encourage healthy eating and regular exercise from an early age. Here are some essential approaches:
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- Adopt healthy eating patterns from a younger age itself. Avoid packaged food and beverages.
- Trade screen time for quality time with family. Engage in activities like cooking together, and going for walks that foster a positive environment.
- Ensure you get sufficient sleep.
- Manage stress by practicing relaxation techniques such as meditation or deep breathing.
- Engage in sports and aim to create an active lifestyle.
- Form a community initiative to provide safe play areas for children.
Several key policies that need to be established include:
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- Providing access to healthy and nutritious food that is affordable for everyone.
- Limiting the advertising of high-sugar, high-sodium, and high-fat foods.
- Establishing guidelines for schools to limit unhealthy food options in cafeterias.
- Setting up nutrition education programs within the community to teach the importance of balanced nutrition and to guide the consumers on making healthier food choices.
Conclusion
The rising prevalence of obesity calls for a coordinated response to this complex issue. To combat this growing epidemic, collaborative efforts among the communities, healthcare providers, educators, and policymakers are essential. Together, we can create a healthier future for ourselves and generations to come.
Dr Varsha Attri
MBBS
I’m a dedicated MBBS doctor with a strong passion for medical research. After graduating from SGRD University Of Health Sciences and working as a medical officer, I realized my passion for medical writing. I thrive on continuous learning and seek to expand my knowledge and skills in the field of Medical Journalism. Outside of medicine, I enjoy reading books and connecting with nature which fuel my creativity and inspire my writing. I’m eager to contribute meaningful content that informs and educates others in healthcare.
