The Key to a Healthier You: Understanding and Combating Obesity


Obesity is a complex and multifactorial medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. The term “metabolic obesity,” which refers to the accumulation of visceral fat in lean or obese individuals, may better identify cardiovascular disease risk than the currently used definitions of obesity.

  • The prevalence of obesity has been increasing globally in recent decades. According to the World Health Organization (WHO), in 2016, over 1.9 billion adults were overweight; of these, over 650 million were obese.
  • The prevalence of obesity is highest in North America, Australia, and New Zealand, where approximately 1 in 3 adults are affected.
  • In Europe, around 1 in 4 adults are affected by obesity.
  • In low- and middle-income countries, the prevalence of obesity is increasing, but it remains lower than in high-income countries.

obesity and age

obesity or overweight graph

“Worldwide, more than 2.1 billion people are overweight or obese. In the United States, nearly 35% of adults are classified as obese, and one-third of children and adolescents are obese or overweight.”

   “Overweight and obesity are the fifth leading cause of death in the world, responsible for nearly 3.4 million deaths annually.”

“The health care costs caused by obesity are difficult to determine accurately and vary from country to country. In the United States, obesity-related costs have been identified as hundreds of billions of dollars.”


Definition of obesity

It is defined by a raised Body Mass Index (BMI) of 30 or higher, while a BMI of 25-29.9 is considered overweight. BMI is calculated as a person’s weight in kilograms divided by the square of their height in meters.

obesity BMI index

Childhood obesity

Childhood obesity has reached epidemic proportions in industrialized countries. Twenty-five percent of children in the United States are overweight, and 11% are obese. It is well known that childhood overweight and obesity significantly affect physical and mental health.

While it has been argued for many years that the increase in childhood obesity is due to increased fat consumption, contradictory results have been obtained in cross-sectional and longitudinal studies.

Results from the NHANES study have shown that fat consumption among American children has declined over the past three decades. For example, average fat consumption among males aged 12-19 decreased from 37.0% (SD = 0.29%) of total caloric intake in 1971-1974 to 32.0% (SD = 0.42%) in 1999-2000.

“Childhood obesity is a problem that places a child at great risk for becoming an obese adult.”

What can we do to detect childhood obesity?

  1. Obese children have a higher risk of becoming obese adults than their thinner peers.
  2. Parental weight may interact with a child’s weight status in developing obesity in adulthood.
  3. Obese children with obese parents are likelier to become obese adults than obese children with thin parents.
  4. The prediction of obesity in adulthood based on childhood obesity improves with the child’s age.
  5. The older the obese child gets, the more likely they are to become an obese adult.
  6. Involving parents in the treatment process is essential to the success of weight control in children.
  7. Seeing the parent and child separately in treatment sessions rather than treating them together may be appropriate.
  8. Children with lean parents may control their weight better than children of obese parents.
  9. In obese children, adherence to exercise is likely to be a problem, and the selection or design of an exercise program should consider these adherence problems.
  10. The adequacy of the child’s diet should be evaluated in terms of what the child eats and the prescribed diet.
  11. Similarly, the growth of the obese child should be monitored during the diet and related to the expected height, which may be based on the parents’ size.

For prevention

Prevention can be achieved through various measures in the built environment, physical activity, and nutrition. Children are often considered the priority target group for intervention strategies because weight loss in adulthood is complex, and there are more potential interventions for children than adults. Schools are natural for influencing children’s nutrition and physical activity environments. Similar opportunities for action exist in other settings, such as preschools and after-school programs. Second, it isn’t easy to reduce excessive weight in adults once it is established. Therefore, it would make more sense to begin preventing and treating obesity in childhood. virus

Early detection of excessive weight gain relative to linear growth should become a standard clinical practice by the following measures:

(a) routine recording of height to allow monitoring of weight and height and body mass index (BMI)

(b) expansion of existing surveillance programs to screen all children up to 18 years of age at least annually

(c) interpretation of weight and height and BMI indices based on prescribed reference data

(d) early intervention after an increase in weight percentiles or BMI is detected.

The possible mechanism leading to obesity

The pathological enlargement of fat cells alters the nutrient signals responsible for obesity. The traditional view is that the leading cause is that much more excess energy (your daily calorie intake) is stored than the body uses. The extra power is stored in the fat cells, producing the characteristic obesity pathology.

Adipose tissue secretes several hormones (adipokines) that signal essential organs to maintain metabolic homeostasis, and their dysfunction has been linked to various metabolic diseases. In addition, obesity induces the production of inflammatory cytokines (often referred to as adipocytokines along with adipokines) and the infiltration of immune cells into adipose tissue, leading to chronic low-level inflammation.

Leptin is a product of the obesity gene (ob). After synthesis and secretion from adipocytes, it binds to and activates its corresponding receptor, the leptin receptor (LEP -R), in white adipose tissue. Also, the peptide hormone leptin (released from adipose tissue) regulates food intake, body mass, and reproductive function and plays a role in fetal growth, proinflammatory immune responses, angiogenesis, and lipolysis. Leptin resistance is characterized by decreased satiety, excessive nutrient consumption, and increased body mass. This often leads to obesity, which reduces the effectiveness of using exogenous leptin as a therapeutic agent. Therefore, combining leptin therapies with leptin sensitizers could help overcome this resistance and obesity.

Comorbidities of obesity

The increasing prevalence of obesity is accompanied by a rising number of patients suffering from the metabolic complications of obesity. The main difficulties are grouped under the term metabolic syndrome. This syndrome is characterized by plasma lipid disorders (atherogenic dyslipidemia), elevated blood pressure, high plasma glucose, and a prothrombotic state. At the heart of the metabolic syndrome is insulin resistance, a general disorder of metabolic processes. The clinical consequences of metabolic syndrome include coronary heart disease and stroke, type 2 diabetes and its complications, fatty liver, cholesterol gallstones, and possibly some forms of cancer.

Main complications;

Several factors can contribute to the development of obesity, including:


A diet that is high in calories, particularly from processed foods, sugar, and unhealthy fats, can lead to weight gain and obesity.

Physical Inactivity

A sedentary lifestyle, characterized by little to no physical activity, can also contribute to weight gain and obesity.


Obesity can run in families and can be influenced by genetic factors.

Medical Conditions

Certain medical conditions, such as hypothyroidism and polycystic ovary syndrome (PCOS), can lead to weight gain and obesity.


Certain medications, such as antipsychotics, steroids, and antidepressants, can lead to weight gain and obesity.


Lack of sleep or poor sleep quality can disrupt hormones that regulate hunger and metabolism, leading to weight gain.

Socioeconomic status

People with lower incomes and less education are more likely to have poor diets and to engage in less physical activity, increasing the risk of obesity.


Chronic stress can lead to overeating, particularly high-calorie, sugary foods, contributing to weight gain and obesity.

An obesogenic environment

Obesogenic environment refers to the physical and social surroundings that promote excessive calorie intake and physical inactivity, leading to weight gain and obesity.

More importantly, classify the numerous environmental factors that play an essential role in the ecological dysregulation of body weight.

Some examples of obesogenic factors include:

The most critical environmental obesity-promoting factors are related to the built environment, such as urban planning, traffic and school, inactivity, TV and screen-related immobility, smartphones, and video games; they are followed by dietary factors, such as unbalanced ingredients, pollutants, fast eating, portion size, sweet drinks, snack foods, and junk foods, supported by advertising, socio-cultural and ethnic factors, in addition to global environmental changes and seasonal light-dark photoperiod.

Easy access to high-calorie, unhealthy foods:

The abundance of fast food restaurants, convenience stores, and vending machines selling junk food contributes to the overconsumption of calories and weight gain.

Lack of physical activity opportunities:

Urban environments designed primarily for motor vehicle traffic and lack of sidewalks and bike paths can discourage physical activity and contribute to weight gain.

Sedentary behaviors:

Increased passive activities, such as prolonged sitting in front of a computer or television, can lead to weight gain and obesity.


Advertising for unhealthy foods and drinks, particularly to children, can contribute to overconsumption and weight gain.

Social norms and cultural attitudes:

Social norms and cultural attitudes promoting overeating and discouraging physical activity can contribute to weight gain and obesity.

Neighborhood characteristics:

Neighborhoods lacking supermarkets, parks, and safe spaces for physical activity can contribute to a lack of opportunities for healthy behaviors and weight gain, and obesity.

“To address the obesogenic environment, there is a need for systemic changes at the community, governmental, and societal levels, including improvements in food and physical activity environments, promotion of healthy behaviors, and regulation of marketing to children.”

Treatment options for obesity

A modern approach to obesity recognizes the multifactorial causes of weight gain and the health benefits of weight loss. Fundamental to all weight loss efforts is a change in lifestyle, diet, and physical activity.

The first step of intervention is a lifestyle change. Dietary changes, like the ketogenic diet, could help lose weight and decrease body fat. The second step is characterized by intervention in diet regimen. The third step is drug treatment. The fourth step is bariatric surgery. Usually, it can be the first step in subjects with BMI higher than 45-50 kg/m2 and very high CV risk.

The approach should be a high-quality diet that patients adhere to, accompanied by a physical activity prescription that describes the frequency, intensity, type, and time of activity, with a minimum of 150 minutes of moderate exercise per week.

For patients struggling with weight loss who would benefit health-wise from weight loss, treatment of medications that contribute to weight gain and the use of approved chronic weight management medications, along with lifestyle changes, are appropriate.

“It’s important to note that obesity is a complex issue, and there is no one-size-fits-all solution. It is essential to work with a healthcare professional to develop a personalized treatment plan that is safe and effective.”

Critical areas of obesity;

Causes of obesity:

Researchers are studying the interplay between genetic, environmental, and behavioral factors that contribute to the development of obesity.

Health consequences of obesity:

Obesity is linked to numerous health problems, including cardiovascular disease, type 2 diabetes, and certain cancers. Researchers are working to understand better the mechanisms through which obesity contributes to these conditions.

Investigating potential treatments:

There is a growing interest in developing new and more effective treatments for obesity. This includes lifestyle interventions, such as diet and physical activity, as well as pharmacological and surgical approaches.

Studying the economic impact of obesity:

Obesity is a major public health challenge with significant financial consequences. Researchers are working to understand better the costs of obesity to individuals, families, and society as a whole.

Evaluating the effectiveness of interventions:

Researchers are working to assess the impact of different interventions, such as school-based programs, community-wide initiatives, and policy changes, on reducing the prevalence of obesity.

Lifestyle Changes:

Changing your diet, such as eating fewer calories and reducing portion sizes, and increasing physical activity, can help you lose weight and maintain weight loss. In addition, behavior therapy, such as cognitive-behavioral therapy and motivational interviewing, can help you adopt and maintain healthy lifestyle changes.


Several medications have been approved for treating obesity, including Orlistat, Lorcaserin, and Phentermine-Topiramate. These medications reduce appetite, increase feelings of fullness, or block fat absorption.

Bariatric Surgery:

Bariatric surgery, such as gastric bypass and gastric banding, is an option for individuals with severe obesity who have not been able to achieve significant weight loss through lifestyle changes and medication. This surgery works by reducing the stomach size, limiting food intake, or altering the digestive process.

Microbial treatments:

Microbiome-induced fermentation of dietary fiber and starch in the lower gastrointestinal tract may also produce SCFAs (short-chain fatty acids), which can regulate the production of intestinal hormones such as peptide YY (PYY) in the intestinal epithelium and GLP-1, GLP-2 (glucagon-like peptides), and the secretion of gastric inhibitory peptides by K cells. Changes in specific microbial populations may be more important than overall phylogenetic ratios, leading to changes in the production of enzymes and SCFAs, which in turn affect insulin and glucose regulation and ultimately lead to obesity. In obese patients, enzymes involved in glucose signaling pathways are downregulate

Fecal Microbiota Transplantation:

FMT has recently attracted much research interest in treating obesity. There is promising evidence that the FMT microbiota of healthy individuals may contribute to weight loss and maintenance in patients suffering from obesity.