What is Obesity?

While “obesity” simplistically means too much body fat, an understanding of what too much body fat is necessary. Weight terms such as underweight, overweight and obesity are based on a term called body mass index, abbreviated as BMI which is a comparison of your body weight to your height which can be easily calculated using BMI calculators which are easily assessible on the internet.

Obesity cannot be discussed without checking into overweight which has a BMI of between 25 to 29.9.

When BMI exceeds 29.9 in adults, medically the person is declared to be obese. That is to mean a BMI of 29.9 indicates overweight. Obesity in children is confirmed in relation to normal weight values and clusters medically.

How many people are affected?

Data from the World Health Organization (WHO) indicates that obesity has nearly tripled since 1975 on a global scale. The following estimates from the WHO indicate the burden of obesity worldwide making obesity an epidemic.

• In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese.
• 39% of adults aged 18 years and over were overweight in 2016, and 13% were obese.
• 40 million children under the age of 5 were overweight or obese in 2018.
• Over 340 million children and adolescents aged 5-19 were overweight or obese in 2016.

To focus on children in the African context: in 2016, the World Health Organization (WHO) reported that an estimated 41 million children under the age of five years were overweight or obese globally. The report further stated that in Africa alone, the number of children under five years who were overweight had increased by nearly 50 per cent since 2000.

Causes of Obesity

Obesity is complex in the way in which it arises because it involves a combination of an individual’s genes and the environment ranging from social factors, behavior, cultural aspects, and prevailing economic status including modernization, urbanization and globalization of food markets.

The basis of obesity is imbalance between consumed calories and expended calories.

In addition to imbalance in calories, causes of obesity can be broadly classified as and include:

1. Dietary changes

• an increased intake of energy – dense foods that are high in fat.
• Overconsumption of processed food

2. Physical inactivity

• inadequate physical activity
• Increasingly sedentary nature of many forms of work.
• Changing modes of transportation
• Increasing urbanization.

3. Genetics

• Genes are important in determining a person's susceptibility to weight gain because genes affect metabolism, appetite, satiety, and tendency to use eating as a stress coping mechanism.

4. Unhealthy environment

• Children and teens growing up and observing parents what they eat and virtually on television, social media.

5. Mother’s diet during pregnancy

• children born to mother’s who practiced unhealthy diet decisions during pregancy are often predisposed to being obese

Certain medical conditions may also lead to weight gain and eventually obesity.

These include:

• Prader-Willi syndrome: is a rare condition that an individual is born with which causes excessive hunger
• Cushing’s syndrome: a condition caused by having an excessive amount of the stress hormone cortisol in your body
• Polycystic ovary syndrome (PCOS): is a condition that causes female reproductive hormones imbalance
• osteoarthritis and other conditions that cause pain and eventually lead to inactivity
• hypothyroidism : a condition in which the thyroid gland does not produce enough or at all some important hormones

Clinical effects of obesity

Obesity can lead to the following clinical conditions:

1. Sex hormone imbalance: may lead to infertility and hormone-dependent tumors
2. cardiovascular diseases including high blood pressure
3. Diabetes type 2; diabetes
4. Mechanical stress to the body including low back pain, shortness of breath

Medical Complications

Complications often arise when obesity is not well managed.

The following conditions are common complications:

1. Disease of the gall bladder
2. Non-alcoholic fatty liver disease
3. Reproductive abnormalities such as abnormal menses and infertility
4. stroke
5. hypertension
6. diabetes
7. cancer of the colon, kidney, pancreas, breast
8. Psychosocial challenges including poor self esteem, depression, and poor quality of life especially in children
9. Obesity in childhood increases the chances of obesity, premature death and potential disability in adulthood.

How is diabetes diagnosed medically?

For obesity to be treated, it ought o be diagnosed by medical professionals experienced in weight problems:

Diagnosis of obesity involves:

Assessment – this is the determination of the degree of obesity and the risk status. Assessment includes:

• measuring weight, height, and waist circumference
• calculate basal metabolic index (BMI)

Management of Obesity

Following assessment and confirmation of obesity, management of obesity is necessary and should be initiated early to reverse the excessive weight and avoid occurrence of obesity-related complications.

Reduction of excess weight at individual level will include:

• Limit energy intake from total fats and sugars.
• Increase consumption of fruits and vegetables, as well as legumes, whole grains and nuts.
• Engage in regular physical activity.

In addition to managing obesity at individual level, measures can be instituted at the societal level through engaging people in undertaking regular physical level and healthier dietary choices through institutions including family, schools, prisons to effectively and sustainably prevent those those are predisposed to being obese from getting obese and maintain a relatively low weight .

Treatment of obesity is pursued when an individual is not been able to lose weight on their own following medical intervention. Weight specialist are involved and may include a dietitian/nutritionist, therapist, and in some cases a surgeon

Treatment options include:

1. lifestyle and behavior change; education on better food choices and perhaps an eating plan superimposed with exercise to help regulate and reduce weight

1. Prescription of medical weight loss drugs may be done in cases where other methods of losing weight have not worked. Weight loss drugs will require close monitoring with the doctor since some drugs may have side effects

1. weight loss surgery; bariatric surgery work by limiting the amount of food that can be consumed comfortably or preventing absorption of food and calories