NCC Officers' Training Academy
GWALIOR (Est 1965)
Obesity
Overview
Overweight is a condition of excessive fat deposits.
Obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity can lead to increased risk of type 2 diabetes and heart disease, it can affect bone health and reproduction, it increases the risk of certain cancers. Obesity influences the quality of living, such as sleeping or moving.
The diagnosis of overweight and obesity is made by measuring people’s weight and height and by calculating the body mass index (BMI): weight (kg)/height² (m²). The body mass index is a surrogate marker of fatness and additional measurements, such as the waist circumference, can help the diagnosis of obesity.
The BMI categories for defining obesity vary by age and gender in infants, children and adolescents.
Adults
For adults, WHO defines overweight and obesity as follows:
- overweight is a BMI greater than or equal to 25; and
- obesity is a BMI greater than or equal to 30.
For children, age needs to be considered when defining overweight and obesity.
Children under 5 years of age
For children under 5 years of age:
- overweight is weight-for-height greater than 2 standard deviations above WHO Child Growth Standards median; and
- obesity is weight-for-height greater than 3 standard deviations above the WHO Child Growth Standards median.
Children aged between 5–19 years
Overweight and obesity are defined as follows for children aged between 5–19 years:
- overweight is BMI-for-age greater than 1 standard deviation above the WHO Growth Reference median; and
- obesity is greater than 2 standard deviations above the WHO Growth Reference median.
Types of Obesity
- Android Obesity (Apple-shaped): Characterized by excess fat accumulation around the abdomen. This type is associated with a higher risk of heart disease, type 2 diabetes, and high blood pressure.
- Gynoid Obesity (Pear-shaped): Characterized by excess fat accumulation around the hips and thighs. This type is generally considered less risky for health complications compared to android obesity.
Key facts
- Global Prevalence: In 2016, over 1.9 billion adults aged 18 years and older were overweight. Of these, over 650 million were obese.
- Childhood Obesity: Childhood obesity has nearly tripled since 1975. In 2016, over 41 million children under the age of 5 were overweight or obese.
- Health Consequences: Obesity is a major risk factor for noncommunicable diseases such as cardiovascular diseases (heart attacks and stroke), diabetes, musculoskeletal disorders (especially osteoarthritis), and certain types of cancer (endometrial, breast, colon, kidney, and liver cancer)
- Economic Burden: The global economic cost of obesity is estimated to be over 2 trillion US dollars.
Cause of Obesity
Obesity results from an imbalance between energy intake and energy expenditure.
Overweight and obesity result from an imbalance of energy intake (diet) and energy expenditure (physical activity).
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).
Key contributing factors include:
- Unhealthy Diet: High consumption of processed foods, sugary drinks, and excessive calories.
- Physical Inactivity: Lack of regular exercise and sedentary lifestyle.
- Genetic Predisposition: Family history of obesity can increase susceptibility.
- Hormonal Imbalances: Conditions like hypothyroidism can contribute to weight gain.
- Medications: Certain medications can cause weight gain as a side effct.
- Psychological Factors: Stress, emotional eating, and sleep disorders can influence weight management.
Risk Factors of Obesity
The health risks caused by overweight and obesity are increasingly well documented and understood.
In 2019, higher-than-optimal BMI caused an estimated 5 million deaths from noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, cancers, neurological disorders, chronic respiratory diseases, and digestive disorders (1).
Being overweight in childhood and adolescence affects children’s and adolescents’ immediate health and is associated with greater risk and earlier onset of various NCDs, such as type 2 diabetes and cardiovascular disease. Childhood and adolescent obesity have adverse psychosocial consequences; it affects school performance and quality of life, compounded by stigma, discrimination and bullying. Children with obesity are very likely to be adults with obesity and are also at a higher risk of developing NCDs in adulthood.
The economic impacts of the obesity epidemic are also important. If nothing is done, the global costs of overweight and obesity are predicted to reach US$ 3 trillion per year by 2030 and more than US$ 18 trillion by 2060 (2).
Finally, the rise in obesity rates in low-and middle-income countries, including among lower socio-economic groups, is fast globalizing a problem that was once associated only with high-income countries.
Diagnosis of Obesity
- Body Mass Index (BMI): A simple calculation of weight in relation to height. A BMI of 30 or higher is generally considered obese.
- Waist Circumference: Measures abdominal fat, which is a strong predictor of health risks.
- Medical History and Physical Examination: To assess overall health and identify potential underlying conditions.
Prevention and control
Overweight and obesity, as well as their related noncommunicable diseases, are largely preventable and manageable.
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:
- 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.
Health practitioners need to
- assess the weight and height of people accessing the health facilities;
- provide counselling on healthy diet and lifestyles;
- when a diagnosis of obesity is established, provide integrated obesity prevention and management health services including on healthy diet, physical activity and medical and surgical measures; and
- monitor other NCD risk factors (blood glucose, lipids and blood pressure) and assess the presence of comorbidities and disability, including mental health disorders.
The dietary and physical activity patterns for individual people are largely the result of environmental and societal conditions that greatly constrain personal choice. Obesity is a societal rather than an individual responsibility, with the solutions to be found through the creation of supportive environments and communities that embed healthy diets and regular physical activity as the most accessible, available and affordable behaviours of daily life.
Stopping the rise in obesity demands multisectoral actions such as food manufacturing, marketing and pricing and others that seek to address the wider determinants of health (such as poverty reduction and urban planning).
Such policies and actions include:
- structural, fiscal and regulatory actions aimed at creating healthy food environments that make healthier food options available, accessible and desirable; and
- health sector responses designed and equipped to identify risk, prevent, treat and manage the disease. These actions need to build upon and be integrated into broader efforts to address NCDs and strengthen health systems through a primary health care approach.
The food industry can play a significant role in promoting healthy diets by:
- reducing the fat, sugar and salt content of processed foods;
- ensuring that healthy and nutritious choices are available and affordable to all consumers;
- restricting marketing of foods high in sugars, salt and fats, especially those foods aimed at children and teenagers; and
- ensuring the availability of healthy food choices and supporting regular physical activity practice in the workplace
WHO’s Stance on Obesity
WHO has recognized the need to tackle the global obesity crisis in an urgent manner for many years.
The World Health Assembly Global Nutrition Targets aiming to ensure no increase in childhood overweight, and the NCD target to halt the rise of diabetes and obesity by 2025, were endorsed by WHO Member States. They recognized that accelerated global action is needed to address pervasive and corrosive problem of the double burden of malnutrition.
At the 75th World Health Assembly in 2022, Member States demanded and adopted new recommendations for the prevention and management of obesity and endorsed the WHO Acceleration plan to stop obesity. Since its endorsement, the Acceleration plan has shaped the political environment to generate impetus needed for sustainable change, created a platform to shape, streamline and prioritize policy, support implementation in countries and drive impact and strengthen accountability at national and global level.
