The Obesity Pandemic: What can we do about it?

Obesity today is a global crisis; the number of cases is on a continuous rise. As per the WHO,  “during the years 1975 to 2016, the prevalence of overweight or obese children and adolescents aged 5–19 years increased more than four-fold from 4% to 18% globally”. In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these, over 650 million were obese. 

Overweight or obesity is a chronic health condition that leads to abnormal or excessive fat accumulation in adipose tissue. The excess fat around the waist and trunk (abdominal, central, or android obesity) or peripherally around the body (gynoid obesity) can have severe complications. The disease is significantly increasing and surpassing traditional conditions such as undernutrition, infectious diseases, and many others. A particular trend related to obesity is that the number of people with the disease is slowly increasing even in the low- and middle-income countries, particularly in the urban areas, which earlier was mainly confined to the higher income countries. 

How is Obesity Measured? 

Obesity is divided into three classes. Among the various methods, the most basic and standard procedure is the body mass index (BMI). BMI considers a person’s weight and height to calculate the level of adiposity. Accordingly, the three classes of obesity are Overweight (not obese), Class 1 (low-risk) obesity, Class 2 (moderate-risk) obesity, and Class 3 (high-risk), obesity. 

Some other methods such as Bioelectric Impedance (BIA), Waist Circumference, Air-Displacement Plethysmography, Waist-to-Hip Ratio, Skinfold Thickness, and others also used to measure Obesity. 

Why is obesity a problem?

According to the global burden of disease (2017), over the years, Obesity has grown to epidemic proportions, with around 4 million people dying each year due to being overweight or obese. Overweight and obesity are considered big health problems as they can lead to many potentially life-threatening conditions or diseases if ignored for an extended period. Obesity is a risk factor for many health complications such as pulmonary embolism, joint osteoarthritis (OA), cardiovascular disease, and certain types of cancer. 

Besides these, it is linked to other health problems, including strokes, sleep apnea, fatty liver disease, kidney disease, pregnancy problems, etc. Obesity can hamper day-to-day physical activity, impact cognitive abilities, and lead to psychological issues such as depression, stress, and many others.

What causes obesity?

An Individual’s metabolic activity, genetics, environmental factors, behavior, and hormones can supposedly cause overweight and obesity. Primarily, the intake of more calories than the body requires is considered the leading cause of obesity. Over time if calories are not burned, the body stores the extra calories as body fat. Physical inactivity and a sedentary lifestyle increase the risk of obesity many times.

What are the risk factors for obesity?

Apart from calorie and physical activity, some of the genetic and social factors also influence the prevalence of obesity. Among various factors, some of the most common risk factors include:

Genes – The genes are supposed to have a small role in obesity. The gene, along with unhealthy diets and lifestyles, enhances the risk of obesity. The appetite pattern, calories burning time, and eating habits impact the risks of obesity.

Medical conditions– Certain medical conditions such as Cohen syndrome, Prader-Willi syndrome, Cushing syndrome, and other disorders are directly associated with the weight increase.

Age – As per the CDC, in the united states, in 2017–2018, “the prevalence of obesity was 40.0% among young adults aged 20 to 39 years, 44.8% among middle-aged adults aged 40 to 59 years and 42.8% among adults aged 60 and older”. With age, specific hormonal changes, and an inactive lifestyle increase risk of obesity.

Socio-economic conditions – The socioeconomic conditions such as education level, income, and ethnicity directly relate to obesity. As per the CDC, in the US, men and women with college degrees had lower obesity prevalence than those with less education. Also, among women, a higher prevalence was observed in the middle and low-income groups than in the higher income group.

Sex – A person’s sex can have an impact on obesity. For example, in the united states, black or Hispanic women are more obese than black or Hispanic men.

Some of the other factors, such as stress, depression, ceasing smoking, low sleep pattern, and pregnancy, also increase the risk of obesity.

Obesity Treatment Market 

Depending upon the cause and severity, the treatment option for obesity includes a lifestyle intervention, pharmacotherapy, and weight-loss procedures (including bariatric surgery). Significant progress has occurred in all three modalities in recent years, which has improved people’s lives with obesity. 

The lifestyle intervention focuses on a weight reduction program that includes healthy eating programs, physical activity, and healthy sleep patterns. Pharmacological treatments are recommended to reduce the intake or absorption of nutrients. These medications act on specific body parts. The aim of the interventions is to block the absorption of fat from foods or in some cases to regulate the urge to eat and to decrease the appetite. Pharmacological treatment is recommended with lifestyle changes. These interventions are followed only after recommended by doctors and can have some side effects also. During the last decades, many weight-loss interventions have entered clinical trials. Still, the majority have been withdrawn or ceased, not all because of lack of efficacy, but due to safety issues. 

Today, at the global level, some of the key companies such as Rhythm Pharmaceuticals, Gelesis, Novo Nordisk, Saniona, Medix, MedImmune, AstraZeneca, Boehringer Ingelheim, Gubra Pharma, and others are involved in developing therapies for obesity. The launch of the treatments in the coming years will significantly improve people’s lives affected by obesity. 

Similarly, surgical intervention is recommended to extremely obese patients if the lifestyle changes and medicines fail to produce a desirable outcome. The surgical intervention includes gastrectomy, gastric bypass surgery, and others. However, these surgeries are quite risky options as these can also cause infection, bleeding, and in some cases, even death.

What lies ahead

As discussed earlier, the prevalence of obesity has increased significantly over the decades. It has a particular impact on national productivity, economy, healthcare infrastructure, even though it is preventable. Obesity and its related illnesses take a large chunk of an individual’s income (for medical care and prescription needs), apart from time and productivity. Similarly, it causes unnecessary burdens such as higher insurance premiums, lower wages in certain fields, social bias and discrimination, limited opportunities (particularly in the areas requiring physical activity such as armed services), and many others. 

The WHO’s World Health Assembly in 2004 and again in 2011, through its political declaration on the non-communicable disease (NCDs), has described the need for actions to support healthy diets and regular physical activity patterns at the population level. Similarly, the governments, NGOs, health groups, are also promoting healthy lifestyle habits and environments at their level to reduce the burden of obesity and its related diseases. People are also getting self-conscious and taking these diseases seriously. Among all, the younger generation is actively adopting a healthy lifestyle that includes regular exercise, yoga, and a healthy diet. Although the number is quite low, in the coming year with regular promotion the number is likely to increase.