About Obesity and Associated Health Complications

Obesity is a chronic disease characterized by excessive fat accumulation or distribution that presents a risk to health and requires lifelong care. Virtually every system in the body is affected by obesity, which is associated with more than 200 weight-related health conditions including heart disease, type II diabetes, and many cancers. It affects overall quality of life and sense of well-being. The health complications associated with obesity can start early in life, and the longer obesity is left untreated, the greater the potential impact of these negative effects on morbidity and mortality. As a group, people with severe obesity have a 6- to 12-fold increase in the all-cause mortality rate.

What Causes Obesity?

The excessive accumulation of body fat that defines obesity is a result of higher energy intake than energy consumption, facilitated by excessive caloric intake, sedentary lifestyle, mental disorders, or genetic factors. Inflammasome-induced systemic inflammation also plays a major role in the development and progression of obesity and its associated health complications. Nutrient overload, especially glucose and fat, trigger inflammasome activation leading to hypothalamic inflammation, contributing to increased appetite and uncontrolled eating. Chronic overeating leads to an increased number and size of fat cells and formation of visceral fat in other non-adipose tissues evoking cardiovascular and liver diseases. Fat tissue can also secrete inflammasome-induced proinflammatory cytokines and adipokines affecting the local microenvironment, induce insulin resistance, hyperglycemia, and activate associated inflammatory signaling pathways. This further exacerbates the development and progression of obesity-associated diseases.

What Is the Prevalence of Obesity?

According to the CDC, more than 100 million US adults aged 20 years or older are obese, of which more than 22 million are severely obese, and 14.7 million children and adolescents aged 2-19 years are obese. Obesity is a substantial public health crisis not only in the United States but internationally, with the prevalence increasing rapidly in numerous industrialized nations. The World Obesity Federation predicted that by 2035, over 4 billion people (51% of the world’s population) will be overweight or obese.

How is Obesity Diagnosed?

To diagnose obesity, assessment of the degree of body fat and clinical assessment of weight-related complications are recommended. BMI calculations, waist circumference, and waist/hip ratio are common measures of the degree of body fat used in routine clinical practice. Assessment of weight related complications commonly includes screening for prediabetes, type 2 diabetes, dyslipidemia, hypertension, metabolic syndrome, cardiovascular disease, nonalcoholic fatty liver disease, osteoarthritis, and mental depression.

How is Obesity Treated?

Management of obesity, like other chronic diseases requires ongoing lifelong treatment. The goal of obesity treatment is more than achieving weight loss, it is about improving health and wellbeing. It is recommended that care be provided by qualified clinicians who provide evidence-based treatment options that address the comorbidities of obesity. Treatment includes nutrition and behavior modification, physical activity, drug therapy, and when appropriate, metabolic/bariatric surgery.